Let's Talk About Emotional Changes After Stroke

Updated:Dec 9,2015

Right after a stroke, a survivor may respond one way, yet weeks later respond differently. Some survivors may react with sadness; others may be cheerful. These emotional reactions may occur because of biological or psychological causes due to stroke. These changes may vary with time and can interfere with rehabilitation.

How does stroke cause emotional changes?
Emotions may be hard to control, especially right after a stroke. Some changes are a result of the actual injury and chemical changes to the brain caused by the stroke.

Others are a normal reaction to the challenges, fears and frustrations that one may feel trying to deal  with the effects of the stroke. Often, talking about the effects of the stroke and acknowledging these feelings helps stroke survivors deal with these emotions.

What are some common emotional changes after stroke?

Pseudobulbar Affect, also called “emotional lability,” “reflex crying” or “labile mood,” can cause:

  • Rapid mood changes — a person may “spill over into tears” for no obvious reason and then quickly stop crying or start laughing.
  • Crying or laughing that doesn’t match a person’s mood.
  • Crying or laughing at unusual times or that lasts longer than seems appropriate.

Post-stroke depression is characterized by:

  • Feelings of sadness
  • Hopelessness or helplessness
  • Irritability
  • Changes in eating, sleeping and thinking

Treatment for post-stroke depression may be needed. If not treated, depression can be an obstacle to a survivor’s recovery. Don’t hesitate to take antidepressant medications prescribed by your doctor.

Other common emotional reactions include:

  • Frustration
  • Anxiety
  • Anger
  • Apathy or not caring what happens
  • Lack of motivation
  • Depression or sadness
How can I cope with my changing emotions?

  • Tell yourself that your feelings aren’t “good” or “bad.” Let yourself cope without feeling guilty about your emotions.
  • Find people who understand what you’re feeling. Ask about a support group.
  • Get enough exercise and do enjoyable activities.
  • Give yourself credit for the progress you’ve made. Celebrate the large and small gains.
  • Learn to “talk” to yourself in a positive way. Allow yourself to make mistakes.
  • Ask your doctor for help. Ask for a referral to a mental health specialist for psychological counseling and/or medication.
  • Stroke may cause you to tire more easily. Rest when you feel fatigued. Make sure you get enough sleep at night. Sometimes lack of sleep can cause emotional changes and cause you not to cope as well.

How can I learn more?

  1. Call 1-888-4-STROKE (1-888-478-7653) to learn more about stroke or find local support groups, or visit StrokeAssociation.org.
  2. Sign up to get Stroke Connection magazine, a free magazine for stroke survivors and caregivers at strokeconnection.org.
  3. Connect with others sharing similar journeys with stroke by joining our Support Network at strokeassociation.org/supportnetwork.

We have many other fact sheets to help you make healthier choices to reduce your risk, manage disease or care for a loved one. Visit strokeassociation.org/letstalkaboutstroke to learn more. 

Do you have questions for your doctor or nurse?

Take a few minutes to write your questions for the next time you see your healthcare provider:

What can my family do to help me when I am emotional?

Will these emotional changes improve over time?

©2015, American Heart Association

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