Mary has spent 2 weeks on the acute stroke unit and is about to be transferred to a stroke rehabilitation unit. Staff on the acute unit wonder whether Mary may have a mood disorder.
They observe:
- poor eye contact
- occasional tearfulness
- occasional reluctance to participate in therapy (particularly in occupational therapy)
Ignore problems as it’s only two weeks since her stroke
False: A stroke can be a sudden devastating life event. It is not uncommon for someone to feel sad, upset and frustrated. However, it is still important to acknowledge these feelings. Given the potential negative impact of depression on rehabilitation and function it is also important not to ignore the development of any significant symptoms of mood disorder.
Carry out mood screening
True: It is important to assess the symptoms from an early stage. This allows clarification of diagnosis and provides a baseline for ongoing monitoring. However, at this stage, only two weeks after stroke, it is hard to ascertain whether symptoms are persistent and it is too early for an accurate diagnosis.
Prescribe antidepressants
False: From the information provided there is no strong evidence that Mary has a depressive illness. RCP (2008) and SIGN 118 (2010) guidelines indicate that anti-depressants should not be used routinely to prevent depression.
Be aware of possible mood disturbance, document this and monitor for changes
True: At this stage in Mary’s journey she may be reacting in an understandable manner following her stroke. However, it is important to monitor her mood to ensure that a more significant mood disorder does not develop.
Page last reviewed: 24 Feb 2020
