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Psychological rehabilitation after a stroke. Rehabilitation neurological center "Evexia". Ask other people for help

How can I help a person who has had a stroke? Olga Frolova, a medical psychologist at the Vladimir City Hospital No. 4, tells our readers about this as an expert.

- Olga Sergeevna, what role do relatives play in the rehabilitation of a patient after a stroke?

After medical assistance, the help of relatives and close people is urgently needed. It should be regular. It is important to help actively - to study, to restore lost skills. If a person cannot move his hand, then it is necessary to teach it again. The period after a stroke is especially acute for those who, before the illness, were engaged in vigorous activity or were in high positions. And after a stroke, sometimes even basic actions and skills become difficult. It happens that patients are unable to answer simple questions due to speech impairment. Sometimes, with a severe stroke, the character changes. Negative traits are more pronounced. No need to get angry, offended, shout at the patient. Especially if, for some reason, he does not want to respond to calls and perform simple exercises. You need to understand and accept his difficult psychological state. In order for a patient after a stroke to be able to feel love from their loved ones, it is necessary to pay more attention to him, give small assignments, show that he is needed. During this period, support and approval are very important: you could not do this a week ago, but now you are doing it. This strengthens the patient's belief that he is going in the right direction.

- Can patients fully recover?

It does not depend on the person, but on the severity and extent of the disease. Someone is recovering completely. It is necessary to help such patients first to relieve acute stress, and then to successfully rehabilitate. It is important to restore and train cognitive functions. Thinking speed, memory, attention. A person must necessarily engage in mental work, solve problems, learn poetry. Very often he has a fear of another stroke. Some are wondering whether to work further or quit? Work! If you feel normal and if there is such an opportunity. As soon as a person stops doing mental work, the entire cognitive sphere immediately decreases. It is imperative to follow all the recommendations of the doctors.

- Is a stroke associated with depression?

80% of stroke patients are depressed. They see themselves as a burden. Especially if the disease is severe, with paralysis, speech impairment. Although the stroke itself also causes sadness. The disease can affect those parts of the brain that are responsible for emotions, and this can be the reason for low mood, unwillingness to do anything. Psychological help is most often needed by both the patient and his relatives. The impetus for getting out of depression can be either psychotherapy or medication.

-How to improve your mood, relieve stress?

- Observe the regime of work and rest. 8-9 hours of sleep is required. Maintain a proper diet. To refuse from bad habits. Use music therapy and art therapy, auto-training, emotional and muscle relaxation. Daily walks in the fresh air help. Respiratory gymnastics is good, it is worth taking up a hobby - what a person likes. In general, to experience more positive emotions - someone will enjoy a bouquet of flowers, someone will enjoy a photo of their beloved granddaughter or cat.

Cardiologist

Higher education:

Cardiologist

Saratov State Medical University IN AND. Razumovsky (SSMU, media)

Education level - Specialist

Additional education:

"Emergency cardiology"

1990 - Ryazan Medical Institute named after academician I.P. Pavlova


The process of rehabilitation after an experienced stroke, along with somatic complications, is hampered by the disorder of cognitive functions, pathological emotional reactions of the patient to the consequences of the disease. For this reason, there is a need for psychological adaptation of patients who have undergone acute cerebrovascular accident. Full psychological rehabilitation of patients after stroke consists of several directions.

Intrapersonal correction

Complications after a stroke lead to deformation of mental processes and pathological changes in the patient's personality.

Post-stroke depression

Depressive states cannot be unambiguously explained by only one vascular lesion of the brain. At an early stage of recovery, a person's rejection of his new physical and mental appearance arises. The patient develops an acute sense of shame due to the emerging helplessness and forced dependence on others, there is a fear of possible disability, self-esteem falls. Characteristic personality traits are aggravated: apathy, tearfulness are possible, in others - outbursts of irritability, anger.

Realizing the length and complexity of treatment, patients often overestimate the severity of their condition and lose faith in their ability to recover. As a result, the motivation to be included in the rehabilitation process falls. As a result of the depression that has arisen, patients not only stop making personal efforts for the sake of recovery, but also reject the help of doctors and loved ones.

Psychological help

After a stroke, psychological correction is shown using the methods of humanistic psychotherapy. It is necessary to get the patient to accept his position, to take responsibility for restoring his health, to form a commitment to treatment. Acceptance of oneself occurs due to the acceptance of the patient in a new state by his micro-society: a psychologist, relatives, friends, medical personnel, members of a rehabilitation group.

Group sessions (art therapy, video therapy) help not only restore tactile sensitivity and motor skills, but also contribute to emotional uplift and meeting the need for communication.

The use of methods of body-oriented psychotherapy, special breathing exercises for relaxation help relieve muscle tension, restore coordination of movements and establish contact with your body.

Drug therapy

Unfortunately, depression after a stroke also develops as a result of certain medications (corticosteroids, tranquilizers, barbiturates, cardiac glycosides) prescribed for bodily recovery. In the case of a permanent depressed mental state of the patient, a correction of the course of drug therapy and the selection of antidepressants are required. Elderly patients are prescribed escitalopram. With moderate depression of the psychoemotional state and for the prevention of depressive disorder, it is recommended to take Tazodon, Paroxetine, Fluoxetine, Malnacipran.



Vascular dementia

It has been established that a stroke of the left hemisphere or several micro-strokes significantly increase the risk of dementia. The clinical manifestations of vascular dementia are very diverse and are determined by the localization of the lesion. Most often, the disease is diagnosed in elderly patients and is characterized by a decrease in memory and an increase in dementia. Psychological help for people with dementia is classes in art therapy, music therapy, aimed at improving memory, maintaining intellectual activity. Shows lessons in a group for the development of communicative potential.

Post-stroke psychosis

After a stroke, a regression of the victim's mental activity often occurs. Many functions of the psyche are temporarily lost, and inappropriate behavior arises. Excessive emotional excitement, immediacy, spontaneity, or, conversely, deceit, suspicion, aggressiveness, obsessions are noted. Most often, aggression is observed in elderly patients. The patient's closest circle of relatives and friends is not ready for such changes. The danger of this condition is that the patient can harm himself and others.

Psychosis, mainly in the form of hallucinations and delirium (delirium of jealousy, damage, poisoning, exposure is more often noted), remains a rare complication of stroke. It develops as a result of damage to certain areas of the brain. It can appear immediately after an ischemic attack with the formation of a pathological focus in the left hemisphere, or even after a year or more, if the focus is on the right. People with a history of mental health problems or a predisposition to them are more likely to develop psychosis after a stroke.

At an early stage of vascular psychosis, the condition can be controlled with drugs (atypical antipsychotics, anticonvulsants). The main thing is to timely detect a change in the personality of a loved one and seek help from a doctor (neurologist, psychiatrist). He will be able to assess the severity of the patient's condition and the amount of medical care required.

Interpersonal correction

As a result of the disease, the patient experiences a loss of previous social roles and a change in the nature of relationships with others. Therefore, a special target audience for the work of a psychologist is also the patient's relatives, who need to help build the right relationship with him, help understand his condition, and deal with their own experiences.

Formation of new life values ​​and meaning of life

In many patients, complications after a stroke provoke a decrease or complete loss of performance. There is a need for the premature termination of labor activity or its continuation in the changed conditions. The impossibility of realizing professional skills, the loss of the previous social status, the crisis of self-identity often lead to frustration. Therefore, patients need help in adapting to fatal

More than half of the inhabitants of Russia (53%) die due to diseases of the cardiovascular system: this is more than from all other causes combined. It is generally accepted that we are talking mainly about myocardial infarction, but this is not true: in 2 out of 5 cases, the culprit of death is a "vascular catastrophe" of the brain. According to statistics, every 1.5 minutes in Russia, someone has a stroke.

The insidiousness of a stroke is not only deadly. Up to 80% of survivors after acute blockage of a cerebral artery or cerebral hemorrhage become disabled, and a third of them require constant care. A serious problem in Russia is the rehabilitation of patients who have survived a stroke: only one in five is undergoing rehabilitation treatment aimed at returning to a full life.


Meanwhile, timely psychological rehabilitation according to the program, developed in accordance with the recommendations of experts in the field of rehabilitation therapy, allows to achieve a significant improvement in the patient's well-being, as well as to protect him from death due to complications of a stroke.

Research data show that one in two patients who have experienced an attack dies within a year after it, but treatment outside the home, in a specialized center, reduces the likelihood of a tragic outcome by half.

What is a stroke

The brain is without a doubt the most important organ of the human body, and it needs active nutrition and blood supply. Even such a phenomenon as fainting is "invented" by nature in order to ensure the flow of oxygen to the head - in a horizontal position.


The vessels of the brain, like the vessels of the whole organism, wear out with age: this may be due to atherosclerosis - the appearance of cholesterol plaques that narrow the lumen of the arteries - or hypertension. If the pathological process develops slowly, then it leads to a gradual deterioration in the functioning of the nervous system: therefore, many elderly people develop vascular dementia, in which there is a deterioration in memory, attention, intelligence, changes in character, and so on.


If, under certain circumstances, a vessel in the brain is clogged, compressed or ruptured, an acute disturbance of cerebral circulation occurs. This condition requires urgent medical attention, which is aimed at eliminating the consequences of an attack and can save the patient's life or reduce the degree of damage to the nervous system.


Unfortunately, it is impossible to help a person who has suffered a stroke at home. Therefore, it is so important to recognize the signs of this condition and deliver the patient to a specialized hospital as soon as possible.

Types of strokes

Depending on the mechanism of circulatory disorders, there are two main types of stroke:

  • Ischemic stroke . It develops when the lumen of a vessel is clogged with an atherosclerotic plaque, a thrombus (blood clot), an air bubble, and so on. Another possible cause of ischemic stroke is a sharp drop in blood pressure, in which blood does not flow to a specific area of ​​the brain. Strokes of this type are diagnosed in 80% of patients.
  • Hemorrhagic stroke. It usually develops as a result of a sharp jump in blood pressure, which leads to rupture of the cerebral vessel, followed by hemorrhage into the soft tissues of the brain or the space between its outer membranes. According to statistics, a hemorrhagic stroke often ends with the death of the patient: it requires emergency surgical care aimed at removing the hematoma that squeezes the brain.

What is a microstroke?

In some cases, impaired blood circulation in the brain is of a short-term nature and goes away on its own within 24 hours after the first symptoms of a stroke. Doctors call this condition a transient ischemic attack (TIA), but the term “microstroke” is popular among ordinary people.

Despite the fact that it does not threaten the patient's life and in most cases does not entail serious health consequences, a microstroke requires mandatory examination by a neurologist, treatment and rehabilitation: 10% of patients develop a “full-fledged” stroke in the next 90 days after TIA.

As a rule, an attack of cerebrovascular accident begins with a person's complaints about acute pain in the head. It is important to know the main symptoms of a stroke, which doctors, for convenience, have combined into the abbreviation BLOW:

  • U (smile): Ask the person you suspect of a stroke to smile. If, at the same time, the corner of the lip on one side remains lowered (or the whole face seems to be distorted), then this is a sign of a stroke.
  • D: movement the patient becomes asymmetrical - he cannot raise both arms or bend his legs synchronously, one limb lags behind or does not obey at all. Also, a person with a stroke often loses balance and falls to the ground.
  • A: articulation(the ability to pronounce words) is difficult for the patient, the tongue is braided like that of a drunk, sometimes he is not able to pronounce the simplest phrase, confuses syllables, stutters or hums.
  • R: solution must be taken immediately - if at least one of the above signs occurs, you must call an ambulance and call an intensive care team. Minutes are counted.

The consequences of strokes

Severe brain damage or delays in medical care kill one in three people with a stroke. The consequences of an attack on those who survived depend on several factors. The most significant of them are the extent of damage to the nervous system, the part of the brain in which the stroke occurred, the timeliness and quality of treatment.

For example, if the brain stem center, which is responsible for vital functions - respiration, heartbeat, thermoregulation and others - remains without oxygen, then the patient's life will hang by a thread.

In some other situations, the functions of the affected areas are taken over by other nerve centers, making it possible over time to compensate for all violations and return to a full life.

Is it possible to fully recover from a stroke?

Despite the scientific progress of recent decades in medicine, there are still many blank spots. And first of all, this applies to neurophysiology. Experienced doctors who treat patients after strokes avoid accurate predictions: in world practice, there are many cases when patients with signs of severe brain damage fully recovered their health. At the same time, alas, opposite stories are not uncommon - when a seemingly insignificant disturbance of nervous functions turned into disability, and even expensive drugs and procedures did not have a pronounced effect on the patient's condition.


Nevertheless, doctors note that the discipline of patients and their relatives, as well as an optimistic attitude, make it possible to achieve tangible results in recovery from a stroke - regardless of the diagnosis and statistical data. The desire to gain independence and restore lost functions, be it the ability to speak, strength and sensitivity in the legs and arms, vision, a firm gait without crutches and a cane sometimes works wonders. But it is also highly desirable to provide the patient with the necessary organizational and medical support aimed at preventing recurrent attacks and preventing possible complications and injuries. So, it is important that rehabilitation takes place in a comfortable and friendly environment, and relatives or medical workers monitor compliance with medical prescriptions, attendance at procedures, and monitor the performance of physical exercises.

Doctors assign a significant role in recovery from a stroke to psychological support of the patient: often people who have experienced an attack feel depressed due to the loss of their usual abilities.

This is noted in both elderly and young patients, and relatives are not always able to properly support a person, returning him interest in life and motivation to overcome the disease. An experienced psychologist will not only be able to find the right words, but also suggest effective practical ways to overcome depression.

How long does it take to recover from a stroke

Experts agree that it is optimal to start early rehabilitation activities, the duration of which should be from several weeks to a year. Most of the reversibly lost functions, as a rule, return to the patient during the first months after the attack; after the first half of the year, the progress of recovery slows down significantly, but does not stop. There are cases where certain skills - for example, speech, hearing or sensitivity of paralyzed limbs - returned to the patient several years after the stroke. To increase the chances of such an outcome, it is necessary to continue the wellness procedures even after the end of rehabilitation, as well as to take courses of supportive therapy from time to time.

Rehabilitation methods

Post-stroke rehabilitation is divided into four main areas:

  • Recovery of the motor system... Includes a variety of techniques to combat paralysis. These include massage, kinesiotherapy, physiotherapy exercises, restoration of walking skills, physiotherapy and occupational therapy - restoration of skills necessary in daily life.
  • Recovery of speech and memory... Within the framework of this direction, a speech therapist (with a specialization in aphasiology) works with the patient, who, with the help of special exercises, returns the patient's ability to speak clearly.
  • Restoration of pelvic functions... Since some patients after a stroke have urinary incontinence and problems with stools, a rehabilitation doctor prescribes medications and physiotherapy procedures that allow partially or completely restore the functioning of the genitourinary system and intestines.
  • Psychological recovery implies consultation with a psychologist, as well as activities aimed at the socialization of the patient. For people who have suffered a stroke, especially in old age, it is important not to be alone, to communicate with others, to have a hobby. Therefore, treatment courses in rehabilitation centers often include a cultural and leisure program.

Benefits of taking a course of psychological rehabilitation at the Three Sisters

Recovering from a stroke in modern rehabilitation centers is the most advanced method of care, which is much more effective than “home” treatment. After all, the patient's relatives, even if they sincerely want to help him, most often are not specialists in rehabilitation therapy and often themselves need training in the skills of caring for a person with disabilities.

Three Sisters is one of the best rehabilitation centers in Russia, where a friendly team of qualified doctors day after day helps tens and hundreds of patients recover from injuries, surgeries, strokes and chronic diseases. The clinic is located in an ecologically clean place in a pine forest near Moscow and is equipped for round-the-clock stay of patients of any severity. Doctors working in the Three Sisters are the authors of exclusive rehabilitation methods based on many years of experience with patients, and they also practice the most effective approaches to restorative treatment according to the world medical community, such as Bobath therapy, Exart method, PNF method. other.


Patients of the "Three Sisters" can undergo psychological rehabilitation courses without parting with their relatives - for this, the center provides conditions for a joint stay. At the service of patients: a restaurant, a gym, Internet access and a landscaped area for walking.


“Three Sisters” is rehabilitation not only with benefit, but also with comfort.


N. G. Ermakova

PERSONAL FEATURES OF PATIENTS WITH CONSEQUENCES OF STROKE UNDER STATIONARY REHABILITATION

Based on the study of the personality of patients in the recovery period of stroke, the dominant reactions of the personality to the disease in the form of depression, psychasthenia, autism, and anxiety were revealed. Identified personality traits that prevent the formation of an adequate attitude in the process of rehabilitation treatment: pessimism, impulsivity, suspicion, demonstrativeness, isolation. The analysis of the personality traits of the patients facilitated the choice of targets for psychological influence. The study involved 102 patients with the consequences of a stroke in a rehabilitation hospital.

PERSONAL CHARACTERISTICS OF PATIENTS AFTER STROKE IN THE MEDICAL REHABILITATION IN HOSPITAL

Personal characteristics in 102 patients after the stroke during medical rehabilitation in hospital have been studied. According to the research, the dominant reactions to the disease are depression, psychasthenia, social introversion and anxiety. Such personal characteristics as pessimism, impulsiveness, autism are obstacles for overcoming the disease and developing positive attitudes to the treatment. The research findings were used for identifying the targets of psychological therapy.

In recent decades, there has been an increase in the number of cerebral stroke diseases, which makes the rehabilitation of post-stroke patients an urgent medical and social problem, aimed at restoring impaired functions, returning the patient to society and to work that they can. In rehabilitation, along with drug therapy and methods of physical influence, psychosocial methods are of great importance, aimed at forming an adequate position of the patient in the process of treatment.

Of great importance is the formation of a positive psychological attitude of the patient to overcome the consequences of the disease, the attitude to long-term rehabilitation. The formation of a positive attitude is aimed at continuing to fulfill the doctor's prescriptions at home (regular medication, exercise physiotherapy exercises, self-care, a feasible load at home, walking), at improving the quality of life of patients and preventing recurrent stroke.

An important factor in the formation of an active orientation of the personality towards the restoration of impaired functions and health promotion is an adequate understanding of the patient about his illness, the internal picture of the disease. Along with organic factors (localization and volume of the lesion), psychosocial factors (age, gender), as well as the patient's personality traits, influence the formation of an attitude towards their disease in patients with the consequences of a stroke. As noted by Yu. A. Aleksandrovsky, the awareness of the disease and the formation of the patient's internal picture of the disease are influenced by:

Information about the symptoms of the disease;

Individual typological features;

Sociocultural and microsocial relationships;

Features of psychogenic response to "key" psychotrauma.

A sudden and serious illness is a mental trauma for the patient and is accompanied by neurotic, hypochondriacal, depressive reactions to the illness. In this regard, it is of great importance to study the personality traits of post-stroke patients and identify those of them that prevent the formation of a positive attitude towards treatment.

The aim of this work was to identify the personality characteristics of patients with the consequences of stroke and to study the participation of the patient's personality in the formation of a focus on treatment.

The study involved 102 patients from 38 to 65 years old; 81 men, 21 women; with the left hemispheric localization of the lesion - 58 patients, with the right hemispheric - 44; with mild hemi-paresis - 55; with moderate hemiparesis - 32; with severe hemiparesis - 15. Residual mild cognitive impairments were observed in 12 patients: in the form of violations of praxis (7 people); and with residual symptoms of dysarthria (5 patients).

In the course of rehabilitation treatment, a study of the attitude of patients to treatment and to the disease was carried out on a clinical five-point scale in the process of counseling and observation. The higher the score on the treatment attitude scale, the more the patient's responsibility for the outcome of treatment was noted. The higher the score on the scale of attitudes toward the disease, the more pronounced the patient was

assessment of the disease. The quality of life was assessed on a five-point scale; self-service level assessment: Barthel scale, FIM scale. For the study of personality, the Minnesota multidisciplinary personality questionnaire was used - the MMP1 scale; as well as the Spielberger-Khanin scale of personal and reactive anxiety. A comparative analysis of the mean values ​​of the indicators of men and women, as well as of patients with left hemispheric and right hemispheric localization of the lesion was carried out using Student's t test, and a correlation analysis of the study results was carried out.

All patients received complex rehabilitation treatment in the inpatient rehabilitation center of the city hospital No. 40 of the Kurortny district of St. Petersburg in 1999-2005. In the process of inpatient rehabilitation, patients received physiotherapy exercises, physiotherapy, psychotherapy, if necessary, they were engaged in a household rehabilitation room; speech therapy assistance. With all patients who took part in the study, an orientation conversation (two or three meetings) was conducted, aimed at studying the emotional state; to study the patient's attitudes in relation to the disease and treatment; in relation to the healing and life perspective. Symptomatically oriented, cognitive-behavioral psychotherapy was used. Cognitive psychotherapy was applied individually and in a group and was aimed at researching and correcting irrational attitudes, Behavioral psychotherapy was carried out in a group and was aimed at mastering the techniques of self-regulation and emotional stabilization (autogenous

naya training, thematic meditation).

In a comparative analysis of the results, the assessment of the quality of life in women is higher than in men, although it is not significant (3.21 and 3.09) (Table 1). Both women and men showed similar indicators of attitudes towards illness (3.38 and 3.36) and towards treatment (2.52 and 2.58), which reflects an unexpressed tendency to overestimate the severity of the condition, as well as to accept responsibility. on himself for the outcome of treatment. In women, the indicators of self-service scales are slightly higher, which indicates a greater functional and domestic adaptability of women [Barthel scale (85.24 and 82.24) and FIM scale (94.57 and 91.14)]. On the FIM scale, the indicators in women are significantly higher, which reflects their greater ability in terms of the indicator of communication, which is included in this scale.

According to the results of the study of the personality characteristics of patients using the MMP1 technique, in the group as a whole, there is an increase in indicators 2 and 1 of the scale, as well as in indicator 8 of the MMP1 scale, which can be regarded as an indicator of depressive experience of the consequences of the disease (G. Welsh code 21 "83674 / 590-LFK / ...).

When comparing the indicators of men and women, the following differences are observed: women (n = 21) compared with men (n = 81) have significant increases on the F scale (58.91 ± 12.17 and 52.68 ± 11.64; p< 0,05), что свидетельствует о большей внутренней напряженности женщин, недовольстве ситуацией (табл. 1). Повышение по 6-й шкале также значимо выше у женщин (70,33 ± 11,17 и 61,46 ±9,64; p <0,001), что характеризуется более выраженным у женщин наличием «сверхценных» идей, подозрительности, паранойяльных

reactions; tendency to get stuck on negative experiences, affective saturation of experiences, sthenic type of response. Differences are also noted on other scales, although not significant. According to the 7th scale of psychasthenia - 66.91 ± 13.35 in women and 62.36 ± 11.29 in men, which indicates a greater suspiciousness, fearfulness and anxiety in women.

In women, there is an increase in the 4th scale (66.09 ± 12.65 and 61.76 ± 11.14 in men), which indicates a greater impulsivity in women. The third scale MMP1 (hysteria) is also higher in women (67.47 ± 14.42 and 64.97 ± 10.63 in men) and indicates a greater emotional instability in women.

Scale 9 (social introversion) is also higher in women (59.09 ± 7.44) than in men (55.83 ± 8.49). The higher the score, the more the orientation to the world of subjective experiences and the less the orientation to the world of the real environment.

High indicators on the 8th scale in women (70.29 ± 14.29) and in men (69.01 ± 11.75) indicate autism, immersion in their problems in both men and women. The combination with a high 6th MMP1 scale in women (70.33 ± 11.17) and in men (61.46 ± 9.64) with the leading second and first scales indicates an autistic, affectively saturated experience of their defect as both men and women. 2nd scale (depression): 73.86 ± 13.39 in women and 74.77 ± 12.11 in men; and 1st scale (hypochondria): 72.14 ± 13.96 in women and 72.25 ± 14.82 in men.

Male profile ММР1, coded according to G. Welsh - 21 "83764-590 / LFK /;

The female profile, coded according to G. Welsh - 2168 "374-509 / FLK /.

The indicators of the Spielberger-Khanin scale in men and women are similar and quite high. Reactive anxiety: in women - 50.76 ± 5.02 and in men - 50.43 ± 6.11; personal anxiety: in women - 48.52 ± 4.52; in men - 48.62 ± 5.54. The dominance of reactive anxiety is observed.

In women, the indicators of anxiety on the Taylor scale are significantly higher: 19.71 ± 6.94 and in men 15.38 ± 6.62 (Table 1).

Thus, compared to men, women have significantly more pronounced internal tension, suspicion, a tendency to form overvalued ideas and anxiety. Women also have higher rates of impulsivity, emotional instability and immersion in subjective experiences.

When comparing the indicators of patients with right-hemispheric and left-hemispheric localizations of the lesion in right-hemispheric patients, the indicators of the quality of life are slightly higher, although not significant, which is largely due to the preserved function of the leading right hand (3.14 and 3.09) (Table 2 ). In relation to the disease (3.41 and 3.22) and to treatment (2.62 and 2.53) in the right hemispheric patients, on average in the group, the indicators are slightly higher than in the left hemispheric patients, although not significantly. This reflects a slightly greater overestimation of the severity of the condition in right hemispheric patients. On self-service scales, the Barthel score is higher in left hemispheric patients (82.98 and 83.64), which indicates their greater functional adaptability. On the FIM scale (in which the indicator of communication is included), the score is higher in right hemispheric patients (92.71 and 91.14) with preserved speech function.

Comparative analysis of personality indicators of women (21) and men (81) with the consequences of stroke

Feature name Women (21) Men (81) TR

Quality of life 3.21 ± 0.41 3.09 ± 0.38 0.28 0.779

Attitude to the disease 3.38 ± 0.56 3.36 ± 0.53 0.148 0.882

Attitude towards treatment 2.52 ± 0.72 2.58 ± 0.69 -0.329 0.743

Bartel's scale 85.24 ± 5.73 82.84 ± 6.31 1.78 0.078

FIM scale 94.57 ± 5.01 91.14 ± 5.13 2.739 0.0073 **

Reactive anxiety 50.76 ± 5.02 50.43 ± 6.11 0.228 0.821

Personal anxiety 48.52 ± 4.52 48.62 ± 5.54 -0.081 0.935

Insincerity scale ММР1 (b) 58.62 ± 11.48 59.57 ± 9.91 -0.378 0.706

Significance scale MMP1 (B) 58.91 ± 12.17 52.68 ± 11.67 2.159 0.033 *

MMP1 correction scale (K) 50.67 ± 9.76 50.43 ± 9.54 0.099 0.92

MMP1 hypochondria scale No. (1) 72.14 ± 13.96 72.25 ± 14.82 -0.029 0.976

MMP1 depression scale B (2) 73.86 ± 13.39 74.77 ± 12.11 -0.299 0.765

Hysteria scale ММР1 Well (3) 67.47 ± 14.42 64.97 ± 10.63 0.889 0.375

Psychopathy scale MMP1 Pd (4) 66.09 ± 12.65 61.76 ± 11.14 1.543 0.125

Masculinity-femininity scale MMR1 MG (5) 59.95 ± 12.41 58.85 ± 8.13 0.491 0.624

Paranoia scale MMP1 Ra (6) 70.33 ± 11.17 61.46 ± 9.64 3.638 0.0004 ***

Psychasthenia scale ММР1 Р1 (7) 66.91 ± 13.35 62.36 ± 11.29 1.582 0.116

Schizophrenia scale MMP1 Fe (8) 70.29 ± 14.29 69.01 ± 11.75 0.426 0.671

Hypomania scale MMP1 Ma (9) 57.14 ± 10.48 57.91 ± 10.16 -0.302 0.763

Social introversion scale ММР1 (0) 59.09 ± 7.44 55.83 ± 8.49 1.608 0.111

Taylor scale (at) 19.71 ± 6.94 15.38 ± 6.62 2.64 0.009 **

Note. The sign "*" marks the reliability of the differences< 0,05; знаком «**» - достоверность р < 0,01; знаком «***» - достоверностьр <0,001.

When comparing the personal characteristics of patients with the left hemispheric localization of the lesion and the right hemispheric localization of the lesion, the following picture is observed. Patients with a lesion in the right hemisphere (n = 44) have higher indicators on the MMP1 hypochondria scale (75.23 ± 15.17) than in patients with left hemisphere localization (n = 58) (69.95 ± 13.82 ), although not significantly (Table 2). In patients with the localization of the lesion in the right hemisphere, the indicators for the 8th

scale (70.09 ± 13.45) than in patients with the left hemispheric localization of the lesion (68.64 ± 11.35), while the indicators on the scale 2 (depression) are equally high in the right hemispheric (75.05 ± 12 , 57) and in left hemispheric patients (74.22 ± 12.23) (code coded according to G. Welsh, in right hemispheric patients 128 "36745-90 / LF / K: in left hemispheric patients - 2" 183746-590 / LFK /. Right hemispheric patients also have higher indices on the Taylor anxiety scale, although not significantly (17.34 ± 6.72 and 15.47 ± 6.95).

Comparative analysis of personality indicators of patients with left hemispheric (58) and right hemispheric (44) localization of the lesion

Feature name Right hemispherical (44) Left hemispherical (58) T R

Quality of life 3.14 ± 0.37 3.09 ± 0.38 0.691 0.491

Attitude to the disease 3.41 ± 0.79 3.32 ± 0.55 0.652 0.515

Attitude towards treatment 2.62 ± 0.67 2.53 ± 0.69 0.662 0.509

Bartel's scale 82.98 ± 5.75 83.64 ± 5.81 -0.587 0.556

FIM scale 92.72 ± 5.98 91.14 ± 5.01 1.489 0.139

Reactive anxiety 50.84 ± 5.03 50.36 ± 6.09 0.223 0.726

Personal anxiety 48.69 ± 4.37 48.56 ± 5.52 0.061 0.931

Insincerity scale ММР1 (b) 59.09 ± 11.36 59.59 ± 9.32 -0.241 0.809

Significance scale MMP1 (B) 54.77 ± 12.36 53.34 ± 11.76 0.594 0.553

MMP1 correction scale (K) 49.32 ± 10.01 51.36 ± 9.17 -1.072 0.286

MMP1 hypochondria scale No. (1) 75.23 ± 15.17 69.95 ± 13.82 1.832 0.069

MMP1 depression scale B (2) 75.05 ± 12.57 74.22 ± 12.23 0.331 0.741

Hysteria scale ММР1 Well (3) 66.16 ± 10.98 64.47 ± 11.82 1.036 0.303

Psychopathy scale MMP1 Pd (4) 63.16 ± 12.54 62.28 ± 10.81 0.381 0.704

Masculinity-femininity scale MMR1 MG (5) 60.09 ± 9.11 58.31 ± 9.12 0.977 0.331

Paranoia scale MMP1 Ra (6) 64.82 ± 10.15 62.12 ± 10.78 1.283 0.202

Psychasthenia scale ММР1 Р1 (7) 64.34 ± 11.03 62.51 ± 12.43 0.777 0.438

Schizophrenia scale MMP1 Fe (8) 70.09 ± 13.45 68.64 ± 11.35 0.591 0.556

Hypomania scale MMP1 Ma (9) 58.07 ± 9.95 57.51 ± 10.42 0.278 0.781

Social introversion scale ММР1 (0) 56.27 ± 8.36 56.67 ± 8.43 -0.238 0.812

Taylor scale 17.34 ± 6.72 15.47 ± 6.95 1.371 0.174

Note. No significant differences were found.

Thus, in right-hemisphere patients, there is a more pronounced hypochondria, anxiety about their illness and associated physical limitations and consequences, than in patients with the localization of the lesion in the left hemisphere. Despite the fact that in patients with localization of the lesion in the right hemisphere, left-sided hemiparesis is observed, that is, the function of the left, non-dominant hand suffers.

Correlation analysis results

The correlation matrix makes it possible to single out several correlation pleiades (r> 0.40); R<0, 01:

1st correlation pleiad. Psychasthenia - the 7th scale ММР1 has the greatest (9) number of connections with other indicators: 1) 8th scale ММР1 +0.71; 2) Taylor's anxiety scale +0.64; 3) 2nd scale (depression) MMP1 +0.55; 4) 6th scale of paranoia ММР1 +0.50; 5) 3rd scale

la hysteria MMP1 +0.50; 6) 1st scale of MMP hypochondria! +0.49; 7) F-scale MMR! +0.49; 8) 4th scale of MMP psychopathy! +0.45; 9) Spiel-berger reactive alarm +0.45;

2nd correlation pleiad. Anxiety (Taylor's scale of anxiety) has 8 connections (r> 0.40): 1) 7th scale (psychasthenia) MMP! +0.61; 2) K-scale MMR! -0.54; 3) F-scale MMR! +0.54; 4) 2nd scale of MMP depression! +0.52; 5) Spielberger's reactive anxiety +0.54; 6) 6th scale of MMR paranoia! +0.49; 7) 4th scale of MMP psychopathy! +0.43; 8) Spielberger's personal anxiety +0.41;

3rd correlation pleiad. Autisticness of experiences (8th scale of MMR!) Has 8 connections (r> 0.40): 1) 7th scale of psychasthenia MMR! +0.71; 2) 4th scale of psychopathy MMP! - +0.61; 3) F-scale MMR! +0.61; 4) 2nd scale of MMP depression! +0.48; 5) Taylor's anxiety scale +0.46; 6) 3rd scale of MMR hysteria! +0.46;

7) 1st scale of MMP hypochondria! + 0.45;

8) 6th scale of MMR paranoia! +0.40;

4th correlation pleiad. Depression (2nd scale MMR!) Has 7 connections (r> 0.40): 1) 3rd scale (hysteria) MMR! +0.57; 2) 1st scale (hypochondria) MMR! +0.53; 3) 7th scale (psychasthenia) MMR! +0.55; 4) Taylor's anxiety scale +0.52;

5) 8th scale of schizophrenia MMP! +0.48;

6) attitude to the disease (overestimation of the severity of the condition) +0.47; 7) Spielberger's reactive anxiety +0.43.

In the 1st correlation pleiad - psychasthenia - the 7th MMR scale! (weakness, weakness) - there is a high positive correlation with the 8 MMR scale! (autistic experiences). The patients' immersion in their problems, the difficulty of comprehending and processing them is combined with a depressive reaction to the situation (2nd scale of MMP!) And is aggravated (6th scale of MMP!)

on their feelings, suspicion, up to the formation of irrational, paranoid ideas.

In the first months after the illness, patients make attempts to understand the causes of the onset of the disease and investigate, first of all, external factors of influence and influence. Among the objective reasons, long-term chronic stress is often distinguished: illness of relatives and caring for them; death of close relatives; material losses; protracted conflicts in the family and at work, intensification of labor. In a number of cases, subjectively distorted and mystically colored reasons were considered (revenge of enemies, envious, offended). The role of such risk factors as internal predisposition to the disease (hypertension, heart disease, diabetes), as well as the influence of lifestyle, bad habits (overeating, smoking, alcohol) were less susceptible to analysis by patients.

2nd correlation pleiad - alarms a. The Taylor anxiety scale score is closely related to the 7 MMR scale! - psychasthenia (states of uselessness, defenselessness). A negative correlation with the K-scale and a positive one with the F-scale of the MMP testifies to the feeling of defenselessness! in combination with the 2nd scale of depression. According to our clinical observations, the cause of anxiety at the first stage of the disease is associated with an indistinct idea of ​​patients about their disease, its causes, the prospects for cure, about the possibilities of restoring functions and controlling their condition, about the medical and life perspective.

The 3rd correlational pleiad - autistic experiences - also has many connections, and above all with psychosthenia.

(7th scale) and 4th scale (psychopathy), depression (2nd scale) and hysteria (3rd scale). Difficulties in experiencing prolonged somatic hardships, physical suffering and inconvenience, difficulty in movement and in self-care, rapid fatigue, the need for prolonged exercises to restore movements - all this led in a number of cases to impulsive discharges, to protest, demonstrative behavior, to the refusal of patients from procedures. The feeling of hopelessness arising in this case intensified the depressive background, aggravated it with an alarming coloration. Episodes of impulsive discharge in the behavior of patients were often associated with a lack of faith in treatment, with insufficient awareness of the patient about a long period of the recovery process, as well as with an inability to recognize and accept their feelings and inform others about them. Alexithymia was aggravated by the irrational attitude that "one must endure one's pain and experiences and be silent," which was more often noted in men. On the part of relatives, there was often a lack of emotional support and sympathy, or excessive manipulation of the patient.

4th correlation pleiad - depression. The 2nd scale of depression MMP1 - positively correlates with the 3rd scale of hysteria, 1st scale of hypochondria and 7th scale of psychasthenia MMP1.

Hypochondriacal fixation on the situation, distancing oneself from others were observed in combination with demonstrativeness, exclusivity (“I have a special illness”) and led to an overestimation of the severity of the condition and to a feeling of hopelessness. In this case, partnership relations with staff were difficult to form; patients were observed

the difficulty of actualizing the mature "I" of the personality, aimed at coping with the disease.

Often, hypochondriasis and helplessness were induced by the anxious-depressive mood of the patient's relative.

In the process of complex rehabilitation in the hospital, the patients underwent cognitive and behavioral psychotherapy, individually and in a group aimed at researching and correcting irrational attitudes; correction of the internal picture of the disease; on the formation of an optimistic healing and life perspective. The analysis of the personality traits of patients, the study of attitudes towards the disease, treatment and life perspective made it possible to choose a targeted psychotherapeutic effect on the problem. In the case of inadequate beliefs of patients in their helplessness before the disease, giving rise to depression and anxiety, information and emotional support were used. Informing patients about the causes and consequences of the disease was carried out by the attending physician-neuropathologist in the process of rational (explanatory) psychotherapy during conversations with patients individually and in the ward. In the process of conducting rational psychotherapy by the attending physician, the patients were also informed about the methods and techniques that the patients themselves can carry out to restore the impaired functions. Patients were encouraged to repeat exercise therapy exercises on their own, in the afternoon; to perform therapeutic walking; to diet; to the regular intake of medications and procedures. An explanation of the possibility of preventing

rotation of recurrent disease. This encouraging information received from an authority figure by the patients greatly contributed to the formation of hope of recovery and a positive treatment outlook.

The provision of emotional support, as well as the correction of dysfunctional attitudes of patients was carried out by a medical psychologist in the process of psychotherapy, taking into account the characteristics of the patient's personality.

In the case of an autistic experience of the disease, difficulties in understanding and accepting their feelings by the patients were revealed. Classes were conducted aimed at developing the skills of emotional identification and response. With depressive attitudes of the patient, hypochondria, lack of faith in recovery, individually and in a group, work was carried out aimed at increasing the resources of the adult "I" of the patient himself.

In the context of inpatient rehabilitation, there was a difference in the nature of communication between women and men. In women's wards, the topic of discussion, as a rule, was the problems associated with illness and health, with its change in connection with procedures, with atmospheric pressure, with relations in the ward and, to a lesser extent, other, non-medical topics (discussion of biographies of actors , movie stars and showbiz). In the men's wards, after a brief discussion of the medical history of a newly arrived neighbor, the content of communication was mainly focused not on medical, but on other topics: professional occupations, problems of the state structure and the economy, the success of sports teams, especially fishing.

The fact of communication in the wards is of a positive psychotherapeutic nature

and is, in fact, a therapy environment. The factor of therapy by the collective of the ward in a rehabilitation hospital unlocks the autistic identification with the image "I am a seriously ill patient" and connects it with the general group collective image: "I am recovering my strength." In a collective way, the idea of ​​the disease, of the prospects for recovery reflect an optimistic prognosis of the therapeutic and life prospects of the therapeutic environment of the rehabilitation department. A weak “I am sick” through identification with others is replaced by a strong “We are recovering” and forms a new, individual, optimistic image of “I am a recovering”.

It should be noted that women are more successful than men in rebuilding and changing cognitive and behavioral styles in relation to themselves ("I will love myself more, I will rest more") and to others ("as my children want, so let them live") (“I’m guilty myself, I took too much on myself,” “I thought that I wouldn’t be demolished,” etc.).

Joint participation in a group of women and men, discussion of attitudes was a teaching factor for both men and women.The positive attitude of women towards treatment, with patience and hope, was an inspiring example for men, while a philosophical attitude towards the life goals of men was important food for thought for women.

Patients with the right hemispheric localization of the lesion focus were characterized by greater hypochondriasis, passivity, anxiety; irrational attitudes about healing and illness. Correction of maladaptive settings

The wok was performed individually and in a group. Joint participation in a group of patients with left hemispheric and right hemispheric localization of the lesion, discussion of attitudes towards treatment and disease was a teaching factor for right hemispheric patients. Patience, diligence and more active participation in the treatment of left-hemispheric patients gave visible results (improved walking, increased range of motion), strengthened their faith in a cure and inspired hope in other patients.

When studying the characteristics of the personality of patients in the recovery period of stroke, the dominant reactions of the personality to the disease were distinguished: psychasthenia, depression, autistic experiences and anxiety. Depression significantly reduces the success of the rehabilitation process, as noted by many authors.

According to our observations, personality traits such as demonstrativeness, impulsiveness, suspicion and a tendency to be fixed on the problem; pessimism and autistic experience of their problems hinder the development of an adequate attitude to the disease and to treatment. A number of authors note alexithymia in vascular patients as a difficulty in expressing their feelings and experiences.

The same personality traits as optimism, willingness to take responsibility for oneself, patience, self-sufficiency, according to our observations, contributed to the formation of a positive attitude towards rehabilitation treatment, active participation in its process.

In patients with the consequences of a stroke, during the recovery period, the attitude towards the disease is reworked. Feelings of helplessness and defenselessness

ness arising at the stage of early rehabilitation are replaced by a search for the guilty ones, including their own guilt, and then their own responsibility for their illness and for their health.

Psychotherapeutic work was aimed at researching and correcting irrational attitudes, at correcting the internal picture, at forming a positive medical and life perspective. Of great importance in the formation of compliance, as well as in the correction of the internal picture of the disease and in the prevention of recurrent stroke, is the formation of patients' attitudes towards the active participation of the patient himself in the treatment process.

Irrational cognitive and behavioral attitudes of the individual in relation to himself and the world were identified and corrected in the process of psychotherapy individually and in a group. The personality traits of the patients revealed in the process of the study contributed to the most purposeful choice of the psychotherapeutic strategy.

As a result of the study of the personality of patients in the recovery period of stroke, psychological reactions to a traumatic situation (sudden severe illness) - depression, psychasthenia, autistic feelings, anxiety - were revealed. The mechanisms of processing the situation, as well as the personality traits of patients, which hinder the acceptance of an adequate role in the treatment process: demonstrativeness, impulsiveness, suspicion, isolation, pessimism were revealed. Based on observations, personality traits were identified that contribute to the formation of a positive attitude towards rehabilitation treatment:

optimism, willingness to take responsibility for the outcome of treatment on oneself, patience, self-sufficiency. The analysis of the personality traits of patients, the study and comparison of attitudes (in relation to treatment, to the disease, and to the life perspective) contributed to the choice of targets for psychological influence.

Psychotherapeutic measures in the process of complex inpatient rehabilitation of post-stroke patients were aimed at active inclusion of patients in the process of rehabilitation treatment, at the formation of an adequate internal picture of the disease, at the formation of a positive medical and life perspective.

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The content of the article:

Post-stroke depression is a condition due to which a person can completely lose the taste for life, stop fighting for himself. The voiced problem occurs due to the fact that the patient is injured not only physically, but also emotionally. Based on the relevance of the sounded factor, it is worth understanding some aspects of its development.

What is post-stroke depression

Post-stroke depression (PID) is a common complication after such damage to the body and impaired circulation in the brain. More than a third of people who have suffered a stroke experience this mental pathology in the future. The development of this disease depends on many reasons, among which social and cognitive factors are leading.

Emotional disorder in the form of PID occurs after a stroke focus on neurotransmitters located in the brain. Further, due to the lack of emotion mediators in the form of norepinephrine and serotonin, post-stroke depression starts to start.

For some people, it is expressed exclusively in minor emotional instability, which is easily corrected. However, after the tragedy that happened to them, most of the victims are very acutely aware of all the manifestations of PID.

Causes of Post-Stroke Depression


As life practice shows, out of the blue, not a single problem arises. After long research and observation, experts have identified the factors provoking the occurrence of post-stroke depression as follows:
  • An unstable emotional state in the past... There is a specific type of people who are already initially predisposed to being constantly under stress. Consequently, such a serious situation as a stroke, only exacerbates the emotional instability of the patient.
  • Acute reaction to what happened... After partial or complete loss of professional and everyday skills, the likelihood of post-stroke depression increases. The patient develops a feeling of his own helplessness, which has an extremely negative effect on his psychological state.
  • Severe consequences of a stroke... If the focus of the disease has covered the left side of the human body, then the likelihood of PID increases. In addition, it should be noted the localization of the center of the lesion in the optic tubercle and basal ganglia, which also leads to the likelihood of developing a stress state in the patient.
  • Oxygen starvation of the brain... As already mentioned, the focus of a stroke has an extremely negative effect on the blood supply to this human organ. Consequently, the access of oxygen to the brain becomes problematic, which leads to a depressed emotional state.
  • Lack of support from loved ones... The trouble is easier to endure only when there are loyal and attentive people nearby. In some cases, relatives perceive a family member after a stroke as a burden, which has an extremely negative effect on his psyche.
The listed reasons for PID have both physical sources of education and emotional factors provoking the problem. In most cases, the onset of post-stroke depression is complex in nature, so you should not ignore the first warning bells, harbingers of impending disaster.

The main signs of post-stroke depression in humans


In this case, it is very difficult to give a clear definition of the current problem, because sometimes it has a rather hidden picture of pathological dynamics. However, according to some signs, you can easily identify a person who has post-stroke depression:
  1. Emotional instability... A similar violation is expressed in a person with a voiced problem in the form of a constant feeling of depression and unwillingness to perceive any pleasures of life. To this state is added a systematic premonition of impending disaster and general discomfort in the perception of reality.
  2. Behavioral changes... In post-stroke depression, deviation from the norm begins with a lack of initiative in the affected person with a pronounced unwillingness to further rehabilitation. As a result, the patient becomes irritable at times before the manifestation of aggression towards the close environment. It is expressed in motor restlessness, depending on the degree of damage to the body.
  3. Somatic deformities... Patients diagnosed with post-stroke depression quite often experience so-called “wandering” symptoms throughout the body, which cause pain. All this can be accompanied by asthenic syndrome and a feeling of discomfort in the chest due to lack of oxygen.
  4. The cognitive dissonance... Slow and difficult thinking is often the result of the sounded factor. At the same time, after a stroke, a person's concentration of attention decreases and a negative attitude towards society appears.

Features of the treatment of depression after a stroke

It is necessary to get rid of this condition unequivocally, because it has rather serious consequences. It is strictly forbidden to prescribe treatment based on data from the Internet and advice from friends, because we are talking about a serious psychological disorder.

Treatment of post-stroke depression with medications


At the first signs of the problem voiced, it is necessary to urgently consult a specialist. Treatment of post-stroke emotional disorders is challenging and may involve the following medications:
  • Antidepressants... As already mentioned, the lesion focus negatively affects the accumulation of norepinephrine and serotonin in the victim's body. Therefore, it is necessary at all costs to make up for the lack of sounded substances. This will help drugs such as Cipramil, Sertraline and Paroxetine. These funds belong to the group of balanced antidepressants. Moclobemide, Fluoxetine and Nortriptyline will also be salvation in the voiced problem. These drugs are classified as activating antidepressants. Mirtazapine, Fevarin and Agomelatine significantly reduce intellectual (cognitive) impairment after a stroke. They belong to the group of sedative antidepressants, and they should be taken exclusively as prescribed by a specialist.
  • Atypical antipsychotics... Emotional disorder after a stroke is eradicated with the help of sounded drugs. A typical subset of these medications can cause Parkinsonian complications. As a result, the capabilities of the human motor apparatus are significantly limited. Quetiapine, Clozapine, Ziprasidone, Peritsiazine and Olanzapine can help solve the problem of post-stroke depression without any complications. The usual term for taking these drugs is 6 months.
  • Psychostimulants... They can be prescribed by a doctor in combination with antidepressants. Social alertness, apathy and loss of interest in life are perfectly treated in this case with the help of Deoxinate, Ritalin, Focalin and Provigil. They must be used with great care and only as prescribed by a doctor, because they can cause mental dependence and even provoke stimulatory psychosis.

Treatment of depression after a stroke without medication


When treating post-stroke depression, medications can be dispensed with. To do this, you can use the techniques of psychotherapy, folk remedies, remedial gymnastics and massage.

Let's take a look at popular ways to help get rid of depression:

  1. Psychotherapy... It can be carried out both in groups and in personal contact with a specialist. This method of dealing with mental illness is definitely not a substitute for drug therapy. However, in the form of accompanying measures, when striving to find a life without stress, it will do just fine. The relatives and friends of the victim need to approach the choice of a specialist with great responsibility. He must have experience working with such patients who then found positive dynamics after sessions with a psychotherapist.
  2. Folk remedies... In addition to antidepressants, you can try to relieve stress after a stroke using recipes that have been proven for centuries. Angelica infusion has proven itself excellently, in which the roots are the most healing. Two tablespoons of crushed raw materials for 0.5 liters of boiling water must be insisted for an hour. Then you need to drink the resulting elixir of vigor every 6 hours (4 doses per day). Mint, lemon balm, cucumber herb, hops, chamomile and valerian root are also useful in the treatment of post-stroke depression at home.
  3. Patient massage... The natural way to tone the whole organism has always been the sounding remedy. Many rehabilitation centers offer their services under this plan. You can resort to the help of a massage therapist who will come to the patient's home. However, in this case, you must first inquire about the experience of the specialist and the recommendations available to him.
  4. Transcranial stimulation technique... Science does not stand still, so this progressive method of dealing with post-stroke depression began to be widely popular. The sounded procedure is that a weak current is directed to the victim's brain. Such manipulation irritates the motor cortex of the brain, triggering the patient's emotions in the future.
  5. Physiotherapy... The path of recovery from a stroke is never an easy and painless process. However, even at home, it is realistic to perform special exercises on a daily basis, which were advised by a specialist. As a result, the patient will have an incentive that will not allow starting the mechanism of the described mental illness.

Note! These methods of dealing with the disease after a stroke are quite simple and do not require significant material costs. However, in most cases, the use of antidepressants and antipsychotics is still indispensable.

Rules of conduct with a person with depression after a stroke


We present to your attention recommendations for handling a person with post-stroke depression:
  • Healthy microclimate in the family... Clarification of relationships in a circle of loved ones during this period is simply inappropriate, because it can only aggravate the post-stroke depression in the patient. It is necessary to bury the "hatchet of war" once and for all when there is an injured person in the family. If there is an urgent need to enter into a conflict with relatives, this should be done outside the home walls and not in the presence of the patient after a stroke.
  • Behavior according to the scheme "you are not a burden"... Of course, both a stroke and a microstroke make significant adjustments to the life of the victim's family. He begins to painfully feel his limitations in many issues, while considering himself an inferior person. It is necessary to coordinate the life of the victim so that he can do things that are feasible and not burdensome for him.
  • Organization of full-fledged communication... You cannot close yourself in four walls when a loved one has a stroke. There is no need to be afraid of visitors who want to communicate with the victim. Communication with familiar people will help to avoid the development of post-stroke depression.
  • Maximum care... When organizing the life of a patient, it should be remembered that he was seriously injured both physically and mentally. A stroke is not the flu, in which it is enough to take antibiotics and stay in bed. Therefore, without going to extremes in the form of overprotectiveness, it is necessary to surround the victim with maximum attention.
How to get rid of post-stroke depression - watch the video:


Post-stroke depression is a factor that should alarm all family members of the victim. The close circle is able to get rid of the voiced problem if you make every effort to do so. You need to take care of your loved ones, because their psychological state after a stroke inflicted by fate can significantly complicate rehabilitation after a stroke.