Psychological Effects of Stroke

In the past week we’ve been discussing various issues around stroke for stroke awareness month. Today we will focus on some of the psychosocial effects associated with stroke which can negatively affect a survivor’s rehabilitation. These psychological issues may affect rehabilitation outcomes through;

• Reduced interest in rehabilitation
• Non-adherence to home programs
• Reduction in energy level
• Less motivation and hope about the future
• Increased/easy fatiguability
• Anger and reduced tolerance

Psychosocial well-being is frequently threatened following stroke. A stroke survivor who appears to have successfully completed or is still in a rehabilitation program, may fail to adapt to home and work environments because one or more psychosocial factors that have not been addressed during rehabilitation. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent amongst others. The two most important factors are depression and social isolation.
Rehabilitation needs not focus only on the physical outcome of the patients, but also incorporate how the psychosocial aspects of the individual’s life can be positively affected.

Depression

Stroke survivors are often greatly challenged by post-stroke depression, which can lengthen rehabilitation and recovery time considerably. Many of them experience feelings of hopelessness, anxiety, and dehumanization. Stroke-associated depression may reduce survival and increase the risk of recurrent vascular events. Besides having a deep impact on the survivors themselves, post-stroke depression also affects family and friends. These are some of the common symptoms of post-stroke depression;

• Persistent sad, anxious, or “empty” mood
• Restlessness and irritability
• Feelings of hopelessness
• Loss of interest or pleasure in hobbies and activities, including sex
• Decreased energy and fatigue
• Difficulty concentrating, remembering, and making decisions
• Insomnia or oversleeping
• Appetite swings and/or weight changes
• Thoughts of death or suicide attempts

All of the above-mentioned symptoms will negatively affect rehabilitation process. If five or more of these symptoms persist for longer than two weeks, depression may be the cause and it needs to be addressed.

Social Isolation Post-Stroke (Low Self Esteem)

One may feel discouraged and down, but just as you can rehabilitate your body after a stroke, you can also raise your self-esteem by not isolating yourself from friends and family. These are common signs and symptoms of someone isolating themselves:

• Withdrawal from social gatherings
• Loss of interest in personal hygiene
• Social Anxiety

Here are a few tips that are helpful for stroke survivors and caregivers to combat psychosocial effects of stroke:

• Keeping a diary and writing down your thoughts and feelings may help lower your stress level and provide balance. It is a good way to solve problems and get to know yourself better.
• Affirm yourself with positive statements and change the thoughts that are negative and limiting.
• Visualize/picture what you want to create in life and work towards achieving it the best way you can.
• Get your mind busy by reading books, praying and meditating, depending on what you enjoy doing most.
• Focus more on seeing the best in yourself and not minding people’s comments about your current status
• Change your thoughts and you can change how you feel and act.
• Exercise, a regular workout routine is good for psychological health.
• Take up hobbies and other social activities that keep you engaged with other people.
• Do not be shy or afraid to admit you may need professional help. A psychologist or other form of counselor can help you manage your symptoms professionally and discreetly.

Nurture yourself. Take care of yourself physically, emotionally, mentally, and spiritually. At PCA, we can help you with your exercise programs, but we can also make the right recommendations and referrals when there are other considerations effecting your rehab.