Post-stroke depression is common and can affect a patient’s motivation, outlook and recovery. By recognizing symptoms early and using supportive strategies such as positive psychology, patients, families and care teams can work together to support emotional well-being during stroke rehabilitation.
Understanding post-stroke depression
A stroke is a life-changing event. In addition to physical challenges, many patients experience emotional changes that may affect their recovery. Post-stroke depression is one of the most common emotional conditions following a stroke and may develop weeks or months after the initial event.
According to the American Stroke Association, about 30% of stroke patients experience some level of depression. These feelings could impact their recovery and rehabilitation progress.
Along with medication, positive psychology strategies can go a long way to help patients cope with post-stroke depression.
Common symptoms of post-stroke depression
Stroke recovery often requires relearning skills that once felt automatic. When progress feels slow or uncertain, patients may feel discouraged or overwhelmed. While many patients openly talk about physical symptoms, they may be less willing to discuss emotions.
Common signs of post-stroke depression include:
- Changes in appetite
- Trouble sleeping
- Low motivation during recovery
- Increased irritability
- Withdrawal from family, friends or activities
The Three Good Things Model
The Three Good Things Model is a positive psychology technique developed by psychologist Martin Seligman. It encourages people to shift their thinking from negative to positive in three steps:
- Identify three good things that happened during the day.
- Write them down.
- Reflect on them and your role in making them happen.
These moments do not need to be major events. Completing a therapy session, enjoying a visit or taking a few extra steps can all count. Over time, this practice can help patients recognize progress and build a more hopeful outlook.
Using the Three Good Things Model for post-stroke depression
Encompass Health Rehabilitation Hospital of Concord in New Hampshire adopted the Three Good Things Model to support those experiencing post-stroke depression.
Karen Newpower, director of the hospital's therapy operations, researched various methods before landing on the Three Good Things Model. This could be used for anyone recovering from a serious illness or injury. They all have a risk of depression because they're going through so many changes," she said.
Before starting the activity, a speech-language pathologist determines whether a patient is cognitively able to participate. If appropriate, their occupational therapist provides a Three Good Things poster for their room. Throughout the day, members of their care team help them identify three good things from the day.
"It can be their wife coming to visit, or it could be accomplishing a certain number of steps during their therapy," Newpower said. "I think, honestly, it brings us all up."
Based on early success with stroke patients, the hospital plans to expand it to other patient populations in the future.