National Institute of Mental Health. Depression and Stroke

Transcription

1 Natioal Istitute of Metal Health Depressio ad Stroke

2 Depressio ot oly affects your brai ad behavior it affects your etire body. Depressio has bee liked with other health problems, icludig stroke. Dealig with more tha oe health problem at a time ca be difficult, so proper treatmet is importat.

3 What is depressio? major depressive disorder, or depressio, is a serious metal illess. Depressio iterferes with your daily life ad routie ad reduces your quality of life. about 6.7 percet of u.s. adults ages 18 ad older have depressio. 1 Sigs ad Symptoms of Depressio ogoig sad, axious, or empty feeligs feelig hopeless feelig guilty, worthless, or helpless feelig irritable or restless loss of iterest i activities or hobbies oce ejoyable, icludig sex feelig tired all the time Difficulty cocetratig, rememberig details, or makig decisios Difficulty fallig asleep or stayig asleep, a coditio called isomia, or sleepig all the time overeatig or loss of appetite thoughts of death ad suicide or suicide attempts ogoig aches ad pais, headaches, cramps, or digestive problems that do ot ease with treatmet. for more iformatio, see the imh booklet o Depressio at idex.shtml. What is a stroke? a stroke occurs whe the blood supply to part of the brai is suddely iterrupted, such as whe a blood vessel bursts or a clot blocks blood flow. although strokes occur i ad damage the brai, they ca affect the whole body. strokes may cause paralysis (the complete or partial loss of the ability to move), speech problems, or the iability to complete daily tasks. sometimes these

4 effects are temporary ad sometimes they are permaet. stroke survivors ofte eed rehabilitatio, therapy that helps people relear skills or lear ew skills. rehabilitatio ad recovery are uique for each perso. How are depressio ad stroke liked? may people require metal health treatmet after a stroke to address depressio, axiety, frustratio, or ager. several factors may affect the risk ad severity of depressio after a stroke, icludig: area of the brai where stroke damage occurred persoal or family history of depressio or other mood or axiety disorders level of social isolatio before the stroke. 2 stroke survivors who are depressed may be less likely to follow treatmet plas ad may be more irritable or have chages i persoality. 3 stroke, heart disease, ad depressio may also be related. stroke ad heart disease share some risk factors, such as high blood pressure ad beig overweight. oe recet study showed that older people with heart disease who had more severe ad frequet depressio symptoms were more likely to have a stroke. 4 How is depressio treated i people who have had a stroke? Depressio is diagosed ad treated by a health care provider. treatig depressio ad other metal disorders may help with stroke recovery. 5 after a stroke, treatmet with atidepressat medicatios or problem-solvig therapy (a type of psychotherapy, or talk therapy) may prevet serious depressio before it begis. 5 problem-solvig therapy helps people idetify problems that iterfere with daily life ad cotribute to depressive symptoms ad fid ways to solve those problems.

5 recovery from depressio takes time but treatmets are effective. at preset, the most commo treatmets for depressio iclude: cogitive behavioral therapy (cbt), a type of psychotherapy, or talk therapy, that helps people chage egative thikig styles ad behaviors that may cotribute to their depressio selective serotoi reuptake ihibitor (ssri), a type of atidepressat medicatio that icludes citalopram (celexa), sertralie (Zoloft), ad fluoxetie (prozac) serotoi ad orepiephrie reuptake ihibitor (sri), a type of atidepressat medicatio similar to ssri that icludes velafaxie (effexor) ad duloxetie (cymbalta). While curretly available depressio treatmets are geerally well tolerated ad safe, talk with your health care provider about side effects, possible drug iteractios, ad other treatmet optios. for the latest iformatio o medicatios, visit the u.s. food ad Drug admiistratio website at ot everyoe respods to treatmet the same way. medicatios ca take several weeks to work, may eed to be combied with ogoig talk therapy, or may eed to be chaged or adjusted to miimize side effects ad achieve the best results. more iformatio about depressio treatmets ca be foud o the imh website at publicatios/depressio/how-is-depressio-detected-adtreated.shtml. if you thik you are depressed or kow someoe who is, do t lose hope. seek help for depressio.

6 What is vascular depressio? vascular depressio is a late-life form of depressio that usually oly affects people ages 60 or older. Blood vessels may harde over time, reducig or blockig ormal blood flow to the brai. this reduced or blocked blood flow ca lead to vascular depressio. people with vascular depressio may also be at risk for heart disease or stroke. 6 although there are o highly effective treatmets for vascular depressio, scietists are makig progress i uderstadig ad treatig this coditio. researchers are studyig the specific brai chages liked to blood vessel problems. i older people with depressio, higher blood pressure is liked with abormal chages i white matter, the tracts of erve fibers that coect ad allow commuicatio betwee differet parts of the brai. 7 some of these abormal chages were liked with specific problems i the frotal lobe, a area of the brai ivolved i thought processes such as plaig, problem solvig, ad judgmet. these abormal chages may also affect a perso s respose to treatmet with atidepressat medicatios. oe recet study showed that vascular depressio ca be effectively treated with repetitive trascraial magetic stimulatio (rtms). 8 the u.s. food ad Drug admiistratio has approved rtms to treat major depressio. study participats had ot respoded to stadard depressio treatmets. after 2 weeks, those who received rtms were more likely to have achieved remissio (o loger had ay symptoms of depressio) compared with those who did ot receive rtms. further studies aim to fid the lowest possible dose of rtms that ca be used to most effectively treat people with vascular depressio.

7 For More Iformatio o Depressio visit the atioal library of medicie s medlieplus e español for iformatio o cliical trials atioal library of medicie cliical trials database iformatio from imh is available i multiple formats. You ca browse olie, dowload documets i pdf, ad order materials through the mail. check the imh website at for the latest iformatio o this topic ad to order publicatios. if you do ot have iteret access please cotact the imh iformatio resource ceter at the umbers listed below. Natioal Istitute of Metal Health sciece Writig, press & Dissemiatio Brach 6001 executive Boulevard room 8184, msc 9663 Bethesda, md phoe: or imH (6464) toll-free tty: or toll-free fax: imhifo@ih.gov Website: For More Iformatio o Stroke Natioal Istitute of Neurological Disorders ad Stroke (NINDS) p.o. Box 5801 Bethesda, md phoe: or tty: Website:

8 Citatios 1. Kessler rc, chiu Wt, Demler o, merikagas Kr, Walters ee. prevalece, severity, ad comorbidity of 12-moth Dsm-iv disorders i the atioal comorbidity survey replicatio. Arch Ge Psychiatry Ju; 62(6): Bode-albala B, litwak e, elkid ms, rudek t, sacco rl. social isolatio ad outcomes post stroke. Neurology Ju 14; 64(11): Depressio i Primary Care: Volume 1. Detectio ad Diagosis. Cliical Practice Guidelie, Number 5. Depressio Guidelie pael. agecy for Health care policy ad research. Departmet of Health ad Huma services:rockville, md. ahcpr publicatio o april Wouts l, oude voshaar rc, Bremmer ma, Buitelaar JK, peix BW, Beekma at. cardiac disease, depressive symptoms, ad icidet stroke i a elderly populatio. Arch Ge Psychiatry may; 65(5): robiso rg, Jorge re, moser DJ, acio l, solodki a, small sl, fozetti p, Hegel m, ardt s. escitalopram ad problem-solvig therapy for prevetio of poststroke depressio: a radomized cotrolled trial. JAMA may 28; 299(20): Krisha Kr, taylor WD, mcquoid Dr, macfall Jr, paye me, provezale Jm, steffes Dc. cliical characteristics of magetic resoace imagig-defied subcortical ischemic depressio. Biol Psychiatry feb 15; 55(4):390 7.

9 7. alexopoulos Gs, murphy cf, Guig-Dixo fm, latoussakis v, Kaellopoulos D, Klimstra s, lim Ko, Hoptma mj. microstructural white matter abormalities ad remissio of geriatric depressio. Am J Psychiatry feb; 165(2): Jorge re, moser DJ, acio l, robiso rg. treatmet of vascular depressio usig repetitive trascraial magetic stimulatio. Arch Ge Psychiatry mar; 65(3):

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