American Stroke Foundation

This presentation for the Stroke Education Series was presented by Lindsey Jenkins, PhD of the University of Kansas Health System on Post-Stroke Depression. Thank you to The University of Kansas Health System for partnering with the American Stroke Foundation for the Stroke Education Series.

This webinar will review different types of stroke and psychological concerns associated with stroke. Treatment options for post-stroke depression are also discussed.

Hemorrhagic strokes happen when we have an aneurysm or a weakened blood vessel that bursts, causing blood to fill areas around the brain. In turn, swelling and pressure are created, which damages the brain cells and tissues.

• An intracerebral hemorrhagic stroke occurs most commonly due to hypertension, from high blood pressure, and aging blood vessels.
• A subarachnoid hemorrhagic stroke occurs when there is bleeding between the brain and the brain covering. The main causes are: aneurysms, arteriovenous malformation, bleeding disorders, head injuries, and blood thinners.

Ischemic strokes are blood clots that get caught in a blood vessel, which causes the brain to be deprived of oxygen. Once the flow of oxygen stops, parts of the brain tissue become damaged. The main cause of ischemic stroke is hypertension.

Transient Ischemic Attacks (TIA) are sometimes thought of as mini strokes. The symptoms last only for about 24 hours. Some of the main causes of TIA are low blood flow, embolism, and small blood vessels blocked temporarily.

• There are about 800,000 people that have a stroke each year. Stroke is the 5^th leading cause of death in the US. Women are more likely to experience a stroke than men.
• There are many risk factors that can lead to stroke. Some of these may be due to genetic predispositions and many may be due to lifestyle.
• There are a handful of symptoms that can alert you that you or a loved one are experiencing a stroke. BE FAST is an acronym that helps detail the symptoms of a stroke. Balance, Eyes, Face, Arms, Speech, & Time.

• Experiencing and surviving a stroke is a life-altering experience that can leave us with some concern about our life moving forward. The age at which you experience stroke can be predictive of the psycho-social functioning throughout recovery and life afterwards.
• Adjustment disorder is characterized as a behavioral symptom that newly develops within 3 months of a stressor. The distress you feel and display outwardly is out of proportion to the situation. Adjustment disorder can greatly impair your engagement and performance in life activities.

Post-Stroke depression is the most common mood disorder among the stroke survivor population. This can be caused by neurological changes in the brain. This could also be a reaction to the life-altering changes from stroke. Post-Stroke depression can be treated with antidepressants or psychotherapy.

Post-stroke depression can be diagnosed if there is no interest in past enjoyed activities, direct consequence of the medical condition, and impairment in social or occupational functioning.

Pseudobulbar Affect (PBA) is an occurrence in which an individual begins to cry or laugh severely out of place. PBA can decrease with time and can be treated with medications.

This Venn diagram shows the common symptoms one may feel living with stroke and depression. Some characteristics are stroke specific, while some are unique to depression, but there is a lot of overlap.

There are many avenues you can take when looking at treatment for stroke. Some of the most common are daily blood pressure checks, diabetes management, stopping smoking, healthy dieting, more exercise, and creating goals for yourself.