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1 in 4 Stroke Survivors Suffers From PTSD: Study

And that can pose serious psychological challenges, researcher says

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PTSD is triggered in people who have strokes and TIAs by a variety of sequential factors, Edmondson said. First, there is a significant, terrifying, life-threatening event that is often accompanied by internal cues, such as a rapid heart rate and high blood pressure. "It's called the fight or flight response, and it's our innate response to fear," he said. An emotional ambulance ride, invasive tests, hospitalization and sometimes surgery follow.

Next, people must adjust to the shock of what has just happened, Edmondson said. "We walk through our lives with the naive belief that we're invulnerable," he said. "Often what is traumatic [about a stroke or heart attack] is that such unspoken assumptions are broken."

And once home, physical and environmental cues can stimulate the fear response all over again. Unlike a soldier who can leave the battlefield, stroke patients typically return to the place where the crisis occurred. Many patients may simply see the living room chair where they had the stroke and immediately feel PTSD symptoms.

Flashbacks, nightmares, palpitations, chills, and elevated heart rate and blood pressure may occur for months or years after their return home, Edmondson said. Severe anxiety, headaches and outbursts of anger also are likely for patients with PTSD.

"PTSD is a huge detriment to quality of life, a debilitating disorder in its own right, and deserves to be treated," said Edmondson.

Edmondson said that although the research does not show that strokes cause PTSD, he thinks it comes close. "You can't develop PTSD without a life-threatening event," he said. "Having PTSD can't cause a stroke a month ago, so this research is some of the strongest causal evidence we have."

Dr. Rafael Ortiz, director of the division of neuroendovascular disease and stroke at Lenox Hill Hospital in New York City, said he thinks this is the first time PTSD has been so closely associated with strokes and TIAs. "It's important that after suffering from a stroke, people are taken care of by a comprehensive team of doctors and other specialists, including psychologists and nurses who are very well-trained," he said.

Edmondson encouraged patients and family to talk with their physicians about PTSD. "I really hope this research lets survivors and their family members know it's not weird and it's nothing to be ashamed of," he said. "It's treatable. Tell somebody."

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