Sudden major health crises like stroke and heart attacks are often extremely frightening and can serve as a wake-up call to the patient and his loved ones. When a survivor returns home, he will likely have a long road ahead of physician visits, new medications, lifestyle modifications and rehabilitation.
More than 795,000 Americans annually suffer a stroke, with 610,000 of those being first-timers. This means hundreds of thousands of survivors each year face life with new physical, mental and emotional challenges due to their new health issues, which can be extremely difficult.
Vinit Mehrotra, M.D., a neurologist and physician on the medical staff at Texas Health Fort Worth, says it is crucial for rehabilitation to begin immediately to speed recovery.
“Recovery begins immediately after a stroke, with it being more rapid in the beginning and taking up to a year,” he explains. “Rehab is extremely important to the recovery process and can range from acute inpatient rehab to outpatient physical therapy, depending on the extent of the neurological deficit.”
Despite improvements in all areas of medicine, stroke patients struggle to adjust to their “new normal” of an ongoing problem. In fact, an article published in the journal Rehabilitation Nursing more than 20 years ago discusses the idea that while the initial concerns after a stroke normally focus on physical changes and functional abilities, emotional and cognitive issues must also be addressed.
In the study discussed in the paper, patients were interviewed at one week, one month, three months and six months after their stroke to evaluate their mental state. Significant changes occurred in their mood, judgment, memory and personality, with recurrent themes of depression, memory loss, anxiety, irritability, and decreased energy and initiative.
Mehrotra explains that a survivor’s family and friends should play a significant role in reminding him that things will get better with time.
“Patients require great emotional support after a stroke,” he says. “Most importantly, the patient needs to know there is hope that recovery is possible. Family should reinforce this idea as often as possible. The greatest hurdle after is likely the mental aspect, which is quite difficult for patients. That’s why the reminder of hope for recovery should be such a consistent theme going forward.”
The American Stroke Association addresses the potential emotional and behavioral changes a survivor may experience, including mood disorders like depression and/or anxiety, pseudobulbar affect (involuntary outbursts of crying, laughing or anger) and dementia. And although the brain has suffered injury due to stroke and life may look quite different, the changes experienced after one can improve with rehabilitation and time. Additionally, medication, counseling or a combination of the two may be most effective in battling depression, anxiety and other mood changes after a stroke, according to the National Stroke Association (NSA).
The NSA recommends tackling behavioral and emotional changes as soon as possible after the stroke, working with the patient’s care team. It also suggests the following practical tips:
- Try to remain active and stay involved in hobbies and social activities as much as possible.
- Visit with family and friends regularly, be open and honest about your progress and don’t be afraid to ask for their help!
- Set daily, weekly, monthly and long-term goals to give you a sense of accomplishment and concrete things to work toward.
- Do things that make you happy and give you a sense of purpose.
- Get involved with your local stroke association and join a survivor support group to meet people who have had similar experiences to discuss challenges and share victories.
While a survivor should indeed focus on strengthening his emotional well-being as much as possible, Mehrotra reminds us that it’s also important to prevent additional strokes with continued medical attention.
“It is very important to continue to address the risk factors involved,” he explains. “These include high blood pressure, diabetes, high cholesterol, etc. It is of utmost importance to treat these risk factors. Diet and exercise cannot be overlooked either. Patients must comply with any medications, especially blood thinners, if they are prescribed. Finally, continue to work closely with your neurologist to ensure optimal care.”
To find a neurologist with Texas Health Resources who can help you manage your vascular health following a stroke, visit TexasHealth.org/provider.