Stroke and depression

    
      Re: Stroke and depression
    


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Posted by ccf neuro M.D.* on August 18, 1997 at 16:45:49:

In Reply to: Stroke and depression posted by Michael on July 24, 1997 at 09:40:51:
  I am interested in any information regarding correlation between stroke and
  resulting depression.  Where might I find more information?  Thank you.
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Michael,
Stroke has long been recognized as a cause of depression, and in patients with strokes, depression afterward is really the rule, not the exception. Part of this relates to obvious so-called situational depression or "adjustment disorder" type depression, where one is depressed in response to some negative event in his or her life, such as the death of a loved one, for instance, or in this case, the sudden disability caused by the stroke itself. The incidence and extent of depression in stroke go well beyond this simple connection, however. Most doctors who have studied this phenomenon believe that the actual destruction of the brain tissue caused by the stroke has adverse effect on all the other parts of the brain that previously connected via crossfibers to the damaged area, including the parts of the brain that control and regulate mood. Another area of brain function also frequently affected by strokes that most people are too embarassed to ask about and most doctors fail to discuss is sexual function. Often after a stroke, even if it is only a small one, there is a loss of libido. Depression after stroke should be treated aggressively just as any other type of depression, especially in those patients with significant residual disability, since a lack of motivation or pleasure (also known as anhedonia) will often interfere with an otherwise smooth course of gradual recovery, producing a psychologically based setback in NEUROLOGIC functioning. There are literally entire BOOKS that have been written about the connection between strokes and depression, including what types of strokes most ferquently produce severe depression etc. You could find one in your main branch local public library or any University medical library or bookstore. Most of these are of course cumbersome, jargon-loaded medical books that are at least somewhat confusing to the average person (and physician for that matter in the case of some such works!!!) I think the most important thing for you to realize, however, is that like regular depression, stroke-related depression is generally treatable with antidepressants. I would suggest that this be done in a setting of a neurologist's care specifically, only because certain neurologic problems and complications of stroke may IMITATE depression, and in fact be symptoms of damaged brain areas such as the frontal lobes, for instance. Also, occasionally another previously undiagnosed disorder like Parkinson's disease or thyroid disease is present, which may also cause or mimick depression. I hope you find this information helpful. If you would be interested in being evaluated at the Cleveland Clinic, the department of Neurology's phone number is 216-444-5559; or 1-800-223-2273 extension 45559. Information provided in the neurology forum is intended for general medical informational purposes only. Actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your treating physician.