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Co-Occurrence of Depression with Stroke
Depression is a common, serious and costly illness that affects I in 10
adults in the U.S.
each year, costs the Nation between $30 - $44 billion annually, and causes
impairment,
suffering, and disruption of personal, family, and work life.
Though 80 percent of depressed people can be effectively treated, nearly two out
of three
of those suffering from this illness do not seek or receive appropriate
treatment. Effective
treatments include both medication and psychotherapy, which are sometimes used
in combination.
Depression Co-Occurs with Stroke
Of particular significance, depression often co-occurs with stroke. When this
happens,
the presence of the additional illness, depression, is frequently unrecognized,
leading
to serious and unnecessary consequences for patients and families.
Though depressed feelings can be a common reaction to a stroke, clinical
depression is not
the expected reaction. For this reason, when present, specific treatment should
be
considered for clinical depression even in the presence of a stroke.
Appropriate diagnosis and treatment of depression may bring substantial benefits
to the
patient through improved medical status, enhanced quality of life, a reduction
in the
degree of pain and disability, and improved treatment compliance and
cooperation.
Stroke
The association between depression and stroke has long been recognized for its
negative
impact on an individual's rehabilitation, family relationships, and quality of
life.
Appropriate diagnosis and treatment of depression can shorten the rehabilitation
process
and lead to more rapid recovery and resumption of routine. It can also save
health care
costs (e.g., eliminate nursing home expenses).
There are approximately 3, 000,000 stroke survivors in the U.S. In addition, an
estimated
400,000-550,000 people experience strokes each year, of which an estimated 10-27
percent
experience major depression. An additional 15 to 40 percent exhibit depressive
symptomatology
(not major depression) within the two months following a stroke.
Three-fourths of strokes occur in people 65 years of age and over. With stroke a
leading
cause of disability in older persons, proper recognition and treatment of
depression in
this population is particularly important. The mean duration of major depression
in stroke
patients has been shown to be just under a year.
Among the factors that effect the likelihood and severity of depression
following a stroke
are the location of the brain lesion, previous or family history of depression,
and
pre-stroke social functioning.
Post-stroke patients who are also depressed, particularly those with major
depressive
disorder, are less compliant with rehabilitation, more irritable and demanding,
and may
experience personality change.
The Symptoms of Depression Include...
• Persistent sad or "empty" mood
• Loss of interest or pleasure in ordinary activities
• Decreased energy, fatigue, being "slowed down"
• Sleep disturbances (insomnia, early waking, or oversleeping)
• Eating disturbances (loss of appetite or overeating)
• Difficulty concentrating, remembering, making decisions
• Feelings of guilt, worthlessness, helplessness
• Thoughts of death or suicide; suicide attempts
• Irritability
• Excessive crying
• Chronic aches and pains for no apparent reason
If a person has five or more of these symptoms for more than two weeks, it is
important that
this is brought to the attention of the individual's health care provider.
For Further Information:
On D/ART or Depression, call: 301-443-4140.
Wilmes-Reitz Psychological
23632 Calabasas Rd., Suite 202
Calabasas, California 91302
(818) 591-8270
wrpsych@aol.com
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