Stroke is the fifth leading cause of death in the US, according to the American Heart Association (AHA), accounting for about one in 20 deaths. The AHA also reports that cardiovascular diseases, such as coronary artery disease and stroke, “claimed more lives in 2022 in the United States than all forms of cancer and chronic lower respiratory disease combined.”
May’s Stroke Awareness Month was founded to address high prevalence rates, boost awareness, and educate the public about stroke. The initiative is critical for developing medical treatment programs and research around stroke risk and prevention.
Stroke Awareness Month also draws awareness to the considerable impact that stroke can have on mental health. This article explores the critical link between stroke and mental health and how it can influence recovery. It also shares strategies for emotional support, building resilience, and caring for stroke survivors and their families.
The history and origins of Stroke Awareness Month
National Stroke Awareness Month was established in 1989 after President George H.W. Bush signed Proclamation 5975. The initiative, spearheaded by the US government, the American Heart Association, and other organizations, raises public awareness about stroke prevention, the warning signs of stroke, and the impact of stroke on individuals and families.
Stroke Awareness Month objectives
Stroke Awareness Month has several objectives, beginning with education about stroke, its signs and symptoms, and its risk factors. It also educates individuals on recognizing a stroke using the acronym F.A.S.T.: face drooping, arm weakness, speech difficulty, and time to call 911. Knowing the signs of stroke and acting quickly can significantly improve recovery outcomes.
Stroke Awareness Month also spotlights strategies for preventing and managing stroke risk. This includes promoting heart-healthy eating habits, exercising regularly, quitting smoking, and managing existing health conditions, like high blood pressure. The month also focuses on raising funds for research that supports scientific advancements in stroke prevention, treatment, and rehabilitation. Fundraising also includes survivor support, providing stroke resources for rehabilitation, support groups, and other services.
Ways to participate in Stroke Awareness Month
To get involved, learn about stroke risk factors, warning signs, and how to reduce the risk of or prevent stroke. You may also educate others by sharing posts, articles, and resources on social media using hashtags like #StrokeAwarenessMonth and #StrokeMonth. Other suggestions for participation include the following:
- Organize or participate in local events, such as health fairs, walks, or runs, that focus on stroke awareness and prevention.
- Collaborate with hospitals, community centers, or libraries to distribute educational materials and raise awareness.
- Volunteer at rehabilitation centers or support groups.
- Organize fundraising events, such as bake sales, garage sales, or “thon” events (e.g., walk-a-thons, dance-a-thons), to raise funds for stroke research or support organizations.
- Donate to stroke-related charities, like the American Stroke Association or other reputable stroke research or support groups.
Awareness of stroke and mental health comorbidities
Stroke and mental health challenges often occur together, meaning individuals with stroke can experience a higher risk of developing mental health conditions like depression and anxiety. Likewise, people with certain mental health conditions experience a higher risk of developing stroke. This comorbidity can negatively impact stroke recovery, quality of life, and overall well-being.
Stroke and depression
Depression is a common and serious complication following a stroke, affecting roughly 30% of stroke survivors. This condition, known as post-stroke depression (PSD), can impact a stroke survivor’s physical recovery and overall quality of life. While the exact mechanisms are still being researched, it’s believed that stroke-induced brain damage, particularly in specific regions, can disrupt brain pathways that regulate mood, leading to depression.
Stroke and anxiety
There’s a significant relationship between stroke and anxiety, with the two being interconnected in multiple ways. For example, chronic anxiety can lead to increased stress hormone levels, heart rate, and blood pressure, all of which can damage blood vessels and increase the risk of clots. Additionally, individuals with high anxiety levels may be more likely to engage in behaviors that put them at risk for stroke, such as smoking and alcohol use.
On the other hand, stroke can lead to anxiety. This anxiety is often associated with recovery and the significant life changes some experience post-stroke, such as physical limitations, changes in daily routine, and potential loss of independence. Stroke can also damage brain areas responsible for emotional regulation, potentially leading to or worsening anxiety.
Stroke and post-traumatic stress disorder (PTSD)
Studies show that stroke, particularly in young adults, is associated with an increased risk of developing PTSD. While updated evidence may be needed, existing research suggests that approximately 25% of stroke survivors experience PTSD symptoms within the first year, and roughly one in nine individuals experience chronic PTSD more than a year after a stroke.
Conversely, PTSD has been linked to an elevated risk of stroke and heart attack, affecting physical and cognitive recovery, as well as quality of life. A potential mechanism behind this relationship is the effect of PTSD on blood vessel function, which may increase the risk of heart attack and stroke.
How mental health conditions impact stroke recovery
Mental health conditions, such as depression and anxiety, can significantly impact stroke recovery in many ways. They can decrease motivation and adherence to physical rehabilitation programs, slowing the recovery process. Mental health challenges can increase disability and decrease functional capacity by exacerbating existing neurological issues. In addition, post-stroke depression and anxiety have been linked to a higher risk of recurrent stroke, increased mortality, and poorer quality of life.
Risk factors for post-stroke mental disorders
Not everyone who’s had a stroke will develop a mental health condition. However, recognizing the signs of post-stroke depression and anxiety early on and seeking appropriate treatment can improve outcomes for those who do. Risk factors for post-stroke mental disorders include the following:
- A history of depression or anxiety
- Stroke severity and location
- Long-term disability or physical limitations
- Memory problems and difficulty with thinking and problem-solving
- Social isolation and lack of support
- A history of smoking, hypertension, peripheral artery disease, diabetes, and previous strokes
- Poor sleep quality and insomnia
- Age and sex
- Family history
- High levels of neuroticism
- Obesity
- Socioeconomic status
Reducing the risk of stroke-related mental disorders
A proactive mindset and strong support system can play a key role in reducing the risk of stroke-related mental health challenges. Regular screening for depression and anxiety in stroke survivors, both during care and throughout the rehabilitation process, can aid in early identification and intervention. Strong social support networks, including family and friends, can help stroke survivors manage stress and emotional distress before they become overwhelming. Additionally, psychosocial interventions, like motivational interviewing and problem-solving therapy, can reduce depressive symptoms and improve mood after a stroke.
Strategies to boost mental health and reduce the risk of stroke
Individuals recovering from a stroke should speak with their physician about adopting exercise habits that fit their unique needs. Some stroke survivors also consult with a nutritionist trained in post-stroke nutrition needs. With guidance, there are several things one can do to boost mental health and reduce the risk of future stroke:
- Get plenty of exercise to improve overall health, including psychological and cognitive function
- Eat nutritiously to support overall well-being and promote stroke recovery
- Stay active and social to prevent isolation
- Manage stress with mindfulness techniques like meditation, yoga, or deep breathing
- Do things that nourish and bring you joy, like a hobby or creative project
- Get plenty of quality sleep
- Avoid smoking and consuming alcohol
- Manage existing conditions like high blood pressure (a leading cause of stroke), diabetes, and high cholesterol
Supporting the mental health of stroke patients in recovery
If you’re supporting someone in recovery, begin by learning about the many ways a stroke can impact an individual’s life and well-being, as well as how to recognize the behavioral and emotional signs of mental health difficulties. Actively listen to your loved one and acknowledge their feelings and needs. Encourage positivity and help them focus on their strengths rather than limitations.
Providing practical assistance can help, too. For example, helping with daily living activities and managing household tasks can minimize stress for those in recovery. You may also assist with transportation to appointments and other activities. If possible, become involved in their treatment by attending appointments together, monitoring their health, and managing medications. Encourage counseling or therapy to help the survivor cope with the emotional challenges of recovery.
Group support for stroke patients and their families
Stroke recovery can be a long and gradual process, presenting many challenges for families. Stroke support groups can be an invaluable tool for survivors and their families to share experiences, learn about stroke, and access practical information and resources. These groups offer a safe space to discuss recovery challenges and connect with others who understand. Many groups also provide education and awareness programs, helping to prevent future strokes and improve overall quality of life. Contact the American Stroke Association or the National Stroke Association to find support groups in your area.
Mental health support for stroke survivors
Therapy can be effective for managing mood disorders and improving overall well-being after a stroke. For example, psychotherapy (or “talk therapy”) can help with post-stroke depression, anxiety, and other mental health concerns. Cognitive behavioral therapy (CBT) challenges negative thoughts and behaviors to improve mood and psychological well-being.
Some patients benefit from positive psychology, a technique that helps individuals foster happiness, meaning, and fulfillment through exercises that retrain the brain. Mindfulness techniques, such as meditation, breathing exercises, and yoga or tai chi, can reduce anxiety and depression by helping individuals focus on the present moment.
The benefits of online therapy for stroke survivors
Many stroke survivors and their families find online therapy to be an effective solution to some of the barriers they may face. Virtual therapy platforms like Dr. Mindconnect offer improved access to care, overcoming geographical barriers and allowing survivors to access specialized treatment, which can be particularly helpful for those living in rural communities or with mobility limitations. Online therapy provides flexibility in scheduling, allowing stroke survivors to fit therapy sessions into their weekly routines. Additionally, online therapy is often more affordable than traditional, in-person treatment without insurance.
Research suggests that internet-delivered treatments like CBT can be as effective as face-to-face therapy in a traditional setting. For example, a randomized controlled trial published by the American Heart Association followed the progress of 27 stroke patients enrolled in a telemedicine-delivered CBT program. The study’s participants reported significantly decreased stress, less anxiety, and better sleep upon program completion.
