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Depression in stroke survivors like John Fetterman is common, experts say

JUANA SUMMERS, HOST:

John Fetterman, the new senator from Pennsylvania, checked himself into Walter Reed National Military Medical Center this week. His office said it was to receive treatment for clinical depression, which had become severe in recent weeks. He has also had a tumultuous year. He suffered a near-fatal stroke during his campaign for Senate last May. He resumed campaigning with a speech processing impairment. And after being elected, he's taken on a new job with new demands here in Washington. While Senator Fetterman has experienced depression on and off throughout his life, depression can also follow major health events like strokes. NPR's Rhitu Chatterjee has been looking into that for us. Hey there.

RHITU CHATTERJEE, BYLINE: Hi, Juana.

SUMMERS: So, Rhitu, just how common is it for people to develop depression following a stroke?

CHATTERJEE: Depression is actually the most common psychiatric complication of stroke. You know, studies find that around 30% of stroke patients will go on to have depression in the first five years after the stroke. And there are some risk factors that make it more likely for somebody to experience post-stroke depression. Females are more prone to having post-stroke depression, as are people with a prior history of depression.

SUMMERS: And does that fact, the fact that Senator Fetterman has struggled with depression before, does that put him at higher risk?

CHATTERJEE: Absolutely. Here's what Dr. Jessi Gold, a psychiatrist at Washington University in St. Louis, told me about this connection.

JESSI GOLD: Usually when people have a prior history of depression, since depression is a biologic disease, there's something already in their brain. And so then if a stroke affects their brain, you can assume that it's sort of compounding it as opposed to creating new issues in your brain.

SUMMERS: So for people who experience depression for the first time after a stroke, why is that? Is it mainly because the stroke has changed something in their brain that then affects their mood?

CHATTERJEE: That's definitely part of it. But remember that a stroke can also have and often does have a pretty dramatic impact on people's physical health and how they're able to function daily, which can again increase their chances of becoming depressed. Here's Dr. Jessi Gold again.

GOLD: When somebody has physical limitations or mental limitations as a result of a stroke, you might also feel depressed because of that, right? Like, I'm not able to go to work the same way that I used to. I can't think as clearly as I used to. This is a lot harder than it used to be. Now I am feeling depressed.

CHATTERJEE: And as you mentioned earlier, you know, Senator Fetterman has had trouble with auditory processing since his stroke, which means that he can't understand what's being said and carries a tablet with closed captioning to help him with that. And we know that hearing loss has a huge impact on people's ability to do their jobs, to interact with people at home, at work. And studies have shown that hearing loss does increase the risk of depression as well. And, you know, Juana, it isn't just strokes that trigger depression. Other physical health conditions can do that as well. Neurological conditions like Parkinson's or Alzheimer's, chronic diseases like heart disease and diabetes can also trigger depression because of some of the same reasons. You know, physical and mental health are so closely tied.

SUMMERS: Rhitu, before we let you go, if someone with any of these physical health problems thinks that they might have depression, what's the best way for them to seek mental health care?

CHATTERJEE: First of all, it is really important to seek care because depression can also affect the physical health, people's physical health. And the best place to really start is your doctor, because doctors can prescribe antidepressants if needed and can connect you with a therapist as well.

SUMMERS: NPR's Rhitu Chatterjee. Thank you.

CHATTERJEE: Thank you. Transcript provided by NPR, Copyright NPR.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.