Stroke And Mental Health

What is a stroke?

According to the WHO, strokes are the second leading cause of death and are responsible for around 11% of total deaths. There are three types of stroke: transient ischemic attacks (TIA), haemorrhagic strokes, and ischaemic strokes. The most common type of stroke is an ischaemic stroke which occurs due to a blockage that cuts off the blood supply to the brain. This accounts for 85% of strokes. A stroke occurs when an area of the brain loses its blood flow, which kills brain cells. The way the body functions can be impacted by a brain injury. It may also affect your thoughts and feelings. Where and how much of the brain is damaged during a stroke determines its effects. While some people may only experience minimal short-term problems, others may experience more significant long-term issues. It can include physical problems such as swallowing, sensory issues, and pain, as well as communication issues such as slurring, speaking, and understanding.

Signs of a stroke

A stroke is usually very sudden. However, the symptoms of a stroke tend to vary from person to person. The word "FAST" can be used to recall the main stroke symptoms:

FACE - The person's mouth, eye, or face may have drooped to one side and they may not be able to smile

ARMS - Due to numbness or weakness in one arm, the person might not be able to raise both arms and hold them there.

SPEECH - Despite appearing to be awake, a person may have trouble understanding what you're saying, as well as have slurred or distorted speech. In some cases, they might even be unable to speak at all.

TIME - If you see any of these symptoms or signs, don’t waste any time and call 999 or your emergency number right away.

How does a stroke affect mental health?

Mental disorders can be a stroke risk factor

Depression, anxiety, and other mental disorders can lead to increased destructive habits, namely smoking, alcohol, and decreased sleep.

One study found that veterans with post-traumatic stress disorder (PTSD) are 36% more likely to have a stroke than those without PTSD.¹ The relationship between PTSD and stroke was stronger in people assigned male at birth than in those assigned female at birth.¹

According to recent research, those who experience anxiety have a 33% increased risk of stroke than those who had the lowest anxiety levels.²  The reason for this, though, might be that smoking, an increased pulse, and high blood pressure are all known risk factors for stroke, and anxiety is associated with them. Depression can also lead to someone having a lack of sleep or other destructive environmental habits, which are risk factors for stroke. One study showed that the probability of developing a stroke increased considerably with depression, and this rise was likely unrelated to other risk factors including diabetes and hypertension.³ 

Mental health post-stroke

PTSD, anxiety, and depression can develop or worsen after a heart episode and can impact daily life. According to recent research, simply having had a stroke raises your likelihood of developing depression and/or anxiety. The American Stroke Association states that 20% of stroke survivors experience anxiety. 

One study with over 25,000 patients found that 31% of patients experienced depression up to 5 years after having a stroke.⁴ As the brain is damaged after a stroke, this can cause biochemical changes in the brain which lead to a stroke survivor displaying depression.

Post-traumatic stress disorder is another psychiatric disorder that may be experienced post-stroke. This is expected and common when coping with a debilitating and traumatic condition.

Stroke can cause sudden changes in behaviour 

A change in behavior may be a side effect of the trauma caused to a part of the brain by a stroke. These changes can be temporary or permanent. If the behavioural change is temporary, this will decrease as the recovery process progresses. Depending on which area of the brain is injured and how long the brain goes without blood flow, a stroke may result in temporary or permanent disability.

If you or someone close to you is struggling with mental health

Mind - 0300 123 3393 (Infoline) - Mind is a charity that offers support and advice to those with mental health problems

Anxiety UK  - 03444 775 774 (helpline) or 07537 416 905 (text) - This charity provides support and advice for anyone who is suffering from anxiety

NHS Improving Access to Psychological Therapies (IAPT) - nhs.uk/service-search/find-a-psychological-therapies-service - The NHS provides counselling and therapy services. You are able to self-refer to these services if needed. Please note that this service is only available in England.

Samaritans - 116 123 (freephone) - A charity which provides emotional support for those who are struggling to cope, having suicidal thoughts or are feeling distressed.

When to contact a doctor

You should see a doctor if you:

• have symptoms of depression and anxiety that are not improving.
• find your mood affects your work, relationships with your family and friends and everyday life.
• have thoughts of suicide or self-harm.

If you think you are having a stroke, you should call 999 immediately.

Conclusion

It's critical that you get emergency medical care as soon as you can if you think you could be having a stroke. Additionally, it's crucial to get professional help if you have poor mental health as a result of a stroke.