A pioneering new research project at Glasgow Caledonian University aims to help people affected by stroke manage anxiety and depression through mindfulness.
The Heads:Up study will run over nine weeks, employing techniques including meditation, visualisation and gentle physical movement to help alleviate mood disorders - common after stroke, with up to 50 per cent of people still living with compromised mental health five years later.
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Developed by Dr Maggie Lawrence, the practical programme is based on Jon Kabat-Zinn's Mindfulness Based Stress Reduction (MBSR), a method created by the American mindfulness teacher in the 1980s and widely used across the NHS including in the treatment of eating disorders and multiple sclerosis.
Dr Lawrence, who has a background in neurological rehabilitation, said: "There's very little support when someone's had a stroke. They might be in hospital for a few days and then have a few weeks of follow up with outpatient rehab but after that [they are] left to their own devices.
"Part of the problem is that medical services are geared up to what is physically obvious or apparent so if you have an invisible disability such as problems with cognition or memory, or mood disorders such as depression and anxiety there's really very little help."
Heads:Up aims to change that by arming stroke patients with a toolkit to help them identify and manage ongoing mental health difficulties.
The 14 stroke patients will be joined by a partner, friend or carer in the study, which starts at the end of October, with all 24 learning the techniques to support their own mental health and encourage each other to practice the programme.
Dr Lawrence said: "Quite often relationships break down because there are multiple problems following a stroke but people often don't understand what the issues are so they don't know how to tackle them.
"If people get into the habit of of doing the mindfulness exercises then when they find themselves in stressful situations or getting low, they are able to automatically draw on their new skills."
The £365,000 three-year project is funded by the Stroke Association, who estimate that more than 120,000 people live with the effects of stroke in Scotland with numbers projected to double in the next 20 years.
Around 13,000 people suffer a stroke every year in Scotland, and some 4,000 die.
In July campaigners called for a move towards centralised, specialist stroke units after evidence from England showed more patients survived and were less disabled long-term if they were rushed to regional centres run by experts, instead of relying on local hospitals.
Last year the Stroke Association said that survivors' best chances of recovery were being put at "significant risk" due to lack of information on the availability of rehabilitation.
Dr Lawrence agreed: "If people do find help they are often having to proactively seek it out for themselves.
"Quite often the diagnosis of depression and anxiety is not recognised by health professionals or the people themselves or the people they're living with ... so they can often not know that it is part of their problem and if they have treatment that might help them to engage better with their rehabilitation."
As well as standard mindfulness techniques such as breathing exercises and meditation, Heads:Up will teach participants visualisation skills so even if they're living with limited physical ability, they can still reap the benefits of the full programme.
Dr Lawrence said: "People after a stroke can be affected in many different ways so if a walking mediation or movement is suggested and their response is they can't walk, or can't move easily they are encouraged to visualise the practice.
"Evidence shows that visualisation actually makes those changes to the brain so even though they wouldn't be doing the walking, if they visualise it well enough, it would have the same effect."
Dr Lawrence sees the final Heads:Up offering as community-based, the tailored programme delivered by trained facilitators, obviously signposted and accessible to all those who need it.
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The pilot study, carried out earlier this year was such a success that NHS practitioners have expressed interest in seeing Heads:Up become standardised as part of Scottish stroke rehabilitation services.
Richard Francis, Head of Research Awards at the Stroke Association said: “We know stroke survivors face a battle with depression, anxiety and loss of confidence, yet they are not getting the support they need to have a good quality of life.
"Mindfulness is already well recognised as having a positive impact over many people with anxiety issues. We hope this project will tell us more about how we can better support those battling with anxiety and depression after stroke.”
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