Coping with symptoms of Depression

Stroke Recovery Association NSW > Coping with symptoms of Depression

COPING WITH SYMPTOMS OF DEPRESSION

Depression is a generic term that covers a number of different situations where the common factor is the feeling of depression or a state of depressed mood.  After a Stroke, depression may occur but the situations in which it arises will lead to different types of treatment needs. Depression as an illness is common in the general community and the incidence of it is increasing with time. There are many reasons why a person may get depressed and almost as many ways to treat it. The following are some practical tips to assist you to cope with each of the symptoms of Depression you may be facing.

LOSS OF INTEREST, SLOWED ACTIVITIES, LACK OF ENERGY

  1. Set goals for daily activity. Plan full days of useful activity by making a list of the activities you are going to engage in at different times during the day. Try to stick to this plan as closely as possible. Do not forget to compensate for the fatigue factor (activity followed by rest/relaxation repeated throughout the day – do not overdo it).
  2. Make a list of activities you enjoy. Try to increase the amount of time you spend on these enjoyable activities.
  3. Avoid comparing the way you are behaving or feeling now, while you are depressed, with the way you used to behave or feel before becoming depressed.
  4. Try to remember how far you have come in your recovery – celebrate your achievements no matter how small. Avoid comparing what you could physically do prior to your Stroke to what you can do now. Above all, reward yourself for your efforts.
  5. Seek assistance from those around you to encourage and praise you for each small step you take. Recovering from Stroke and depression takes time – so be kind to yourself.
  6. If a task appears too difficult, do not despair. Break the task down into smaller, easier steps and start again more slowly – praise yourself for trying and have another go.

LOSS OF APPETITE

Eat small portions of food that you particularly like. Take your time and do not feel under pressure to finish if you are eating with others. Drink plenty of fluids, especially water, fruit juices and milkshakes.

LOSS OF INTEREST IN SEX

Seek non-sexual activities with your partner that you still enjoy.  Explain to your partner that your loss of interest and affection is a symptom of your depression, not a rejection of him or her, and that these symptoms will be temporary.

SLEEP DISTRUBANCE

  1. Exercise as much as you are able – it has a twofold effect on your body.
  2. Get up at the same time every morning. 
  3. Avoid sleeping during the day.
  4. Reduce tea and coffee intake if excessive (no more than 2-3 cups per day and none after about 4pm).
  5. Do not lie awake for more than 30 minutes – get up and find a relaxing activity.
  6. Try relaxation or mindfulness exercises. Ask your clinician for more information about these exercises.

MISERABLE FEELINGS, UNPLEASANT THOUGHTS

These negative thoughts and feelings tend to focus your attention on things you do not like about yourself or your life situation. As well as concentrating on your negative features and experiences, when you are depressed you tend to underestimate your positive characteristics and your ability to solve problems. A number of strategies may assist you to achieve a more balanced view of things:

  1. Make a list of your three best features – perhaps with the assistance of a friend or relative.  Carry the list with you and read it to yourself whenever you find yourself focusing on negative thoughts.
  2. Keep a daily record of all the small pleasant things that happen and discuss these events with your friends when you see them.
  3. Recall pleasant occasions in the past and plan pleasant occasions for the future (this may best be done in conversation with a friend).
  4. Consider alternative explanations for unpleasant events of thoughts. Although your initial explanation may be that you are at fault, rethink these conclusions and write down all other possible explanations for these events or thoughts.
  5. Keep yourself busy doing useful activities. Avoid sitting or lying about doing nothing.

WORRYING OR INEFFCTIVE THINKING

Put your worry to a useful purpose. Rather than endlessly pinpointing your problems, pick out one or two problems that seem really important and make a decision to resolve them.  You may like to ask a friend to assist you.

Sit down with a problem-solving sheet (your clinician can provide you with one) and go through the following steps:

  1. State exactly what the problem (or goal) is.
  2. List 5 or 6 possible solutions – write down any ideas that occur to you, not merely the ‘good’ ideas.
  3. Evaluate the good and bad points of each idea in turn.
  4. Choose the solution that best fits your needs.
  5. Plan exactly the steps you will take to put the solution into action.
  6. Review your efforts after attempting to carry out the plan. Praise all efforts. If unsuccessful, start again.

ANGER MANAGEMENT

  1. Accept responsibility for your level of anger.
  2. Learn to track your level of anger: what are the warning signs when you are becoming angry? (for example: raised voice, muscle tension, talking over others)
  3. When is anger a problem? Learn to identify people, places, times of day, situations that affect the level of your mood.
  4. If you find your level of anger is rising, you can gain control and lower the level by following certain steps:
  5. Take in a deep slow breath
  6. As you breathe out, relax your body
  7. Say to yourself ‘clear head, clear body’
  8. Mentally step back from the situations and smile to yourself
  9. Take a walk to remove yourself from the situation
  10. If you still feel angry remove yourself from the situation and focus on a pleasant activity or thought.

CONFLICT RESOLUTION

  1. Look for early warning signs of a developing argument.
  2. As soon as you see an argument is developing say: ‘Hold it, I’m getting angry. I would like to stop the discussion for a minute’. Then think through the following options:
    1. Would you be better off starting the discussion all over again?
    1. Are you (or someone else) too upset to continue sensibly now?  If so, walk away and make the time to come back to the issue at another time.

GENERAL STRATEGIES

  1. Exercise is very effective to lift mood – try to get out of the house and go out in the sunshine.  A short walk is very effective and will assist with other aspects of recovery.
  2. Listen to music.
  3. Try a Relaxation or mindfulness tape.
  4. Watch a comedy on the television, DVD or go out to a movie.
  5. Laughter is a great remedy.
  6. Seek the company of friends, focus on what they are doing in their lives and try not to dwell on your own issues.

REMEMBER: You are not alone

 Depression is an ILLNESS that is very common after Stroke. 

SEEK TREATMENT

If you had high blood pressure or a broken leg you would seek treatment, so discuss how you are feeling with your GP. There are very effective medications and therapies available for the treatment of depression.

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© Stroke Recovery Association NSW 2022

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