For patients and their loved ones, the physical effects of stroke – paralysis, weakness, vision loss, and pain, among many other potential problems – are clear. However, the emotional and mental effects of stroke can be much more difficult to recognize, and they can be just as traumatic and limiting as physical problems – even more so in some cases. For that reason, understanding these changes and taking steps to address them is essential to making the most of stroke rehab and recovery.
Stroke affects everyone differently. The long and short-term consequences depend on the area of the brain affected, the severity of injury to that area, and the overall health of the patient in question. That said, there are a number of emotional and mental after-effects that many stroke survivors have in common.
Stroke is a terrifying and life-changing event, so it is perfectly normal to feel a sense of sadness and loss. However, it is important to know that for many stroke survivors, these feelings go much deeper than can be accounted for by that trauma. Rather, they are caused by physical and chemical changes in the brain related to brain injury. Serious post-stroke depression requires medical attention and can be characterized by feelings of hopelessness, worthlessness, apathy, sluggishness and in many cases, thoughts of death or suicide. This sort of depression, left untreated, can last up to three years after a stroke and can significantly impact a person's progress in stroke rehab, leaving them unable to regain the motivation and focus they need to work towards recovery and reclaim their lives.
Feeling afraid or anxious is also common in the aftermath of stroke and is a reasonable reaction to an unexpected and traumatic event. However, for many stroke survivors, fearfulness and anxiety can become constant and overwhelming. Generally chronic, severe anxiety after stroke is due to stroke-related brain injury, and treatment can prevent this condition from becoming a debilitating one that interferes with stroke recovery.
Emotional lability is a condition in which a person is much more emotional than usual and/or has trouble controlling their emotions. They may become unreasonably upset over small things, cry for no apparent reason, or cycle through strong, exaggerated emotions very quickly (i.e. crying one minute then laughing the next) with no obvious reason for either reaction. Emotional lability is a common effect of many neurological conditions and often occurs as a side effect of brain injuries inflicted by stroke. Typically the condition improves or resolves over time as the brain heals, but if emotional lability is severe enough to inhibit progress with stroke rehab, it can be treated with medication.
Stroke survivors may have trouble with memory, thinking, attention, learning, and impulse control. Following directions may be difficult, as brain injury can slow or impair the ability to process information, and communication may be a struggle. Reading and writing can become a challenge, as can tasks like paying bills or balancing a checkbook. For many people these frustrating difficulties will ease with healing and therapy, but for some, they will be permanent challenges.
Understanding the potential for emotional and cognitive changes in the aftermath of stroke is essential to the process of healing and recovery. These changes, if not properly addressed during the stroke rehab process, can have a significant impact on stroke survivors, slowing progress towards recovery, affecting quality of life over the long-term, as well as relationships with family, friends and caretakers.