Depression is common after a stroke. Around one in three stroke survivors will have some form of depression within the first year. But you may not have it straight away. Depression can appear months or even years later. It can also return over and over again. Some people experience depression alongside anxiety.

It’s very common to feel anxious after a stroke. Around one in four people who have a stroke will experience anxiety within the first five years.

Feeling low or depressed

It’s very common to feel sadness about your stroke and the changes to your life. You might also feel low, like you cannot cope, or do not enjoy things like you usually do.

A low mood can happen to anyone from time to time. But if you feel this way most of the time over several weeks or more, and it’s affecting your ability to enjoy life, it could be a sign of depression.

It’s important to know what to look out for and how to get help if you need it.

Feeling low or depressed can creep up on you. It’s not always easy to know when you need help. Depression can be mild, moderate or severe. Severe depression is a very serious condition. It can sometimes lead to a mental health emergency. So it’s important to take your feelings seriously and talk to someone if you feel something’s not right.

Feeling in despair or suicidal

Sometimes, difficult feelings can lead to self-harming or thinking you cannot go on living.

It’s important to remember suicidal feelings are not permanent. The sooner you tell someone how you’re feeling, the sooner you can get help. If you are feeling this way now, it’s a mental health emergency.

What to do about a mental health emergency

A mental health emergency is serious. Call 999 or go to the nearest accident and emergency department (A&E) if:

1. Someone’s life is at risk – for example, they have seriously harmed themselves or attempted suicide.
2. You do not feel you can keep yourself or someone else safe.

Samaritans offer a free, confidential phone line to talk with a trained volunteer any time, day or night, on 116 123. You can talk about anything that’s troubling you.

Anxiety

Some worries are common after a stroke. For example, you may worry you might have another stroke. You might be frightened about getting around on your own. You may feel stressed about money or worried about your family.

You may find your fears ease over time. But you should seek help if:

• You’re becoming anxious about a wide range of things.
• Anxiety is stopping you from doing things you want or need to do, or causing you distress.
• You feel anxious for no obvious reason.

Getting support and treatment for anxiety can help you focus on things like rehabilitation, eating well and staying active. Feeling more relaxed will help with your recovery, so do not be afraid to seek help with your mental health if you need it.

It may not always be clear what you’re anxious about, which can make these feelings worse. Severe anxiety can be overwhelming. It can make you feel powerless or out of control.

Living with anxiety can lead to sleeping problems, tiredness and muscle tension. You might feel more irritable or avoid certain activities, such as going out or meeting people.

Other people cannot always tell what you’re going through, so it can help to share your feelings with someone you trust.

You can also call our Stroke Support Helpline if you need someone to talk to.

Panic attacks

A panic attack is a sudden, intense rush of anxiety symptoms. It can feel overwhelming. Someone having a panic attack might believe they’re going to faint or even die.

It’s not always possible to tell if someone is having a panic attack or if it’s something physical, such as a heart attack. If you suddenly have new symptoms, or you spot new symptoms in someone else, call 999.

Frequent panic attacks may be diagnosed as panic disorder. It can affect your life if you live with a sense of fear or avoid situations due to worries about having a panic attack.

What can I do about depression and anxiety?

Like many emotional difficulties, having a healthy diet, dealing with sleep problems and being physically active are some of the ways that can help you manage your anxiety and improve your mental health. The NHS has more information and tips.

Breathing and mindfulness

Breathing techniques can be especially helpful when you find yourself becoming anxious. Some people find that mindfulness techniques help with anxiety too. The NHS offers free self-help guides and tips.

Stay active

Although you may not feel like doing anything, being physically active can help you feel more positive. Exercise encourages your brain to release chemicals that lift your mood. Focusing on an activity can also give you a distraction from negative thoughts or feelings. You could start small, such as a short walk outdoors or chair-based exercises.

Talk it through

Talking through worries with someone can put them in perspective. A support group connects you with people going through similar things. Some meet in person and others online. Visit our Support webpage or call our Stroke Support Helpline to find one.

Do something you enjoy

Try to do something you enjoy regularly. A phone call with a friend could give you a boost and ease loneliness. Treat yourself to a haircut or manicure. If you cannot get to a salon, find someone who can come to your house.

Be kind to yourself

Write down compliments you’ve received or your achievements. Read them again when you feel down.

Eat well and limit caffeine and alcohol

If you’re not eating much, or you’re eating lots of junk food, it can make you feel tired and run down. Try to eat regular meals which include lots of fruit and vegetables. Reduce your alcohol and caffeine intake, as they can alter your mood and affect your sleep. Try to follow a good sleep routine, including going to bed and getting up at the same time each day.