NZ Herald Column Kyle MacDonald

Kyle MacDonald: When physical illness leads to depression

This is my column this week in the New Zealand Herald, which is published in the digital edition every Thursday morning Click here for the original article…
“A family member recently had a stroke, and while they were recovering they also got really depressed. Is that common?” Via email

There’s this weird split in medicine, right around the neck, between what’s “physical” and what’s “mental”. (Philosophers interested in how the mind works call it “dualism”.)

The problem is, we’re so used to thinking about the brain and the body as separate things, it can be hard to recognise when a physical injury leads to depression. But it’s actually quite common: even more so when the physical injury is to the brain itself.

A stroke happens when the blood flow to a part of the brain gets interrupted or blocked. Without the oxygen that the blood supplies, that part of the brain stops working. It can potentially lead to temporary or permanent loss of brain function in that area, physical disability or death.

Strokes are the third biggest killer in New Zealand and around 24 people a day experience one. The good news is they’re largely preventable given they are caused by factors like weight, smoking, lack of exercise and alcohol and drug use.

While many people have heard of strokes, it’s much less commonly known that around 70 per cent of stroke survivors suffer emotional consequences as part of their recovery, including depression.

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Feelings of anxiety, fear, anger and frustration after a stroke can also develop into depression. Chronic pain can develop after a stroke, and pain is a common cause of depression. Of course the sudden onset of a stroke, and with it the intense fear, confusion, and thinking you’re going to die, can also be highly traumatic.

So it makes complete sense that a stroke may lead to depression, because while we’re getting better at recognising the emotional impact of grief, trauma, abuse and loss, what bigger loss is there than dealing with a change in how your own mind and body works?

In some ways I think part of the problem is we prefer not to think about how those affected by a disability might feel – to do so puts us face to face with our own fragile mortality. It still amazes me how little attention some pay to their physical health. At the risk of permeating a stereotype, men are often the worst at this. Abject denial is not a great health strategy.

The thing about avoiding strokes is that it requires long-term good health. It requires us to look after ourselves, consider those so called “lifestyle factors” as well as keeping a regular eye on some pretty simple health markers. In the case of strokes the main one is blood pressure.

The good news is that in a week or so (Saturday, October the 1st to be precise) the Stroke Foundation is sponsoring “The Big New Zealand Blood Pressure Check”. At supermarkets around New Zealand you’ll be able to get your blood pressure checked for free.

Find out more here.

While being emotionally affected by sudden health challenges makes complete sense, what makes even more sense is to do everything you can to avoid the problem altogether.


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