Post-Stroke Recovery and Depression: A Difficult Puzzle


Many amazing children out there taking faithful care of their honored elders are able to keep up with a myriad of evolving physical conditions, even difficult ones such the one-handed life that a stroke can inflict. Those physical conditions are challenging enough to deal with on their own. When they become compounded by a sudden mental or emotional change, however, any dedicated caretaker can find themselves suddenly in over their head.

When a group of Danish researchers released a study recently in JAMA, it stunned many to discover that just over one in four stroke victims develop clinical depression within two years (and half of those within the first three months). In fact, for the first three months after a stroke, a person’s risk of clinical depression is eight times higher than it is for a non-stroke victim of the same demographic.

Among stroke victims, there were several factors that proved to increase the risk of depression, including:

  • Being female;
  • Having a more severe stroke;
  • Being older (the older you are, the more likely depression is to set in);
  • Living alone;
  • Being less educated;
  • Being diabetic;
  • Having a personal and/or family history of depression.

How and Why Stroke Causes Depression
The obvious next question is why people who suffer strokes are so much more likely to become clinically depressed. Unfortunately, it is fair to say that any answer we give to this question will be stated in vague generalities, because our very conception of what the brain is changes with each new discovery being made. (It turns out the brain is quite probably a kind of quantum computer, calculating many hundreds of thousands of times faster than we once believed).

So while we do not know what exactly happens inside the brain that changes the way we feel, we do know that large-scale chemical changes occur when a stroke happens. Presumably the problem is caused by those chemical changes…but that is all we can really say for sure at the moment.

The Important Part: Helping Your Honored Elder Cope with Post-Stroke Depression
Unfortunately, knowing that depression is “just” a chemical imbalance in the brain does not make the depression go away, and it can actually exacerbate the situation. After all, few people are eager to admit they are helpless in the face of a tiny number of complex molecules drifting around inside their heads.

Fortunately, they do not have to, because they are not helpless. People overcome post-stroke depression every day, and so can your aging loved ones. Here are a few crucial tools you can leverage to help them:

  • Better Than the Pioneers: One effective psychological tool to beat depression is to compare your circumstances to those of a well-known group that is (or was) clearly worse off than you. One of my favorite people, a lupus patient who was one of the very first people to ever have open heart surgery (back in the day when they literally used a small chainsaw to open your rib cage), used to constantly compare herself to the pioneers. “Sure, I managed to get cancer on the bottom of my foot,” she said once, “but I have custom shoes, and I’m not walking barefoot across Utah pushing a wheelbarrow!”
  • Finding the Silver Lining: It might sound like a cliché, but it is very possible to teach your brain to look for the opportunities, lessons, and character-building facets of even the most difficult challenges. These kinds of thoughts are depression’s worst enemy.
  • Get Social: Someone once said that laughter is the best medicine, but they missed a crucial component; laughing with friends is the best medicine. Laughing alone is better than crying, but social support beats out giggling over some website or email by a wide margin.
  • Embrace the Challenge: Any obstacle in life can be viewed as a problem, or it can be viewed as a challenge. What is the difference? People who do not think they can deal with problems give up. The very concept of ‘challenge,’ on the other hand, carries with it the connotation that it can be beaten…and just believing you can win is often enough to propel you to take action.

By talking about ‘the stroke’ or ‘the depression’ as though it is a separate entity, and more specifically an enemy that can be beaten, you can prime their mind for the fight. This, in turn, will eventually lead to victory.

Depression is never easy to deal with, and depression compounded by the physical after-effects of a stroke is an even greater challenge. But by being attentive, and guiding your aging loved one toward thoughts that make the best of a bad situation, you can help them overcome their own brain, and become themselves again.


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About Peter Mangiola

Peter Mangiola is a senior care advocate with several decades of experience in the industry. Peter helps senior citizens by leveraging his vast knowledge of the healthcare industry and his expertise in identifying effective, affordable healthcare solutions. Peter has been a consultant, educator and regular speaker for many groups and organizations over the years covering a wide variety of topics; including Geriatric Care Management, Dementia, Alzheimer’s and Senior Care Health Service & Advocacy

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