People With Symptoms of Depression May Be at Higher Risk of Stroke
- Researchers say people may have a higher risk of stroke if they’ve had symptoms of depression.
- They add that depression may also hinder a person’s ability to recover from a stroke.
- Experts also note that having a stroke may also increase a person’s risk of depression.
Depression may increase your risk of stroke and, if you have a stroke, it may slow your recovery.
People who had symptoms of depression had a 46% greater chance of suffering a stroke than those who had no such symptoms, according to a study led by Robert Murphy, a PhD student at the University of Galway in Ireland, that was published today in the journal Neurology.
The researchers reached their conclusions after adjusting for age, sex, education, physical activity, and other lifestyle factors.
“Depression affects people around the world and can have a wide range of impacts across a person’s life,” said Murphy in a press release. “Our results show depressive symptoms were linked to increased stroke risk and the risk was similar across different age groups and around the world.”
The study included 26,877 adult study participants from 32 countries in Europe, Asia, North and South America, the Middle East, and Africa.
“This paper represents a major achievement in the understanding of both stroke and depression,” Dustin Hines, PhD, a neuroscientist and assistant professor at the University of Nevada in Las Vegas, told Healthline. “The statistically significant difference between responders who reported depression before the stroke is even more impressive when taken in the light of how heterogeneous the population of people suffering from depression is.”
Researchers reported that 18% of the 13,000 participants who had a stroke had symptoms of depression. Among those who did not have a stroke, the prevalence of depression was 14%.
Participants were asked about their history of depression in the 12 months prior to their stroke, including such symptoms as feeling sad, “blue,” or depressed for two or more consecutive weeks.
The more symptoms of depression participants reported, the higher their risk of stroke, the researchers reported.
For example, those who reported five or more symptoms of depression had a 54% higher risk of stroke than those with no symptoms, researchers said.
“Research has shown that depression can be related to risks associated with hypertension, coronary heart disease, and diabetes. These factors can increase the possibility of a stroke,” said Iris Waichler, a licensed clinical social worker who specializes in strokes, dementia, Alzheimer’s disease, and caregiving at Choosing Therapy, which provides virtual counseling for a variety of mental health issues.
“People who are depressed tend to not take good care of themselves physically or emotionally,” Waichler told Healthline. “They are more likely to ignore medical health issues, may not eat or sleep properly, and may be inconsistent in taking their medications.”
People who suffered from depression also tended to have worse outcomes one month after having a stroke than those who were not depressed.
“This could be due to the fact that depression is associated with physiological changes such as increased inflammation and autonomic nervous system dysregulation, which can have adverse effects on stroke recovery,” Megan Tangradi, clinical director at the New Jersey-based addiction and mental health treatment program Achieve Wellness & Recovery, told Healthline.
“In my work with stroke patients, I have found depression is not uncommon for people after a stroke,” Waichler added. “The loss of independence, physical limitations, limits on self-care abilities, and potential cognitive and speech deficits can be devastating for both the stroke patient and their loved ones. If a person is depressed it can negatively impact their willingness or the determination needed to fully engage in the rehabilitation process. This can inhibit recovery from stroke and result in a worse outcome.”
Karen Sullivan, PhD, a neuropsychologist and founder of the I Care For Your Brain website, said the biggest unanswered question in the study is: “What is it about depression specifically that raises the risk of stroke?”
“Depressive symptoms run the gamut from the physical, the emotional, and the cognitive. It would be very helpful to understand what specific items most strongly correlated with stroke risk,” Sullivan told Healthline. “Even though the study ruled out common factors associated with depression that could confound the results like low physical activity, there are plenty of other lifestyle risks that go along with depression that could have affected the results like poor diet, low socialization, not enough cognitive stimulation, inflammation, [and] non-compliance with medical advice.”
Sullivan said the most important point that medical providers and the public should take from this study is the importance of screening for depression.
“Not only does the treatment of depression improve the person’s quality of life and overall health, it now appears that it reduces the risk of stroke,” she said. “To establish a more causal relation between depression and stroke, large-scale long-term studies are needed and we need to know if successful treatment reduces the risk.”
“An obvious next step is to look for common biomarkers, likely related to metabolic disorders, and try to help people before they have strokes,” Hines said.