Understanding the stroke-depression link – and what survivors and families can do

沙巴足球体育平台 that one of America's best-known stroke survivors was being treated for depression highlights a common and serious connection between the two afflictions.

去年5月，. 约翰·费特曼在他差点致命的中风后登上了全国的头条. On Thursday, his staff announced he had checked into a hospital for depression. He'd experienced depression off and on throughout his life, but it had worsened in recent weeks.

这份事先准备好的声明没有明确地将他的中风与抑郁症联系起来. 但抑郁症通常是中风之后发生的, 这对病人来说很重要, 护理人员和医生应该意识到这种联系, 博士说. 里卡多·豪尔赫, professor of psychiatry and behavioral sciences at Baylor College of Medicine in Houston.

"Stroke not only brings about physical changes and physical impairment but also psychological or behavioral impairment, 这些都需要被认识到,乔治说。, 她还持有学院的Beth K. 斯图尔特·C. 脑损伤医学尤多夫斯基主席.

根据2016年美国心脏协会的数据 科学声明 乔治帮忙写的, poststroke depression affects about a third of stroke survivors at any one time, 尽管他说，根据对抑郁症的定义，估计会有所不同. The likelihood is greater during the first year after a stroke and slowly declines after.

Dr. 埃尔·侯赛尼, 杜伦杜克大学神经学副教授, 北卡罗莱纳, 随着沙巴足球体育平台的推移, 多达一半的中风幸存者可能会在某个时候经历抑郁.

The best-established predictors for poststroke depression include a previous history of depression and the stroke's severity, 侯赛尼说, 谁还帮助撰写了2016年的声明. Significant physical disability and cognitive impairment also "go hand in hand" with poststroke depression risk.

Depression that happens after a stroke is similar in many ways to depression without a stroke, 她说. “它可能表现为一种悲伤感, 绝望, 感觉不值得, having guilty feelings over minor things or having little interest or pleasure in doing things.“抑郁症患者可能难以集中注意力, 精力不足, 变得烦躁, 或者可能不想吃，或者可能吃得太多. 他们可能睡不着，或者睡得太多. 他们可能会考虑自杀. Symptoms typically must occur at least several days over two weeks to qualify as depression.

The diagnosis is complicated by overlapping factors that can appear to be depression but aren't, 侯赛尼说. A stroke survivor might be dealing with issues such as grief from a loss of ability or post-traumatic stress from experiencing a stroke and hospitalization. Stroke survivors also can experience a condition known as pseudobulbar affect, 哪一种会导致不自觉的哭泣, 笑还是生气.

抑郁症甚至会影响短暂性脑缺血发作的人, 或“小中风,“这不会留下任何物理影响. Depression also affects people whose strokes leave them unaware of their disabilities, 这种情况被称为病感失认症.

中风和抑郁症的确切生物学原理尚不清楚. 豪尔赫说 one possibility is that a stroke affects brain circuitry that regulates emotion. Other factors cited by El Husseini include genetic susceptibility and inflammation. 除了生物因素外，社会心理因素也可能起作用.

不管机制如何, it's crucial for stroke survivors and those around them to understand that depression is connected to recovery. "We have multiple studies suggesting that outcomes after a stroke are worse if someone is depressed,侯赛尼说. Poststroke depression has been linked to higher mortality rates after stroke, 大脑功能下降，整体运作能力下降.

幸运的是，有几种治疗中风后抑郁的方法. 问题解决疗法等干预措施会有所帮助, 抗抑郁药物也是如此, 尽管研究在最好的一个上存在冲突, 豪尔赫说. 重复经颅磁刺激, 一种非侵入性的脑部刺激方式, 也显示出了希望.

Stroke survivors who have social support fare better than isolated ones, 侯赛尼说. “这不是唯一的因素, 当然, 一些拥有良好社会支持的人仍然会抑郁."

Early treatment of depression may improve both physical and cognitive recovery from a stroke, 豪尔赫说. Given how many people are affected and the serious implications for their recovery, 他说，所有中风幸存者都需要接受抑郁症筛查.

"Both family and physician need to work together in trying to arrive at a diagnosis," he said. Family members might spot changes a doctor might miss and should alert a physician if they see something.

侯赛尼同意了. "It is very important for caregivers and patients to understand that physical disability is not the only thing that can happen" after a stroke. 抑郁症等问题, 焦虑, 乏力, 认知变化和睡眠问题是真实存在的，但可能更难察觉.

她说:“有些人中风后可能走路和行动都很正常. “但他们可能正在经历许多其他人看不到的其他事情."

988自杀沙巴体育平台点击进入 & Crisis Lifeline connects people in crisis with suicide prevention and mental health counselors. 拨打或发短信988或访问 生命线的网站.

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