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Post-stroke Depression: It’s worse than you think

Feb 2017 Brain MRI showing an ischemic stroke that underwent a hemmorhagic conversion
Picture of Julie Hahnke
Julie Hahnke
Julie is the President of Cecropia Strong and is a stroke survivor, who was finally found after three days. She's a bagpiper, an author, a management consultant, and a nature enthusiast.

The American Heart Assoc/American Stroke Assoc lists that 1 in 3 stroke patients (33%) have post-stroke depression (PSD). But I interviewed a clinical care occupational therapist that I’ve worked with from Whittier Rehab Hospital. She insisted that in her experience, 80% of stroke survivors fight, at some point, with depression. That’s an alarming increase in the life-risk to these already threatened patients!

Neuropsychiatric Disease and Treatment ran an article entitled, “Epidemiology and treatment of post-stroke depression” (published February 2008). It stated, “Although depression may affect functional recovery and quality of life after stroke, such conditions are often ignored. In fact, only a minority of patients are diagnosed and even fewer are treated in the common clinical practice.” The article cites 70 different studies of stroke patients from around the world, and half of them show PSD rates of more than 33%, ranging up to 72%.

Why PSD is so rampant

  • Doctor Vani Rao, M.D., speaks about post-stroke depression in her lecture, “Neuropsychiatry of Stroke,” printed on the Johns Hopkins Medicine website. According to Dr. Rao, “PSD is probably due to a combination of biological, psychological and social factors.

“Psychological stressors such as loss of independence and poor physical functioning can overwhelm anyone, and in the setting of biological vulnerability, can cause depression.”

I had a rough time, too

In the weeks and months following my stroke, I was not a happy camper. My body refused to behave. This is a brief sampling of my first year: Apr – I fell and broke a metatarsal in my foot. Jun – I fell backwards and snapped the bone in my upper arm (the humerus) just below my shoulder. Sep – I fell and broke a rib. Oct – I fell and broke another rib, etc, etc.

My parents flew up from Florida to be near, and the doctors told them that I likely had cognitive loss after so long on the floor, unattended. But, of course, I couldn’t tell them that I was fine (because I had aphasia and I couldn’t get the words out.) I mostly howled like a golden retriever. It was a rough time for everyone, but most of all me!

Hope is not Lost!

The good news is that things will get better. But, you’re going to have to want them to get better, if you’re to have a fighting chance! That’s why I founded this charity. If you’re in the mud fighting your illness, you’re too busy battling to ask for help. But we’re here—and we’ve got your back! Join our e-mail list, and tell us what concerns you. If we have to involve others to find you answers, we’ll be asking for you, a client (and nothing identifying will be said.)

I walked through the halls of the IMPACT Practice Center (where I get my physical therapy) and a recent stroke victim was amazed that I spoke so easily (no aphasia, at that moment.) And I didn’t wear the AFO (the dreaded leg brace, that holds you up, but trains your foot and ankle muscles to forget all they know!) I  explained my history relative to hers. She had just had a stroke 6 months ago, but mine was 4 years past—and during the four years, I’ve never passed on an opportunity to participate in one more study, in one more chance to heal some part of me that isn’t working right.

It’s paid off, but it requires absolute top priority and never giving up. So that’s my advice: put your armor on, because this is a slow, uphill battle. But if you’re patient and determined, you’ll see the results!

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