Depression, including after a stroke

First, check the cause

Depression is common, and it can be treated. Dr. Pan checks for other causes, such as thyroid problems, other illnesses, alcohol, and some medicines.

How it is treated

• Talk therapy, such as cognitive behavioral therapy (CBT), and antidepressant medicine. These help the most people, and together they often work best. A referral to a therapist can be arranged.
• Antidepressants often take four to six weeks to work. Never stop one suddenly: you can feel unwell, and the depression can come back.
• Moving every day, regular sleep times, daylight, and time with people.
• Acupuncture, alongside therapy or medicine: very thin needles. It helps lift mood, improves sleep and eases anxiety, and works well with regular treatment.
• Chinese herbs, prescribed for your pattern, to ease tension and calm the mind. They are checked against the medicines you already take.
• After a stroke, depression is treated the same way. Medicines are chosen to fit with your stroke medicines.

How many visits

Usually once a week at first, alongside therapy or medicine. Six to eight visits make a course; then you and Dr. Pan look at how much better you are: mood, sleep, energy, interest in things. A short mood questionnaire (PHQ-9) at each check makes the progress easy to see.

Common questions

Can I use acupuncture with my antidepressant?

Yes — they work well together. Keep taking your medicine as prescribed; never stop an antidepressant suddenly or on your own. After you have been well for some months, Dr. Pan may lower your medicine with you, slowly.

Is depression after a stroke common?

Yes. It is not weakness, and it is not just a normal part of recovery. Family often notice it first. It can be treated.

Do I need to see a psychiatrist?

Many people with depression are treated in primary care. Dr. Pan will refer you to a psychiatrist when specialist care is needed, such as for severe depression or possible bipolar disorder.