Stroke Related Depression - "I feel like I've just been hit from behind by an ICBM" - Health - http://maxpages.com/resurrection/Depression

There's an important difference between feeling "down" and suffering from depression.
When life disappoints us, like the waves of helplessness following even a "light" stroke, when a loved one is seriously ill or dies...it's natural to feel worried and sad. Such events take the joy out of life, but
often -enough, most people bounce back in a short time.
But when the sadness persists or keeps
returning, when everyday things like sleeping, .working, socializing and simply enjoying
life continue to be difficult, it's not 'just the blues" you 're dealing
with but major depression - an illness that requires treatment. And because it is an
illness, depression can become much worse without proper care.
That's why taking the
first step -seeing your doctor-is so critical.
This site is
designed to help you understand depression as an
illness so that if you or
a loved one suffers from depression, you will recognize the symptoms and seek the appropriate medical care.
As you rend on, keep these importnnt points in mind
A. Depression is a treatable illness
B. learning more about depression and following your treatment program will help improve your prospects for a future free of depression
C. Recovery doesn't happen overnight. It usually takes a few weeks before you see improvement-so don't get discouraged

1. Major depression requires prompt medical I treatment because its symptoms affect nearly every aspect of living. The tell-tale symptoms are a sad, anxious or empty mood that lasts for 2 weeks or more; or loss of interest or pleasure in most activities you once enjoyed. A person with depression also has several or all of these additional symptoms:
2. Feelings of worthlessness, hopelessness, guilt 3. Significant change in weight or appetite
4. Changes in sleep habits (such as insomnia or oversleeping) ".Fatigue, loss of energy; feeling "slowed down" .Agitation, restlessness, irritability
5. Diffiulty concentrating, making decisions .Frequent thoughts of death or suicide,
or suicide attempts
What causes depression?
Both biological and social factors play a role in causing depression.
Medical research has shown that depression is related to a chemical imbalance of he substances called neuro-ransmitters that transmit signals between
nerve cells in the brain. Antidepressant medication to helps correct this imbalance.. :
Life difficulties also contribute to the onset .' of depression. These can result from health issues, stroke, brain related diseases, difficulties in relationships, stress at work, a series of disappointments or separation from those you love-whether as a result of divorce, death or going away to college.

Other factors may be affecting you

OTHER FACTORS THAT MAY BE ASSOCIATED WITH DEPRESSION
1. Illnesses happening at the same time, such as chronic pain, cancer, strokes or thyroid conditions .Postpartum changes
2. Genetic factors (depression may run in the family)
3. Certain medications such as steroids
and some high blood pressure medicines .Alcohol and other substance abuse
4. As you consider
the symptoms and causes of your depression, remember these important points
5. Depression is an illness, just as diabetes and arthritis are illnesses. Having depression is l1Qt your fault and it's l1Qt a sign of weakness
You're not alone in your struggle with depression. As many as one in five Americans will be affected by depression in their lifetime. .This means a lot of people around you - family; friends, neighbors-share some
of the same feelings you do 'I Talking about your symptoms with your doctor
and people you trust can help you
find support and effective measures for dealing with your symptoms ANXIETY SYMPTOMS OFTEN ACCOMPANY DEPRESSION
1. Many people with depression experience anxiety symptoms-such as agitation,
difficulty sleeping af excessive worry: If
you have such symptoms, tell your doctor directly so that your treatment plan
: addresses them effectively:
2. Some patients with depression, however, also have anxiety
disorders that require special attention, such as:
Obsessive-compulsive disorder (OCD).
3. People with OCD have repeated, unwanted thoughts or feelings- for instance, fear of picking up
gerrns that make them anxious.
These aTe obsessions. To neutralize the anxiety; OCD sufferers feel they must perform rituals (compulsions)
such as repeated washing or cleaning
4. Ponic.disordel: Patients with this condition suffer rcpeated panic attacks- sudden periods of severe anxiety in which
their heart races, they have difficulty breathing- and feel trapped 5.Other depressed patients may have social phobiaan avoidance of social or performance situations or agoraphobia, which is a fear of being in public places or even going out of the house I Informing you of these medical conditionsi is not meant to frighten you, but is intended lto help those who have them get the required :
medical help.

Emotional After-Effects of Stroke

Survivors of stroke experience many changes resulting from their illness. Most people are aware of the physical changes that occur following stroke, for example paralysis or
weakness on one side of the body, or difficulty with speech and language comprehension. However many people also experience some changes in their mood. For some these
changes last for a short time, yet others may have ongoing problems.

One quarter to half of all survivors of stroke will experience some degree of depression and/ or anxiety. However many people suffering from depression or anxiety are
unaware that they are unwell. This also means they cannot tell their families, caregivers or doctors that they need help. Because of this, many people who experience mood
changes after stroke (like depression and/ or anxiety) do not receive treatment.

Major depression is likely to be noted and treated by a health professional but milder depression or anxiety may not be recognised. Some people may think they are feeling
down because they have been ill, unable to work, or maybe having difficulty with day to day activities. This is a common reaction to changes in health, but should only last
for a short time. Other people believe their changes in mood are a natural part of the ageing process. It may be even more difficult to recognise depression in people who
have difficulty communicating and understanding.

Recognising and receiving treatment for depression following stroke is important. Depression can slow recovery from stroke and other illnesses, delay resumption of social
and physical activities, and add to stress of families and caregivers (it is not uncommon for caregivers to suffer from depression also).

ANOTHER VIEWPOINT

After stroke, there are probably two main causes of depression: Psychological and Biological

Psychological Cause: This is the feeling of sadness and sorrow that may follow a stroke. Your brain attack may have dramatically changed your life. You may feel sad about
the lost abilities and grieve as you would over the loss of a friendship or death of a relative. Minor feelings of depression about lost abilities is common during your
recovery as you learn to live with the effects of a brain attack.

Biological Cause: This is often a more severe type of depression related to damage to the brain following stroke. The symptoms are often the same as for a psychological
depression and therefore can be difficult to diagnose. The difference is that a biological depression results from how the brain works after it has been injured, whereas the
other is a psychological response to disability and loss. Where and how much of the brain has been injured has a lot to do with whether you experience severe depression
after stroke.

If you or someone you know, have had any of the changes listed below over a persistent period, you may wish to seek advice from a doctor, nurse or other health
professional. There may be an important underlying emotional problem.

It can of course be uncomfortable or embarrassing for some people to discuss their emotions. However, your doctor, nurse or health professional is trained to help with such
matters and will be able to explain things clearly and answer any questions you may have. If you have any concerns for yourself or someone close to you, it is important that
you tell someone. Only then can you receive the help, support and treatment that you may need.

Features of Post-Stroke Depression

Changes in sleep: unable to sleep, or sleeping for a long time, always feeling drowsy.

Changes in your appetite/weight: Either increasing or decreasing.

Changes in mood: often in a bad mood, feeling irritable or sad.

Changes in energy: often feeling tired and unable to finish things you started to do.

Loss of interest: in work, hobbies or sex.

Feelings of restlessness: sometimes laughing or crying when you do not expect it.

Feeling down: feeling guilty, worthless, suicidal or depressed.

Difficulty concentrating: often difficulty completing tasks, making decisions or talking.

Loss of confidence: fear of leaving the house, crossing the road or being alone.

Therapy for Depression

THERAPY FOR
DEPRESSION
Early treatment can help shorten the length of time a depressive episode lasts, lessen its severity and reduce the risk of depression returning. Following your doctor's treatment program improves your chances of recovery
The most common approaches for treating depression are psychotherapy (also called "talk therapy" or counseling) , antidepressant medication or a combination of the two.
Psychotherapy
A psychotherapist is a medical professional trained to help patients understand psycho- logical illnesses and learn how to deal with them. Talking with a therapist can give you valuable support and advice. Antidepressant therapy
As mentioned earlier, antidepressants relieve the symptoms of depression by correcting
the chemical imbalance in the levels of neuro- transmitters (for example, a neurotransmitter called serotonin) in the brain's nerve cells.
The most commonly prescribed antidepressants are the SSRIs,( selective serotonin reuptake inhibitors) .
Types of antidepressants SSRIs generally have fewer of the side
effects associated with the older classes of antidepressants mentioned below: In some patients, SSRIs may cause headache, nausea, agitation, changes in sexual functioning and insomnia. Some of these effects may diminish with time
Tricyclic antidepressants are as effective as the SSRIs but have a higher frequency of side effects- including blurred vision, weight gain, dry mouth or dizziness
MAGIs Cmonoamine Qxidase inhibitors) are prescribed much less frequently than SSRIs or tricyclics because of their side effects. .MAGIs cannot be taken with certain drugs and foods
KEEP YOUR DOCTOR
INFORMED
. As you continue in your treatment
program, keep your doctor informed about how it's going
.When taking medication, follow your
doctor's directions exactly. Do not hesitate to contact your doctor
about any side effects you may be feeling.
If needed, another more suitable medication .can always be found, If you are not happy with your progress, discuss with your doctor whether a change
in antidepressant medication or
psychotherapy maybe helpful. Understanding is the key to success
Following your doctor's treatment advice and taking your medication as prescribed will help you make the most of your therapy: As treatment proresses, symptoms are improving worsening, and how your current medication is making you feel. Above all, call your doctor
right away if you start to have
thoughts about harming yourself in any way.
Seek the support of family and friends, too. They can provide that extra boost of confi- dence you might need to help break free of depression.
Finally; be patient. The factors that caused your depression are complex and do not
change overnight-but they can be changed.
Do the best you can each day: You'll find that small triumphs add up soon enough.

Food combination and Mental Performance

Mental performance or relaxation can be controlled by choosing the right combination of foods. L-tyrosine and L-tryptophan are two amino acids which compete with one another to control brain functions. L-tyrosine is used by the brain to synthesize the neurotransmitters norepinephrine and dopamine, both of which are critical to clear, quick thinking; long-term memory; and feelings of alertness and stability. L-tryptophan is used by the brain to make the neurotransmitter serotonin, which is responsible for slowing down reaction time, imparting satiety after a meal and inducing sleep. L-tyrosine, found in protein-rich foods like meat, poultry, seafood, beans , tofu, and lentils, thus serves as a nutritional stimulant to the brain, whereas L-tryptophan, found in such foods as bananas, sunflowers seeds, and milk (and whose effects are augmented when consumed with carbohydrate-rich foods), slows mental functions.
If L-tyrosine reaches the brain before L-tryptophan, it will prime your brain to function at maximum performance levels all day (or all night, depending upon when you eat the meal or snack). But if L-tryptophan reaches the brain first, it will stimulate the production of serotonin, and your mental performance will ebb and your brain will begin to shut down, even in the middle of the day.

A program of mental fitness and control over your own levels of mental performance, memory, relaxation (and even depression) will facilitate the production of these amino acids and passage through the Blood Brain Barrier.

Glucose and Carbohydrates
Even though carbohydrates help relax the brain, they are necessary for maximum mental performance. If consumption is properly timed, carbohydrate-rich foods, such as pasta, bread, legumes, cereals, grains, fruits, and vegetables, can boost the brain's energy levels.
Carbohydrates (abundant in foods that are high in starch and sugar) are quickly broken down by the body into glucose. Carbohydrates enhance mental performance because the brain thrives on glucose. It supplies your brain with the most basic type of energy it needs to think, remember, solve problems, and control the rest of the body.

Foods that are rich in complex carbohydrates, such as whole grains, brown rice, unrefined cereals and flours, and vegetables and fruits, provide your brain with a steady supply of glucose.

Just as with protein, when you eat carbohydrates is critical to how your brain will respond. Timing is everything.

Breakfast: Begin the day with a mixture of protein and complex carbohydrates: low-fat milk with whole-grain cereal and fresh fruit.

Lunch: To renew mental energy for the afternoon, have a salad with low-fat dressing, shrimp cocktail, or chicken breast and fresh fruit for dessert.

Afternoon Snack: Use the midday snack to supply your brain with carbohydrates. Choose fresh fruit or low-fat crackers and six ounces of fruit juice or vegetable juice cocktail.

Dinner: Start the evening with complex carbohydrates-baked potato or corn-as a side dish; choose a choline-rich entree, such as lentil soup or fish; and finish with a low-fat frozen yogurt dessert.

Bedtime Snack: Relax your brain and prepare for a good night's sleep with warm low-fat milk, honey and banana.

For more information on this topic refer to "Eat Smart Think Smart" by Robert Haas and "Food & Mood" by Elizabeth Somer, MA, RD.

For fun:Dieter's guide to weight loss

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References

FOR
MORE
INFORMATION...
The following orgonizotions provide more informotion on depression ond suggest support groups in your area.
Notionol Allionce for the MentalIy III 200 N Glebe Rd Suite 1015
Arlington, VA 22203-3754 800-950-NAMI (6264)

National Foundation for Depressive Illness, Inc. po Box 2257 New York, NY 10116 800-248-4344

Nationl Mental Health Association
1021 Prince St . Alexandria, VA 22314
800-969-NMHA (6642)

Nationol Depressive ond
Manic Depressive Associotion 730 N Franklin St, Suite 501
Chicago, IL 60610
I 800-82N-DMDA (826-3632)

Anxiety Disorders
Associotion of America
6000 Executive Blvd, Suite 513 Rockville, MD 20852 301-231-9350

Obsessive Compulsive Foundotion PO Box 70
Milford, CT 06460 203-878-5669

FOR PLACING ORDERS,

CALL THE 800#, USE MY NAME, KENNETH HOFF AS DISTRIBUTOR, FOR ORDERING

1 800 395 9148

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Page Updated Sun Mar 9, 2003 11:34am EST