Understanding emotional changes after stroke

Apart from physical changes, stroke can impact a person’s mood, behavior and personality. These could include feelings of anger, irritability, anxiety and sadness. Sometimes, due to how the brain has been injured, stroke survivors may also experience apathy and impulsivity. 

Understanding my emotions

Stroke affects every individual’s well-being in a different way. Some of the consequences of stroke includes:

• Changes in physical appearances
• Loss of physical or bodily functions
• Restricted social activity participation
• Loss of financial income
• Role changes in the family
• Loss of independence

As stroke survivors, you may experience the process of grief and loss. You may go through a range of emotions as part of the stages of grief. (“Five Stages of Grief” developed by psychiatrist, Kübler-Ross). The amount of time spent in each stage differs from person to person. It is important to note that these stages are not linear, and that everybody grieves in their own ways. 

Stages of grief 

What are some common emotional responses I may experience after a stroke?

Anxiety

You may feel worried, frightened or stressed after a stroke. You might be thinking about the future and what life will be like for you. These feelings and thoughts are normal, and you may be able to manage these better as your condition improves. 

Physically, anxiety sometimes look like this: 

• Feeling restless
• Chest tightness
• Feeling short of breath
• Headache
• Feeling out of control
• Feeling fearful

If these physical symptoms become overwhelming, and prevents you from engaging in your day-to-day activities, speak to your doctor. 

Frustration & Anger

You may feel frustrated about not being able to do what you used to do or having to rely on other people. Frustration is a common emotion that nearly all stroke survivors may experience.

During your recovery journey, you may feel this way from time to time. It is important to speak to someone about this as keeping your frustrations and anger to yourself will only make it more difficult for you and your loved ones to fully engage in the recovery process. 

Sadness/Depression

Feeling sad is common and can be a normal reaction after a stroke. If your feelings of sadness and hopelessness persist, and affects your ability to engage in your activities of daily living, you may be depressed. 

Depression can appear at any point after a stroke. It can be as early as a month and as late as several years after a stroke. It is important to know what to look out for and seek early medical help.

Depression affects people in different ways. Here are some common signs:

• Feeling sad or down
• Feeling worthless, helpless or guilty
• Feeling hopeless or desperate
• Feeling anxious
• Loss of confidence
• Loss of interest in things you used to enjoy
• Feeling unmotivated
• Loss of appetite or overeating
• Difficulty focusing and irritability
• Sleeping problems
• Suicidal thoughts

Difficulty controlling your emotions 

Depending on the nature of your stroke, sometimes, the part of your brain that manages your emotions may be affected. You may become more emotional than you used to be or your mood changes very quickly.

Some signs of emotional lability are,

• Finding yourself crying or laughing for no reason.
• Expressing your emotions more intensely that you actually feel them.
• Feeling like you have no control over your emotions.

If you are experiencing these symptoms, speak your doctor about this. 

Mania and euphoria

Mania and euphoria is not a common consequence of stroke, but it does affect some people.

People with mania can have their mood swing high or low. When their mood is extremely high, they can appear being hyperactive and may have difficulty sleeping. 

People with euphoria appear to have constantly high mood and may seem extremely positive.

Will it get better? 

While coping with a stroke can be emotionally overwhelming, most survivors feel better over time. However, sometimes, the emotional changes linger and even worsen. 

Remember, you are not alone. There are resources to help you cope with the way you are feeling.

What may help me manage with the emotional consequences of stroke? 

Depending on the nature and severity of the issues, medication management may be helpful. Non-pharmacological options are also available. Referral to a psychologist or psychiatrist may be warranted.

Medication

There are some medications that can help you with your emotions. These medications affect the chemicals in your brain and lift your mood. 

Psychological Therapy (Psychotherapy)

Psychotherapy refers to a range of treatments to help individuals overcome their mental health difficulties, emotional challenges, and stressful life events.

Psychotherapy provides a safe environment for you to talk openly. Your psychologist will work with you to help understand your thoughts, emotions and behaviours that keep you from feeling your best. You will also learn new skills to better cope with challenges that you face currently and that may arise in the future. The psychologist can work with you one-to-one or together with your partner or other family members.

Article available in Chinese, Malay and Tamil. 

For more information on how to better manage your stroke recovery journey, visit Stroke E-Resources.