Emotional changes after stroke - Newcastle Hospitals NHS Foundation Trust

A stroke is sudden and can have a big impact emotionally. Everyone’s experience of stroke is unique. Feelings of shock, denial, grief, anger and guilt are normal when faced with changes.

What can cause this?

Anxiety
Frustration
Anger
Depression
Emotionalism (Difficulty controlling your emotions)
Mania and euphoria

Anxiety

It is normal to feel anxious after a stroke. Feeling anxious can affect your recovery. You may be frightened about having another stroke, your family or how you will manage with finances.

We all experience slightly different things when we are anxious, some symptoms include:

Feeling restless
A sense of dread
Feeling on edge
Difficulty concentrating
An increased heart rate
Trembling or shaking
Feeling short of breath
A dry mouth
Feeling sick
Or ‘butterflies’ in your stomach

It may not always be clear what you are anxious about, it is important to remember that these feelings are normal and can be controlled.

Frustration

Nearly all stroke survivors will deal with frustration. A lot can change after stroke and so quickly, that it can be hard to accept.

Stroke survivors may feel frustrated about:

Not being able to do what you used to do
Having to rely on other people
Everything taking longer than it used to
Not being able to work or do other things
Not being able to go out
Not being able to express how you’re feeling
Saying the wrong words
Making mistakes
Forgetting things
Feeling tried and having no energy

Feeling frustrated is normal and many people will have to learn how to deal with these frustrations properly, if not dealt with then they can build up and cause further problems.

Anger

Following a stroke feelings of anger may be experienced more often. It may be difficult for people to control their temper and people may feel angry for no reason.

It is important to:

Let it out
Talk to others about your feelings
Focus on positive things
Try relaxation techniques
Listen to others
Work out triggers/causes

Some anger is normal however it can affect health and recovery if anger takes over.

Depression

It is normal to feel down or sad after a stroke. Depression is when feelings of hopelessness and sadness do not go away.

Common signs of depression:

Feeling sad or down
Feeling worthless, helpless or guilty
Feeling hopeless or desperate
Losing confidence
Losing interest in things you used to enjoy
Lacking energy or motivation
Not going out or avoiding others
Finding it difficult to concentrate and make decisions
Having problems sleeping or sleeping too much
Loss of appetite or eating too much

Stroke association reports that at least one third of stroke survivors will have some form of depression within the first year.

It can return at any point so it is important to know what to look for and how to get help and support when needed.

Emotionalism

A stroke can affect ability to control mood and emotions. This is most common in the early stages of stroke. Some people may experience emotions they never have before, such as becoming more upset over things, some laugh at inappropriate times and others may start to swear when they didn’t do so before their stroke.

Signs of emotionalism:

Finding yourself crying or laughing for no reason
Expressing your emotions more intensely than you actually feel them
Feeling that you have no control over emotions
Feeling like even the smallest thing can set you off
Having emotions that seem out of place
Having emotions that come and go quickly

By nature some people are more emotional than others so signs of emotionalism depend entirely on what is normal for the individual.

How can I manage the emotional effects?

It is important to acknowledge that with the suddenness of stroke it can take some time to work through recoveryâ€‹.
The psychological effects are best acknowledged so that you can work through this side of recovery, as well as through the physical recovery after strokeâ€‹.
Acknowledge if you are struggling with any emotional issues and talk to others about how you feel, such as family, health professionals and support organisationsâ€‹/
Be open to looking at ways to help yourself, such as setting goals, using techniques to manage your moodâ€‹.
Asking for support to help with emotional difficulties can be really helpfulâ€‹.
Family may also need support and can access help from many sources.

Intimacy following a stroke

A stroke can also impact on your intimacy, and for many reasons this can be daunting to people.

It could be communication difficulties, physical difficulties or cognitive changes.

Sexual intimacy is important to many people and understandably questions can arise which people can feel embarrassed about.

If there are difficulties within this area it is recommended to speak to your partner first and foremost as they may be able to support through this.

If you don’t feel comfortable discussing it with a partner but you do with a professional, speak with your therapy team or GP.

Will it get better?

When emotions are overwhelming it can be difficult to process. Remember there are lots of people who are there to help cope with the effects following a stroke. Some things that may help include:

Talking therapies: talking therapies allow time and space to explore difficult feelings with a trained therapist.
Cognitive behavioral therapies: CBT can focus on helping to break the cycle of negative thinking and behavior.
Medication: Although this may not work for everyone, some medications can help with emotional changes.
Talk to family and friends: Family and friends may not be aware of how you’re feeling. Tell them how they can help.
Contact your GP: If you are struggling with emotional changes your GP can point you in the right direction.