Everyone feels depressed once in a while. It is feeling worthless, pessimistic, tired and hopeless. Usually these feelings go away after a few days. Occasionally, however, the depression lasts for a longer time and becomes worse. If this happens, the depressed person may fail to meet personal needs and a vicious downward cycle may begin.
As the depressed person withdraws from others, the chances for stimulation are reduced. Apathy prevents the depressed person from accomplishing anything productive, increasing the sense of worthlessness. Sleeping and eating patterns are often disturbed, resulting in physical discomfort. Once established, a depressive condition develops its own momentum and grows unless an event or person intervenes to disrupt it.
Signs of Depression
Depression commonly occurs after a stroke. This is more than sadness. It is an intense physical and psychological reaction to the illness. The many changes and losses the survivor experiences as a result of the stroke can cause depression. The following factors should be considered when suspecting depression:
- Change in appetite
- Change in sleep pattern
- Motor disturbance
- Loss of energy, unwillingness to participate in therapy
- Guilt feelings
- Lack of concentration
- Inability to enjoy life
- Death and suicide wishes
Treatment of severe depression may involve the use of medications and professional counseling. No single treatment has been shown to be best for every stroke survivor.
It is important to recognize that family members can also become severely depressed. They have suffered many losses and, many times, take on stressful new roles and responsibilities.
Depression is often not recognized as a real problem. There is a tendency to say “snap out of it” or to believe a person can become happier by wanting to. Depression is a painful situation and needs to be treated as a serious problem.
For milder depression, and as a beginning approach, counseling is often the most suitable. Working with a depressed survivor is sometimes difficult because the survivor is withdrawn and usually converses slowly and reluctantly. Depression can be considered as a sustained slowdown, and its reversal seen as the facilitation of self-activation. Getting this process going may require patience and attention to the survivor’s body language.
A skilled listener encourages a conversation, which is the beginning of getting out of the rut of a depression. Listening encourages more active talking. Depression is often associated with feelings of helplessness. Listening to the frustrations that bring about such resignation is important. Listening is particularly helpful when the depressed person can express these thoughts and feelings, opening the way for other reactions to disappointments. Often it is all that is necessary for the situation to reverse and the survivor to brighten again and grow. Should the survivor fail to show improvement in a reasonable period, or become more depressed, a peer visitor should consult with the supervisor about the possibility of professional referral.