Although stroke effects are unpredictable, mood disorders such as depression, anxiety and pseudo-bulbar affect are all too common. Studies suggest that simply having a stroke increases the risk of anxiety, depression or both. Research indicates that PBA is more common in survivors of brainstem stroke, but it can occur with other types of strokes too. Depression affects between one- and two-thirds of stroke survivors. It's characterized by feelings of overarching sadness, lack of pleasure in old activities or changes in eating and sleeping patterns. Anxiety occurs when a survivor focuses on worries and concerns. Anxiety affects about 20 percent of survivors. PBA is characterized by a mismatch between feelings and expression, like laughing at a funeral or crying at a joke.
It's not uncommon for survivors to experience all three mood disorders. The good news is that treatment is available. For depression and anxiety, one of the best treatments is counseling or therapy with a licensed mental health practitioner. Caregivers should encourage their loved ones to get assessed. If they're reluctant to see a mental health professional, they might be willing to see a pastor, priest or rabbi.
Here is a short breakdown of possible therapeutic approaches:
Solution Focused Therapy
SFT is future-focused and goal-directed, and centers on solutions instead of the problems that bring people to therapy. It’s also called Solution Focused Brief Therapy and Solution Building Practice Therapy.
Problem Solving Therapy
PST is a brief psychological intervention or “talking therapy” that’s typically four to eight sessions. Problems are identified through collaboration, and the therapist teaches the person a structured approach to solving them.
Cognitive Behavioral Therapy
CBT focuses on examining the relationships between thoughts, feelings and behavior. By exploring thought patterns that lead to self-destructive actions and the beliefs that direct them. The therapist and individual actively work together toward recovery.
Attitude and Commitment Therapy
ACT (also known as Acceptance and Commitment Therapy) teaches people to "just notice," accept and embrace their thoughts, feelings, sensations, memories and other private events (especially unwanted ones) instead of trying to better control them.
IT focuses on interpersonal relationships by improving the way the depressed person communicates and relates. Techniques help the person identify emotions and their sources, express emotions in a healthy way and deal with emotional baggage from past relationships.
MT (also called Mindfulness-Based Cognitive Therapy) helps those who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on cultivating mindfulness. The goal is to become acquainted with the mental states that often characterize mood disorders while learning to develop a new relationship to them.