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Posted by: BARBARA | 2009/11/27

POST STROKE DEPRESSION

My husband who is a diabetic and high blood pressure sufferer, suffered a stroke 2 years ago and was totally paralyzed on the right for a period of about 3 weeks, he then started walking again and gradually his speech improved with speech therapy, however, he suffered a second stroke 8 months later accompanied with a major epileptic fit and in the process he bit his tongue halfway off, fortunately as we all know the tongue heals quickly and this was not a major setback.

I am struggling with him now to do the necessary exercises for his arm which is still partially paralyzed. I am starting to question if it really is paralyzed or if it is a phsycological problem. When he turns over at night or if he yawns or gets excited he is able to lift the arm and straighten his fingers without a problem. He is taking Deprozan 20mg daily and Tegretol 40mg bidaily for the epilepsy.

I am at my wits end as he just wants to sleep and watch TV most of the time, to get him to get dressed and go out to church or just visiting is a major accomplishment, I dont know how to motivate him anymore. He never recieved any treatment for the depression besides the pills. I have made him read books, build puzzles (which he only does if I sit with him), ride the excercise bike, go walking with me and I try to involve him in the day to day tasks in the house. At one stage he was going to work with me every day but seeing as I have changed jobs recently he cannot do that anymore.

Please give me some advice as to how to help him out of this hole that he seems to be in.

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Our expert says:
Expert ImageCyberShrink

Actually, this is an interesting but more complex issue than it might seem. Human neurology is remarkably complex, and in a number of situations, there is a real distinction between one's ability to make deliberate movements, and making the same movements unconsciously . unawares or reflexly.
Discus this with his neuroloist. Its possible that though he needs these drugs at these doses to control the epilepsy, they may well make him droawy and lethargic, explaining his levels of inactivity.
Let me also congratulate you on the remarkable job you obviously have been doing in assisting him - how I wish all stroke sufferers were so lucky ! I know from my own experience of caring for my late mother after her stroke, how much work it can be - but how rewarding - perhaps it was much easier for me to recognize the rewarding component, because while you see only the situation he is in, and where this falls short of what you would wish, from my clinical experience, I am so aware of how much worse such situations are WITHOUT the sort of blessed input you have ben supplying.
Does he see himself as depressed ? If so, a pych assessment could be useful, and treatment could be possible, preferably with a skilled psychiatrist selecting a med that would work with and not against the others meds he needs

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Our users say:
Posted by: cybershrink | 2009/11/27

Actually, this is an interesting but more complex issue than it might seem. Human neurology is remarkably complex, and in a number of situations, there is a real distinction between one's ability to make deliberate movements, and making the same movements unconsciously . unawares or reflexly.
Discus this with his neuroloist. Its possible that though he needs these drugs at these doses to control the epilepsy, they may well make him droawy and lethargic, explaining his levels of inactivity.
Let me also congratulate you on the remarkable job you obviously have been doing in assisting him - how I wish all stroke sufferers were so lucky ! I know from my own experience of caring for my late mother after her stroke, how much work it can be - but how rewarding - perhaps it was much easier for me to recognize the rewarding component, because while you see only the situation he is in, and where this falls short of what you would wish, from my clinical experience, I am so aware of how much worse such situations are WITHOUT the sort of blessed input you have ben supplying.
Does he see himself as depressed ? If so, a pych assessment could be useful, and treatment could be possible, preferably with a skilled psychiatrist selecting a med that would work with and not against the others meds he needs

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