Depression may increase stroke risk, and stroke recovery.

Depression may increase stroke risk, and stroke recovery.

The World Health Organization (WHO) claims that depression is the main cause of disability in the globe. At least 5% of adults are affected, with more women than males reporting symptoms of depression.

Symptomatic depressed individuals are more likely to have a stroke, and their recovery from one is frequently more challenging, according to a multi-national study.

According to this study, persons with depressive symptoms had a 46% higher risk of having a stroke than those without such symptoms.

Over 280 million people worldwide suffer from depression. 10.4% of women in the United States experience depression, which is almost twice as frequent in women as it is in males, according to the Centers for Disease Control and Prevention (CDC).

Psychological signs of depression include a continuously downbeat attitude, a sense of worthlessness, a loss of interest in enjoyable pursuits, trouble concentrating, and even suicidal thoughts.

In addition, physical symptoms including exhaustion, an inability to eat, headaches, chronic pain, and digestive problems may be brought on by sadness.

Moreover, depression and cardiovascular disease (CVD) have been connected in research; one studyTrusted Source found that individuals with coronary heart disease who were depressed had an increased risk of dying.

An international study that was just published in Neurology discovered that those who experience depressed symptoms had a higher chance of both ischemic and hemorrhagic stroke, as well as a worse recovery after a stroke.

What is a stroke?

A stroke happens when a blood vessel in the brain bursts and bleeds or when the blood supply to the brain is cut off. Blood and oxygen cannot reach the brain’s tissues because of the rupture or obstruction.

Stroke is a primary cause of death in the US, according to the Centers for Disease Control and Prevention (CDC). More than 795,000 Americans experience a stroke each year. Brain tissue and cells are damaged and start to die within minutes of being oxygen-deprived.

Strokes often come in three different forms:

  • Temporary ischemia. A blood clot causes a transient ischemic attack (TIA), which normally resolves on its own.
  • Ischemic stroke. It involves an obstruction in the artery brought on by a clot or plaque. The signs and problems of an ischemic stroke may persist permanently or linger longer than those of a TIA.
  • Hemorrhagic stroke. A blood vessel that seeps into the brain either bursts or leaks, which is the source of the condition.

Strokes are often fatal. According to the American Heart Association (AHA), there were 37.6 age-adjusted deaths for every 100,000 stroke diagnosis in 2017. This fatality rate is 13.6% lower than it was in 2007 thanks to medical advances in the treatment of strokes.

What is a Depression?

Depression is basically a common but serious mental disorder, medically termed as Major Depressive Disorder which negatively affects a person’s way of thinking, how the person feels and behaves. This mental disorder is different from mood fluctuations. In addition to causing emotional and physical problems, it can also make it difficult for you to function at work and at home.

Despite the existence of effective treatments for mental disorders, more than 75% of people in low- and middle-income countries do not receive any treatment. There are several barriers to effective mental health care, including a lack of resources, a lack of trained health-care providers, and social stigma associated with mental illness. People with depression in countries of all income levels are frequently misdiagnosed and prescribed antidepressants even when they do not have the disorder.

Details from the stroke and depression study

In total, 26,877 adult study participants from 32 nations in Europe, Asia, North and South America, the Middle East, and Africa participated in the study.

As a neuroscientist and associate professor at the University of Nevada, Las Vegas, Dustin Hines, PhD, stated to Healthline, “This work represents a tremendous achievement in the knowledge of both stroke and depression. “When considered in light of how variable the group of patients suffering from depression is, the statistically significant difference between responders who reported depression before the stroke is even more impressive.”

According to research, 13% of the 13,000 participants who experienced a stroke also had depressive symptoms. Depression was prevalent among those who had no stroke, at 14%.

Increased stroke risk

When compared to people who did not have a stroke (14%), those who had one were more likely to develop depressive symptoms (18%). Those who admitted to having “given up on improving their lives” were at higher risk of suffering a stroke.

Those who had symptoms of depression had a 46% higher risk of stroke than those who did not experience such symptoms, even after the researchers made adjustments for age, sex, education, physical activity, and other lifestyle factors.

The correlation between depressive symptoms and stroke was discovered to be constant across all country economic levels. Stroke risk was increased in people with four or more symptoms of depression than in those with fewer symptoms.

In response to this research, Dr. Benesch stated that “this link between more severe depression and stroke risk is undoubtedly worthy of further examination and may be clinically meaningful.”

“One analogy would be that we are aware that lung cancer is brought on by smoking. We also know that daily smokers have a higher risk of developing lung cancer than smokers who only smoke sometimes (once every six months). Hence, he continued, “it would seem that there is a dose-response relationship.

The study also discovered that although strokes in those with depressive symptoms were not more severe, their outcomes one month after the stroke were worse.

Depression and CVD or stroke

Depression and heart disease and stroke have already been associated in a number of studies.

A 2011 meta-analysis of 17 research revealed that depressive disorders considerably increased the probability of having a stroke, and that the increase was likely independent of other risk factors like diabetes or hypertension. This study was unable to establish a causal relationship, nevertheless.

The same year, a bigger meta-analysis that examined 28 prospective cohort studies came to the conclusion that depression is prospectively linked to a considerably higher chance of having a stroke.

In 2020, a different study discovered that persons who had depressive symptoms had a higher risk of developing heart disease or having a stroke later on.

Despite the association’s modest size, it was nonetheless noticeable among those who did not exhibit depressive disorder-like symptoms.

How depression affects people who’ve had a stroke?

“Depression is not unusual for people following a stroke, I’ve discovered in my experience with stroke patients,” Waichler continued. “Both the stroke sufferer and their loved ones may suffer greatly from the loss of independence, physical limitations, restrictions on one’s capacity for self-care, and probable cognitive and communication problems. A person’s willingness or the requisite amount of resolve to fully engage in the recovery process may be adversely affected by depression. The outcome could be worse as a result and the stroke recovery could be hindered.

The biggest unsolved question in the study, according to Karen Sullivan, PhD, a neuropsychologist and the creator of the I Care For Your Brain website, is “What is it about depression particularly that enhances the risk of stroke?”

“The range of depressive symptoms includes the cognitive, emotional, and physical. Knowing which particular factors were most closely associated to stroke risk would be really beneficial, Sullivan told Healthline. “Even though the study filtered out typical characteristics linked with depression that could confound the results like low physical activity, there are lots of additional lifestyle risks that go along with depression that could have affected the results including bad diet, low socialising, not enough cognitive stimulation, inflammation, [and] noncompliance with medical guidance,” the study’s authors write.

According to Sullivan, the most significant lesson that patients, healthcare professionals, and the general public should learn from this study is the value of depression screening.

In addition to enhancing a person’s general health and quality of life, she added that recent research suggests that treating depression also lowers the chance of stroke. Large-scale, long-term studies are required, and it is important to understand whether effective therapy lowers the risk of stroke in order to demonstrate a more causal link between depression and stroke.

The apparent next step, according to Hines, is to search for widespread biomarkers that may be connected to metabolic issues and attempt to assist patients before they experience a stroke.


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