Recognizing -- and treating -- post-stroke depression

There are around 7 million stroke survivors in the U.S. -- and between a third and a half of them contend with post-stroke depression, as Senator John Fetterman is currently experiencing. He had his stroke in May of 2022 and began treatment for depression in February 2023. (Election stress probably didn’t do him any favors.)

Whether depression is a result of a stroke’s impact on the brain’s neurons and electric circuitry that regulates emotions, chronic inflammation, unknown biological factors and/or PTSD, the bottom line is that stroke survivors and their families need to be aware that physical disabilities aren’t the only post-stroke problems. A person can be physically back on their feet and still experience profound PSD, as well as anxiety, sleep disruption and cognition changes.

Left unrecognized and untreated, PSD can interfere with recovery.

So what can you do? Poststroke social support from friends and family is helpful in decreasing stress that leads to post-stroke emotional turmoil, as are cognitive behavioral therapy, and antidepressant meds. One study found that the most effective antidepressants are the selective serotonin reuptake inhibitors escitalopram and paroxetine. And some practitioners suggest repetitive transcranial magnetic stimulation. It is non-invasive and doesn’t create the side effects associated with electric shock therapy.

Fortunately, you don’t have to do this alone. The American Heart Association suggests that stroke patients and their caregivers who need help reach out to the 988 Suicide & Crisis Lifeline to talk with mental health counselors. Call or text 988 or visit the Lifeline site at 988lifeline.org.