A Patient's Perspective
Advocating for Myself: My Journey Through Poststroke Depression
Am Fam Physician. 2018 Jun 1;97(11):706.
I had a stroke in December of 2016, which left me with right-sided weakness. I didn't know what my recovery would look like. I quickly found myself depressed, something that I had worked to control my entire life. I had previously been diagnosed with conversion disorder and depression. Now, years later, I had lost the ability to do things I wanted to do because of the stroke. I began mourning the fact that I didn't have the life I used to have. As a mother and CPA, people used to count on me, but now it was like I was invisible. Being sidelined was difficult.
A few months after my stroke, I started researching stroke recovery and mental health in an effort to educate myself on my condition. I heard about many other patients struggling with psychiatric illness after a stroke. I reached out to my family doctor to find a psychiatrist who would help me adjust to my life as a stroke patient. I learned that I need to be an advocate for myself. I grew from the experience, and I'm at peace. For me, recognizing that recurrent depression is common following a stroke was the motivation I needed to take control of my recovery.—D.K.
Depression affects about one-third of stroke survivors, according to the American Stroke Association. Emergence of depression following cerebrovascular disease is thought to be caused by an interplay of the psychological reaction to new functional deficits and acute brain changes, including inflammatory response to neurogenesis following ischemia. Depression negatively impacts recovery and can affect quality of life. Despite this well-known and prevalent comorbidity of stroke, the diagnosis may be overlooked because somatic symptoms and cognitive deficits may mask depression. Medication management and psychosocial therapy for poststroke depression may improve outcomes and may even prevent depressive symptoms.
Our patient advocated for her own mental health treatment when she recognized she was experiencing depression following her stroke. Her ability to advocate for herself has given her a new, uplifting perspective on her recovery.
National Stroke Association: http://www.stroke.org/we-can-help/survivors/stroke-recovery/post-stroke-conditions/emotional/depression
Paolucci S. Epidemiology and treatment of post-stroke depression. Neuropsychiatr Dis Treat. 2008;4(1):145–154.
Towfighi A, Ovbiagele B, El Husseini N, et al. Poststroke depression: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2017;48(2):e30–e43.
This series is coordinated by Caroline Wellbery, MD, Associate Deputy Editor, with assistance from Amy Crawford-Faucher, MD; Jo Marie Reilly, MD; and Sanaz Majd, MD.
A collection of Close-ups published in AFP is available at https://www.aafp.org/afp/closeups.
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