John Fetterman’s Depression Mirrors Experience of Stroke Survivors

• Sen. John Fetterman checked in to Walter Reed on Wednesday to receive treatment for depression.
• Fetterman is recovering from a stroke he experienced last May.
• About 1 in 3 stroke survivors experience post-stroke depression in the year after their stroke.

Sen. John Fetterman checked himself into Walter Reed hospital on Wednesday night to be treated for clinical depression, his office said on Thursday.

A senior aide told The Wall Street Journal that Fetterman’s hospital stay could last at least three weeks to a month, during which he will receive medication and speech therapy.

The Pennsylvania Democrat’s depression diagnosis comes as Fetterman continues to recover from a May 2022 stroke that impaired his ability to speak smoothly and impacted his auditory processing abilities. Stroke experts say it’s highly likely the stroke and clinical depression are connected, and that patients who suffer from both conditions are at risk for further issues.

Since his stroke, Fetterman pushed through a highly competitive race and secured a senate seat against his Republican opponent, Dr. Mehmet Oz. Adam Gentleson, Fetterman’s chief of staff, told The New York Times that Fetterman “was forced to do as much as possible” and quickly return to the campaign trail instead of taking time to recover.

About a month into his job, a critical period for freshman senators adjusting to life on Capitol Hill, Fetterman was hospitalized after “feeling lightheaded” during a Senate Democratic retreat on February 8. He was released from the hospital two days later.

While Fetterman has not disclosed whether his previous stroke is related to his depression diagnosis, doctors say his experience is a familiar one among stroke survivors.

Depression is common in stroke survivors, and it can be dangerous

Post-stroke depression (PSD) is common, with studies estimating it affects about one in every three people in the year after their stroke. That rate is at least three times higher than the rate of depression in the general population.

Dr. Bruce Ovbiagele, editor-in-chief of the Journal of the American Heart Association, told Insider that it’s “highly likely” Fetterman’s depression diagnosis is “related to the stroke.”

The reason stroke survivors are at an elevated risk of depression is complex, and may include both biological and social changes that happen after a stroke occurs. Some stroke survivors may suffer permanent damage to their brain cells which are tied to emotions. Others may experience depression as a reaction to the “devastating effects of the stroke” on their ability to live life as they once did, Ovbiagele said.

“Some providers actually have depression screening instruments in their office after a stroke,” Ovbiagele said, “in case there is evidence of depression.”

It can be difficult for family members and medical providers alike to tease apart the difference between depression and the effects of the stroke, as both conditions can impact issues like memory functioning and a flat affect. According to the American Stroke Association, post-stroke depression is also “largely unrecognized, under-diagnosed, and under-treated.”

“It’s kind of a little bit obscure sometimes: is that the stroke itself, or are they actually depressed?” Ovbiagele said.

 

 

AP Photo/Matt Rourke

 

Post-stroke depression is dangerous, too: it’s tied to more deaths in stroke victims, and that’s largely because “people who are depressed oftentimes don’t adhere to the medical regimen that they’re prescribed,” Ovbiagele said.

They may be less likely to take medicine that could prevent another stroke from occurring, or less likely to adopt key lifestyle changes to decrease their risk of having another stroke. Research suggests that people who suffer a more severe stroke, those with a history of depression, and patients with some existing cognitive impairment are all at increased risk of developing PSD after a stroke.

Patients with post-stroke depression may suffer many of the same issues that others with a depression diagnosis encounter, including trouble sleeping, fatigue, trouble concentrating, feeling worthless or suicidal, and restless, unintentional movements, called psychomotor agitation.

Both antidepressant medications and brief, psychosocial interventions have been shown to help stroke survivors with depression.

“The key is picking it up in the first place,” Ovbiagele said.

If you or someone you know is experiencing depression or has had thoughts of harming themself or taking their own life, get help. In the US, call or text 988 to reach the Suicide & Crisis Lifeline, which provides 24/7, free, confidential support for people in distress, as well as best practices for professionals and resources to aid in prevention and crisis situations. Help is also available through the Crisis Text Line — just text “HOME” to 741741. The International Association for Suicide Prevention offers resources for those outside the US.