- Senator John Fetterman has checked himself into a hospital for clinical depression, according to his staff.
- The senator, who won his seat in November, suffered a stroke last May while campaigning.
- Experts say they hope Fetterman’s openness about seeking treatment will help combat stigma around mental illness.
Pennsylvania Sen. John Fetterman checked himself into a Washington, D.C., hospital “to receive treatment for clinical depression,” his chief of staff announced February 16.
“While John has experienced depression off and on throughout his life, it only became severe in recent weeks,” Adam Jentleson said in a statement.
Congress’ attending physician, Dr. Brian P. Monahan, examined Fetterman on Monday and recommended “inpatient care” at Walter Reed National Military Medical Center.
Fetterman is “receiving treatment on a voluntary basis,” according to Jentleson, “and will soon be back to himself.”
The senator, who won his seat in November, suffered a stroke last May while campaigning. The stroke was caused by a blood clot that developed due to an irregular heartbeat.
“Hopefully, [Fetterman’s] case draws attention to the difficulties of treating depression, and the importance of seeking help to prevent negative outcomes such as suicide or prolonged suffering,” Dr. David A. Merrill, a psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, Calif., told Healthline.
Depression after stroke is common
The cause of a depressive episode can be complex and the result of multiple factors.
While the statement from Fetterman’s office didn’t indicate whether his depression was related to his stroke, depression is a common experience for stroke survivors.
Approximately one-third of people experience depression after a stroke, according to a scientific statement from the American Heart Association and American Stroke Association, compared to 5% to 13% of adults who have not had a stroke.
Depression is also 20% to 50% more common after stroke than after a heart attack, research shows.
These statistics come from general studies of stroke survivors, so they provide an overall view of the risk of depression after stroke.
However, Merrill said if you looked at people whose stroke affected the parts of their brain involved in emotion and mood, you might see even higher rates of post-stroke depression.
Adults with depression after a stroke experience poorer health outcomes and quality of life, according to the AHA/ASA statement.
This may result from depression limiting a person’s participation in stroke rehabilitation, or directly affecting their physical or cognitive function.
Depression after a stroke can also increase a person’s risk of dying, according to the statement.
Symptoms of depression after stroke can show up in a number of ways, including persistent sadness or anxiousness, loss of interest in pleasurable activities and difficulty sleeping.
While many people may experience one or more of these symptoms occasionally, if symptoms persist for longer than two weeks, people should seek professional medical help.
Why the increased risk of depression after stroke?
A number of factors may be involved in causing depression among the general population, such as brain chemistry, hormones and genetics.
So “even before we start talking about having damage to the brain, there’s a biologic basis for depression,” said Merrill, with some people having a higher risk of depression.
A stroke also causes structural, electrical or biochemical changes in the brain that may increase a person’s risk of developing depression.
For example, “certain strokes can affect areas of the brain that regulate mood,” said Merrill. This can produce depression, anxiety or PTSD-like symptoms in stroke survivors.
On top of that, a stroke is a major health crisis that can affect a person’s mental health.
“Depression following a stroke can be a normal psychological reaction to the stress of the injury, disability or brush with mortality brought on by the stroke,” Dr. Lee H. Schwamm, an American Heart Association volunteer and professor of neurology at Harvard Medical School in Boston, said in a news release.
According to the AHA/ASA statement, the factors that are most strongly linked with depression after a stroke are physical disability, the severity of the stroke, a history of depression and cognitive impairment.
Treatments for post-stroke depression
Merrill said there are treatments that work for depression, both in people who have had a stroke and those who haven’t.
Counseling and antidepressant medications may be effective in treating depression after stroke, according to the AHA/ASA statement, but more research is needed to determine the optimal therapies.
There are also a limited number of studies looking at whether brain stimulation techniques such as transcranial magnetic stimulation might work for people with depression after stroke. Some of these suggest a possible benefit of these therapies.
Merrill said physical exercise can also be beneficial for people with depression, especially when combined with cognitive rehabilitation.
“This is something we’re doing in our center,” he said. “The outcomes tend to be better when people get their bodies moving to help support their mind.”
The ASA’s Schwann recommends that stroke survivors who experience depression seek help from a qualified professional.
In addition, “support from family, friends, a stroke support group or a combination of resources … can be an important part of a treatment plan for post-stroke depression,” according to the ASA release.
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