Psychological care after stroke is of utmost importance for the complete recovery of the individual. Depression, anxiety and other serious disorders following stroke can seriously affect the quality of life and cause continued hospitalization and economic burden… (American Stroke Association, 2010)
As the incidence of Stroke (cardio-vascular accident, as it is known as medically) increases, especially in the Indian population: the concerns about the consequences are also on the rise. Besides the multitude of neurological effects it produces, comes a plethora of harmful effects on the human mind. Throughout the world, we always discuss the various methods stroke prevention, causes and treatment. Today, let us glance at its deadly effects on the mental health.
Stroke (a neurological condition causing various deficits in movement, speech, sensation, etc. due to decreased blood supply/increased blood clotting in the brain) often occurs as an UNWANTED PACKAGE. Even though with early treatment and adequate physiotherapy, the acute effects can be curtailed in most cases, it is the aftermath of this deadly process that concerns physicians all over the world. In general, each incident of stroke increases the risk of subsequent ones and your doctor will definitely advice you on what steps are necessary to prevent them. Being a psychiatrist, we focus on the rise of serious mental health issues post-stroke, especially in the middle-aged and the elderly.
The BRAIN is one and any dysfunction or injury to it, will affect the body and mind alike! Irrespective of the cause of stroke, 15-20 percent of the affected individuals get affected with Depression (a severe mental illness) within 6-12 months post-stroke and it is believed that the injury to the brain tissue caused by the stroke is directly implicated in the causation of this depression. It is so common that a separate category of ‘Post-stroke depression’ is classified to ascertain the uniqueness of this condition. These patients (in contrast to the other types of depressive disorders) have more of apathy, decreased emotional reaction, slowness of movement and thinking, poor response to standard treatments and often a high suicidal risk. Prompt treatment is necessary.
Depression having a bi-directional relationship with neurological problems, also increases the subsequent risk of strokes. Left-sided strokes and alcohol use increase the risk of subsequent depressive disorders. Neglect or delay in treatment can cause significant weight loss, catatonia (a serious condition characterized by lack of food intake and movement) and high suicidal risk.
Second in risk after stroke are anxiety disorders (generalized anxiety, social anxiety, panic attacks). They can occur within 1-2 years following the stroke and can significantly affect the quality of life. Often confused with heart conditions, they can be cured completely and might benefit from Cognitive behaviour therapy (a form of counselling by qualified clinical psychologists/psychiatrists). In old-aged patients, mixed anxiety and depression can also occur (a particular sub-type of depression) with delayed response to treatment and memory problems.
There are several other conditions: increased risk of addiction disorders, gambling, mood changes, personality disorders, obsessive-compulsive disorder and Parkinson’s disease; that can happen after stroke based on the region of the brain affected. Most importantly, Vascular Dementia (a type of illness that leads to slow memory loss and loss of other brain functions, especially in old age) is distinctly related to repeated strokes and stroke-prevention is one of the ideal ways to prevent an form of dementia. The greater the number of strokes, the more is the risk for mental health conditions. All of the above-mentioned conditions are treatable and seeking early help can save a lot of complications and burden both to the affected and their families.
In most cases the adequate treatment of stroke, proper rehabilitation measures and physiotherapy with recovery counselling can help in preventing mental health issues. However, the BEST IS TO PREVENT! Stroke prevention is the utmost need of the hour. General lifestyle changes, cutting down calories in food, regular exercise/Yoga, healthy coping and stress management, monitoring blood sugar, blood pressure and weight and regular monitoring of the cardiac parameters (specially after the age of 40 years) are of vital importance. To stress the fact, Stroke is one of the most preventable cause of disability and death. Good old fact, Prevention is always BETTER than cure. The aim is not to scare. Diseases have always been there, and will always be. It is important to take wellness measures well ahead in time to improve the quality of life.
Mental health and Stroke prevention are intimately related, as each can be the risk factor for the other. This WORLD STROKE DAY’19, let us keep in mind to watch out for the above-mentioned mental health problems following stroke as well as strive for all the measures to prevent stroke incidence in the young and old alike. LET US ALL HAVE A HEALTHY LIFE AND PROMOTE HEALTH!
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