Emotional changes after stroke

Why do I feel different?

A stroke is sudden and can leave you feeling very shocked. It can affect every part of your life. It’s a lot to deal with, so it’s going to have an effect on your emotional well-being. Everyone’s experience of stroke is unique, but for many people, it feels like they’ve lost the life they had before.

What kinds of problems can it cause?

All of this can be hard to cope with. But if you don’t acknowledge the way you’re feeling and find things that can help you deal with it, these emotions can become overwhelming and lead to problems.

Anxiety

It’s common to feel anxious after a stroke. Around one-quarter of people who have a stroke will experience some form of anxiety within the first five years. You may worry that you’re going to have another stroke or be frightened about getting around on your own.

Frustration

One of the emotions that nearly all stroke survivors have to deal with is frustration. So many things change after a stroke, and so quickly, that it can be hard to accept. You 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 word.

• Making mistakes.

• Forgetting things.

• Feeling tired and having no energy.

Feeling frustrated is natural and you’re going to feel this way from time to time. But if you don’t deal with these frustrations properly, they can build up and make you irritable. This means you’re likely to get annoyed very easily. You may lose your temper and your mood can change quickly, which can be difficult to live with.

Depression

It’s also common to feel down or sad after a stroke. But depression is when feelings of hopelessness and sadness don’t go away. They last for weeks or even months and may come and go. Depression is very common after a stroke. We know that at least one-third of stroke survivors will have some form of depression within the first year. But you may not have it straight away. It can appear at any point, perhaps months or even years down the line.

Anger

You may get angry more often after you’ve had a stroke. You may not be able to control your temper and feel you become angry for no reason. Or you may get angry about things that never would have made you feel that way before. Although some anger is normal, it can affect your health and recovery if you’re angry all the time. It can also make life difficult for you and the people around you.

Difficulty controlling your emotions (emotionalism)

A stroke can affect your ability to control your mood and emotions. This is called emotionalism or emotional lability. It can mean that your mood changes very quickly and you are more emotional than you used to be.

You may find that you cry or laugh more and this can become extreme, such as laughing at something inappropriate. Or it can happen for no reason at all. Some people start to swear when they didn’t do so before their stroke.

Mania and euphoria

Mania is when your mood is extreme. It can be extremely high or extremely low and may swing between the two. Your energy and enthusiasm will change with your mood, so if it’s high you’ll seem hyperactive, you may talk very quickly, have lots of ideas and you may have difficulty sleeping.

Will it get better?

When emotions are overwhelming it can be easy to think that they’ll never get better, but they do. Feeling low, anxious or angry, or not being able to control your emotions are all very common after a stroke, especially in the first few months.

Even if these feelings never completely go away, you’ll probably find them easier to cope with over time. And remember, you’re not on your own. There are lots of people who are there to help you cope with the way you’re feeling. You don’t have to do it alone.

Are there treatments that can help?

Lots of treatments and therapies can help with your emotions after a stroke. Depending on the problems you’re having, your GP may be able to refer you to someone who specialises in mental health, such as a psychologist or a counsellor.

Many people find that talking about the way they’re feeling helps them to be able to understand and deal with it. There are different types of talking therapies available, and your GP may be able to refer you. Medication can often help as well.

Talking therapies

Talking therapies give you time and space to talk about your problems and explore difficult feelings with a trained therapist – this could be a counsellor, psychotherapist, psychologist or a psychiatrist.

This can help you deal with specific problems or develop ways of coping with your thoughts and feelings. Therapists can work with you one-to-one or jointly with your partner or other family members. Group therapy sessions are another option.

Cognitive behavioural therapy

One type of talking therapy that many people find helpful is cognitive behavioural therapy (CBT). This can help with many of the emotions people experience after a stroke and is recommended as a treatment for depression and anxiety.

CBT focuses on your thinking and behaviour and how they are connected. Negative thoughts can stop you from doing things, which in turn, can make you feel worse. CBT can help you break this cycle and improve the way you feel. It usually needs a number of sessions, over the course of several weeks. To help you maintain your progress you can try reading books on CBT, which can guide you through exercises and techniques. There are also interactive computer and online programmes that you can try.

Speak to your GP about your options. You can choose private talking therapy services if you want a choice of a therapist or don’t wish to wait for NHS help. We’ve listed some websites later in this guide that you can use to look up what’s in your area, or you can contact our Stroke Helpline.

Medication

Some drugs can help you with your emotions. Antidepressants are the best known. These drugs affect the chemicals in your brain and lift your mood. This can help to treat depression and sometimes anxiety. Medication can often help with emotionalism (difficulty controlling your emotions) as well.

There are lots of different types of antidepressants and it can take a bit of time to find the right one at the right dose. They can also take a little while to work, and if you wish to come off them you need to get help from the GP on how to stop gradually. So if it’s something you decide to try, you’ll need to persevere and work with your GP to find what works best for you.

Information guides

• Download Emotional changes after stroke guide (PDF)

• Download A complete guide to emotional changes after stroke guide (PDF)

Where to get help and information from the Stroke Association

Helpline
Call us on 0303 3033 100, from a textphone 1800 0303 3033 100
Email: helpline@stroke.org.uk
Our Helpline offers information and support for anyone affected by stroke, including family, friends and carers.

Read our information
Call the Helpline to ask for printed copies of our guides.

Other sources of help and information

British Association for Counselling and Psychotherapy (BACP)
Phone: 01455 883 316
Publishes the Counselling & Psychotherapy Resources Directory. This lists organisations, counsellors and psychotherapists in the UK. Some counsellors operate a sliding scale of charges according to income.

British Psychological Society (BPS)
Phone: 0116 254 9568
Email: info@bps.org.uk
Holds lists of counselling psychologists and neuropsychologists.

Carers UK
Phone: 0808 808 7777
Contact form
Provides information and support to carers.

Counselling directory
Website listing recognised and qualified counsellors and psychotherapists with a postcode search facility.

Inspire Wellbeing
Phone: 028 9032 8474
UK email: hello@inspirewellbeing.org.uk
Ireland: dundalk@inspirewellbeing.ie

MIND
Phone: 0300 123 3393
Email: info@mind.org.uk
Mind is a national mental health charity offering a range of publications and information on local services and support groups.

Change Mental Health
Phone: 0300 323 1545
Email: info@changemh.org
Supports people with mental health problems in Scotland, offers information, support and a drop-in resource centre.

UK Council for Psychotherapy (UKCP)
Phone: 020 70149955
Email: info@ukcp.org.uk
The UK Council for Psychotherapy is the leading organisation for psychotherapists and psychotherapeutic counsellors in the UK.

Disclaimer: The Stroke Association provides the details of other organisations and apps for information only. Inclusion on My Stroke Guide does not constitute a recommendation or endorsement.