Depression is a common experience for Stroke survivors. It’s often caused by biochemical changes in the brain. When the brain is injured, the survivor may not be able to feel positive emotions. Depression can also be a normal psychological reaction to the losses from stroke and can be made worst by well meaning family and friends. It also doesn’t help that there is a lot of denial in more conservative societies like Malaysia.

After a stroke, it is normal to feel sad or worried. But if you feel sad, down or miserable for more than two weeks, you may have depression. You may lose interest or pleasure in things you normally enjoy. You may lack energy, have difficulty sleeping, or sleep more than usual. You may find it difficult to concentrate, to solve problems and to keep appointments. God knows I have dealt with some of these.

Having a stroke is a life-changing event. It can change how you feel about yourself and make you worry about the future. Changes to responsibilities, relationships, work and finances can cause stress and sadness. The impact of stroke on the brain can also cause personality, mood and emotional changes. All this means there is a strong link between stroke, depression and Anxiety.

One in three people experience depression at some point during the five years after their stroke. Depression is most common in the first year after a stroke, however it can happen at any time. Anxiety may also occur, either by itself or together with depression.

Partners, carers and family members of stroke survivors can experience depression and anxiety as well.

Feeling anxious is normal when we feel under pressure. The feelings usually go away when the stressful situation is over. If anxious feelings do not go away, or if you are anxious for no particular reason, you may have anxiety.

Depression and anxiety can make it difficult to manage from day to day, and to participate in your rehabilitation. Depression and anxiety can affect how you feel about yourself, and can have an impact on your relationships. Depression can also increase the risk of cardiovascular disease, which in turn increases the risk of experiencing another stroke. Mortality rates are 10 times higher in people who experience depression after a stroke.

While depression and anxiety are common, they are also highly treatable. Recovery is possible and there are many things that can help. The sooner you get help, the sooner you will move towards recovery.

Depression can also be mitigated by some lifestyle and thought process changes. Some measures I have adopted and practiced to help prevent a full blown episode of clinical depression include:

Acceptance

Acceptance shouldn’t be confused with giving up. Instead of mourning the past, acceptance helped me handle present circumstances and think of my future.

Get support

You can find support through your family, friends, stroke support groups, church and therapy. These are good ways to get advice and have a social outlet. I may have a somewhat estranged relationship with my immediate family but I am also blessed with some very good friends who have walked with me.

Helping Others

Although many people think happiness is a matter of circumstance, what they make of those circumstances often matters more. Those who face adversity often discover, to their own surprise, that they’re as happy or almost as happy as they were before encountering an obstacle like a stroke. Focusing on meaningful goals, finding ways to contribute to others and staying flexible are key. Here are some additional tips. This is why I get involved in advocacy work through organisation like the National Stroke Association of Malaysia as well as run this website.

Staying Informed

Knowing a diagnosis and the details can be less stressful than not knowing. Most people aren’t set up for uncertainty, which can lead to high stress levels. Compare the benefits of comparison thinking. Studies indicate that people usually make the best of their circumstances by comparing themselves to those who are worse off. I constantly scour for scholarly articles and studies to keep abreast of latest development. That’s also how I came across the Perispinal Etanercept Action Group, which does seem promising although definitive results are still years away.

Connecting With Others

Anyone who’s been to a good stroke support group knows that sharing with others makes life better — and lending support can be just as beneficial. When people become sick, talking to other patients can help them feel better. I set up one on Facebook but also participate in a few other groups on the same platform. Seeing how other folks are coping does help me look at my situation in perspective and can be quite motivating as well.

Meditation and Reiki

The practice of meditation has been very helpful to keep my mind quiet. I was also a Reiki teacher and practitioner before my stroke and the continued practice has helped me cope with the physical, emotional and mental aspect of my post stroke reality.

The Role Of Faith

Those who belong to a religious community gain the benefit of social support in trying times. Religious beliefs can also boost emotional resilience by providing meaning and purpose to suffering, and prayer also helps people find peace of mind. I have found that my own Christian faith, particularly in my own Lutheran expression, has been very helpful in staying both stoic but optimistic. And the practice of the Daily Offices, something I have wanted to start for a long time but never did, has been helpful in my physical recovery as well (making the Sign of the Cross has helped my arm mobility)! Even praying the Rosary has helped break my brain fog and regain movement n my fingers.

There are occasions (more often than not) where clinical help is needed, even recommended. If you think depression or anxiety may be an overwhelming issue for you, speak to your doctor. It is important to have a medical diagnosis and a treatment plan that takes into account your personal situation, needs and preferences. Some medications can make you lethargic which can feel like the symptoms of depression, so a medication review can be helpful as a part of this process.

UMMC has an excellent mental health facility. Get your doctor’s referral if you really need it.