A stroke can turn your world upside down. Beyond the physical challenges, many survivors experience a rollercoaster of emotions. However, while these emotional shifts can be overwhelming, understanding them is the first step to recovery.

In this guide we will explore some of the common emotional changes after a stroke. We will also take a look at some practical strategies for coping as well as finding support along your recovery journey.

Let’s dive in!

Jump to a section:
Understanding the Emotional Impact of Stroke
Common Emotional Changes After Stroke
Coping With Emotional Changes After Stroke
Tips for Family and Caregivers

Understanding the Emotional Impact of Stroke

The brain is the control center for our emotions. While there are many areas of the brain involved in regulating emotions, this responsibility is primarily attributed to the limbic system. Now, when a stroke occurs, it may disrupt neural pathways involved in emotional regulation which can lead to various emotional changes. 

However, while a stroke can directly damage areas of the brain involved in emotions, many individuals also experience a wide range of emotions simply due to the challenge of adjusting to life after stroke. In other words, learning to cope with the physical and cognitive aftermath of stroke may be an emotional journey, even if the areas of the brain related to emotional regulation are undamaged. 

Let’t take a look at some of the common emotional changes following a stroke.

Common Emotional Changes After Stroke

Depression

It’s not unusual to feel persistent sadness, hopelessness, or loss of interest in activities you once enjoyed after a stroke. This is a common emotional reaction to the challenges and losses associated with stroke. In fact, one-third of all stroke survivors experience post-stroke depression at some point. 

Anxiety

Post-stroke anxiety is about as common as post-stroke depression, with approximately one-third of all survivors experiencing anxiety in the first year following their stroke. This may include  worries and fears about the future, your health, and your ability to regain independence. These anxious emotional changes after stroke are often linked to the uncertainties life after stroke can bring.

Emotional Lability

Also known as pseudobulbar affect (PBA), this involves sudden, uncontrollable outbursts of laughing or crying, often at inappropriate times. This condition arises from damage to the brain’s emotional control centers. It is estimated to affect up to 1 of 5 survivors in the beginning stages of stroke, and may still affect 1 of 8 survivors beyond 6 months post-stroke.

Irritability, Frustration, and Anger

Difficulties with communication, physical limitations, and adjusting to a new reality can understandably lead to increased irritability , frustration, and anger. These emotional changes are a natural response to the challenges of stroke recovery. 

Apathy

Following a stroke, some individuals may experience a lack of motivation, decreased interest in activities, and emotional withdrawal. This can be a symptom of depression or a separate consequence of the stroke.

Lack of Empathy

While not as common as some of the other emotional changes after stroke, some survivors have difficulties understanding the emotions of others. This may make survivors appear self-centered or uncaring, but it is often related to damage to specific brain areas, such as the right temporal pole and anterior insula.

Some individuals may experience minor emotional challenges after stroke, while others experience intense, persistent emotional changes. If emotional changes are impacting your day-to-day activities and interactions, talk with your doctor. They can further assess why these changes are occurring and recommend appropriate management or treatment strategies.

About 12% of stroke survivors experience suicidal ideation. If you or a loved one are having thoughts of suicide, please call or text 988 to reach the Suicide and Crisis Lifeline if you are in the US or your local emergency number.

Why Do These Changes Occur?

Although we have touched on a few of these reasons, there are a number of factors that contribute in varying ways to emotional changes after a stroke.

Some of these include:

• Brain Damage: The stroke itself can damage areas of the brain responsible for regulating emotions.
• Adjusting to Loss: A stroke often brings significant life changes, including physical limitations, loss of independence, and changes in social roles. These losses can be difficult to process.
• Post-Stroke Fatigue: Many survivors experience post-stroke fatigue, which may cause increased irritability or difficulties with emotional regulation.
• Medication Side Effects: Some medications prescribed after a stroke can have emotional side effects.
• Social Isolation: Difficulties with communication or mobility can lead to social isolation, which can further impact mood.

Coping with Emotional Changes after a Stroke

Navigating the emotional aftermath of a stroke can be challenging. However, there are strategies and resources to help you cope and regain emotional well being as you continue your recovery journey.

Let’s take a look at a few.

1. Acknowledge and Accept Your Feelings

To begin the healing process, don’t ignore or suppress your emotions. Acknowledge them as a natural part of the recovery process. Allow yourself to grieve the losses you’ve experienced and accept that it’s okay to feel a range of emotions.

This includes the more difficult emotions like anger, fear, and sadness. Don’t judge yourself for what you are feeling; simply allow yourself to experience it.

2. Seek Professional Support

To help you navigate this difficult time, it is important to seek professional support and resources including:

• Therapy: A therapist can provide a safe space to explore your feelings, develop coping mechanisms, and address specific emotional challenges like depression or anxiety. Cognitive-behavioral therapy (CBT) is often helpful in changing negative thought patterns.
• Support Groups: Connecting with other stroke survivors can provide a sense of community and understanding. Sharing experiences and learning from others can be incredibly validating. Use the American Stroke Association’s support group finder here to find a local stroke support group.

3. Communicate with Loved Ones

For emotional support, work on openly communicating your feelings with family and friends. Let them know how they can support you. Social isolation is common among stroke survivors. Sometimes, simply having someone to listen to your thoughts, emotions, and concerns can make a significant difference. 

It may take a little bit to feel comfortable with this but learn to be specific about your needs – whether it’s a shoulder to cry on, help with errands, or someone to accompany you to appointments. Clear communication can help your loved ones provide the most effective support.

4. Lifestyle Adjustments

Making positive lifestyle adjustments can significantly impact your emotional well-being. Some of the most common and simple lifestyle adjustment you can make include:

• Healthy Diet: Nourishing your body with a balanced diet can positively impact your mood and energy levels.
• Regular Exercise: Physical activity, even gentle exercises after stroke, can release endorphins, improve mood, and reduce stress.
• Quality Sleep: Aim for 7-8 hours of quality sleep each night. Establish a regular sleep schedule and create a relaxing bedtime routine.
• Stress Management: Practice relaxation techniques such as deep breathing, meditation, or yoga to manage stress and anxiety.  

5. Engage in Meaningful Activities

After a stroke, depending on the severity, you may find yourself unable to do some of the activities you once enjoyed. However, it’s crucial to rediscover joy and purpose by exploring new or adapted activities. 

This could involve spending time in nature, adapting old hobbies, learning new skills, or volunteering in your community. Even small activities can provide a sense of accomplishment and boost your mood, contributing to a more fulfilling life after stroke.

6. Medication Management

Sometimes  new medications can interfere with existing meds, causing an adverse reaction. If you suspect your medication is contributing to emotional changes, talk to your doctor. They may be able to adjust your dosage or prescribe a different medication.

However, absolutely do not make any changes to your medication or healthcare routine without first consulting your doctor.

Tips for Family & Caregivers Dealing With Emotional Changes After Strokes

Supporting a loved one through the emotional challenges after a stroke is crucial. If you are a caregiver or family member to someone that has just suffered a stroke, especially for a young adult, here are a few ways you can help them through this challenging time.

• Be Patient and Understanding: Recovery takes time. Be patient with your loved one as they navigate their emotions and adjust to their new reality.
• Remember Emotional Changes May be Beyond Their Control: Damage to the emotion center of the brain, as well as other areas, may be responsible for changes in your loved one’s emotions. They may still be relearning how to manage their emotions effectively.
• Offer Practical Support: To ease their burden, assist with daily tasks, transportation, and appointments. This can reduce stress and free up their energy to focus on emotional well-being.
• Encourage Social Interaction: Help your loved one stay connected with friends and family. Arrange visits, outings, or video calls.
• Educate Yourself: To better understand their experience, learn about the emotional effects of stroke so you can better understand what your loved one is going through.
• Seek Support for Yourself: Caring for a stroke survivor can be emotionally taxing. Don’t hesitate to seek support for yourself through therapy or support groups.

Emotional Changes After Stroke: The Long-Term Outlook

The emotional changes after a stroke can be significant, but they don’t have to define your future. Many stroke survivors experience these challenges, and with the right support, coping strategies, and professional help, regain emotional well-being and lead fulfilling lives.

By understanding the emotional impact of stroke and taking proactive steps towards recovery, you are taking the first step toward regaining a sense of control, rebuilding your life, and finding new meaning and purpose.

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