It’s not uncommon for depression to follow a stroke, in both the stroke survivor and the caregiving partner. A 2016 study on the factors that influence depression after a stroke finds that optimism and self-esteem in the caregiver can actually help combat the patient’s depression.
The study, presented during the annual meeting of the International Stroke Conference, followed 112 depressed survivors and their partners for up to two months. It differed from past studies because it looked at the survivor and caregiver as a team, rather than as individuals.
“We usually have been focused on the outcome of the stroke survivor, but we found that the self-esteem and optimism of the spouse caretaker is related to the patient’s depression,” says study author Misook Chung, Ph.D., R.N., and associate professor in the University of Kentucky’s College of Nursing. “When the spouse has a high level of self-esteem and optimism, the patient has lower levels of depression,” Chung says.
Because the spouse or partner plays such a vital role in the stroke victim’s recovery, it’s important that he or she get intervention and make emotional health a priority.
Kim Feingold, clinical psychologist and director of cardiac behavioral medicine at Northwestern’s Bluhm Cardiovascular Institute, says she counsels caregivers all the time to be aware of their own needs and not just those of their partner.
“Caregiver burden is something that we know a lot about,” she says. “The chronic stress of caregiving can impact physical and mental health.”
Feingold shared the following tips to help prevent depression in stroke survivors and their caregivers during recovery.
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Take care of yourself
“Caregivers have the tendency to sort of throw everything into the caregiving bucket, and sometimes their own health can sort of fall to the wayside,” says Feingold. She says that it’s important to take care of yourself, as a caregiver, because your partner needs you to be healthy and strong. She advises caregivers to get plenty of sleep, eat a healthy diet and exercise. “Studies show that exercise can be as effective in combating depression as medication for depression,” she says.
It can be hard for the caregiver to take time away, but in the long run, the respite is helpful for both parties. By taking some solo time, the caregiver will reduce stress, which will make him or her calmer and more refreshed. “When they step back into that caregiver role, they can be productive and helpful, and, as a result, there should be less deterioration in their own emotional and physical health,” says Feingold.
Help the patient identify things that are within his or her control
It’s easy to focus on loss following a stroke. One helpful method of reducing depression is to hone in on things that remain within the patient’s control. Point out that there are still many things in life that are her responsibility, such as taking medication, showing up at appointments, socializing with friends and family, participating in rehabilitation and more. Remind her that she still plays an active role in her own life.
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Acknowledge the loss
While it’s helpful to focus on the positive, it’s also important to acknowledge and accept what’s been lost. Grief and negative emotions are a natural part of recovery—for both the patient and the caregiver—and should be recognized, whether it’s on your own, with a loved one or through therapy.
Stay active and social
Both depression and physical limitations pose a huge challenge to social engagement. But it’s important for both the patient and caregiver to remain active. “Pushing yourself to be social or to engage in positive and pleasurable activities can improve emotional functioning and reverse depression,” says Feingold.