Simply supporting the patient as he struggles with depression can help him a great deal. Here are some other things you can do:
- Help him stay as physically active as possible. Talk to the doctor and rehabilitation team about what exercises are appropriate. Find activities you can do together, such as a morning walk around the neighborhood.
- Depressed people often want to sleep during the day. "As much as possible, don't allow a patient to slip into a depressed routine," says Castle. "Break the cycle by encouraging him to be awake during the day with exposure to sunlight." A simple walk outdoors or some time in the garden can really help.
- Structure the day around activities that give him pleasure and a sense of purpose. For example, meet friends for lunch or enjoy a leisurely walk through the mall.
- Try to stay positive and upbeat, but don't foster unrealistic expectations. Instead of saying, "You'll be hiking again in no time," you might say, "If we keep walking together every day, you'll notice that it gets a lot easier."
- Join a support group -- for either or both of you. Talking to other people who're struggling with similar issues can be enormously comforting and helpful. It's also a great way to connect with other stroke survivors and caregivers. Remember that it's not all up to you
In the end, it's really up to the stroke survivor to get help for depression. If he won't talk to his doctor or comply with treatment, you can't make him -- and you shouldn't blame yourself. Keep offering support and provide positive reinforcement when he takes those difficult steps toward recovery.
But there's only so much you can do. If feelings of guilt and sadness overwhelm you, you may need help coming to terms with the fact that he isn't going to get help. Ask his doctor for information about support groups and other resources to help you manage your own feelings.
Source: E. Chemerinski et al. "Improved recovery in activities of daily living associated with remission of post stroke depression." Stroke 32, 2001.
