A new report from Heart & Stroke reveals that women are being harder hit by depression and anxiety post stroke than men. Stroke and mental health: The invisible and inequitable effects on women also highlights that women have fewer opportunities to participate in stroke rehabilitation than men and they are not getting the support they need for their mental health recovery.
Not only is stroke on the rise in Canada, but improved awareness and better treatment and care mean many more people are surviving stroke; new data reveal that more than 920,000 people in Canada are now living with the effects of stroke, which include mental health conditions such as anxiety and depression.
Women’s mental health post stroke
Depression following a stroke is common, but women are at greater risk – they are 20% to 70% more likely to experience depression than men, and they are also more likely to experience anxiety. Mental health conditions such as anxiety and depression are less visible than physical deficits, but they are no less devastating.
“If you experience post-stroke depression, your chance of becoming independent is reduced and your chance of returning home is lower and your chance of dying increases,” says Dr. Mark Bayley, Program Medical Director at UHN-Toronto Rehabilitation Institute and a Heart & Stroke funded researcher.
Lisa Meeches, a film and television producer from Long Plain First Nation in Manitoba, had a stroke in 2016. She drew strength in her recovery from many sources, including her team of health professionals, her family, her community and her Elders. Lisa continues to see an Indigenous therapist and would like to see more discussion about mental and emotional health when it comes to stroke recovery. She urges other women who have experienced stroke to check in with themselves, to have the tenacity to stop and rest, find balance and say no when they need to. “I have learned to live every day to the fullest. I delegate more,” she says. “I really take care of myself and surround myself with positive people and spend time with family and friends. I've also learned not to engage in fights I know I won't win.”
While stroke can happen at all ages and life stages, women are more at risk at three key times in their lives: during pregnancy, right after menopause and when they are elderly. Additionally, they can face challenges that affect their mental health as they recover from stroke at different stages and as a result of gender roles:
- Younger women often have many responsibilities including raising children and working, which can be difficult to manage after a stroke. Additionally, as few people their age can relate to having a stroke, they can feel disconnected and isolated.
- Elderly women have the most strokes and their strokes are the most severe; post-stroke depression and anxiety have a significant negative impact on this age group.
- Women do not always put their own health first, and they often play a greater caregiving role than men.
Dr. Lee-Anne Greer, a psychologist in Prince Edward Island who works with individuals who have experienced stroke, has witnessed a disparity in terms of roles and expectations for women. “I have seen when mothers have had a stroke, they can really struggle to take on all of the roles that they had before, and potentially be trying to get themselves back to work at the same time.”
Unfortunately, women who experience stroke are not getting the support they need for their mental health recovery. Services and resources for mental health support post stroke are lacking and are expensive for those without comprehensive extended health benefits, and wait lists can be long. Additionally, not all therapists or counsellors understand stroke and the impairments that can result, such as cognitive changes or aphasia.
In addition to professional services to support mental health after a stroke, social networks including peer support groups can be an important enabler for women in their recovery. “Having opportunities to connect with others matches the way many women cope,” says Dr. Greer.
“We have revolutionized stroke care in Canada over the past several decades, but recovery services have not kept pace,” says Dr. Patrice Lindsay, Director, Health Systems, Heart & Stroke. “We need to improve support after stroke including more mental health services, and we need to ensure women have equitable access and their voices are heard.”
Women have fewer opportunities to participate in rehabilitation and are disproportionately affected by stroke
Women who experience stroke are at higher risk of dying than men; in 2019, 32% more women died of stroke than men. When women survive stroke, their outcomes are worse. Women are 60% less likely to regain independence in their daily activities after a stroke compared with men, and they report worse quality of life. Women continue to be under-represented in clinical stroke research trials, including those focused on stroke rehabilitation. Fewer women participate in stroke rehabilitation, and they are less likely to return to their homes after a stroke than men; almost twice as many women as men go to long-term care instead due to lack of support systems at home.
About Heart & Stroke
Life. We don’t want you to miss it. That’s why Heart & Stroke has been leading the fight to beat heart disease and stroke for 70 years. We must generate the next medical breakthroughs, so Canadians don’t miss out on precious moments. Together, we are working to prevent disease, save lives and promote recovery through research, health promotion and public policy. Heartandstroke.ca @HeartandStroke
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