The Mystery Behind Post-Stroke Mood Changes

A stroke is a life-threatening medical emergency that occurs when there is a blockage or disruption in the blood supply to the brain, resulting in a lack of oxygen and nutrient delivery to brain cells. This can lead to brain cell death and permanent brain damage if not treated promptly. While strokes can affect anyone at any age, certain risk factors such as high blood pressure, heart disease, diabetes, smoking, and high cholesterol can increase the likelihood of experiencing a stroke. The effects of a stroke depend on the area of the brain impacted and can result in a range of physical and cognitive impairments, including paralysis, speech difficulties, behavioural changes, and emotional control issues. The question of whether strokes can make a person mean will be explored in this article through an examination of the potential emotional and behavioural changes that can occur following a stroke.

Emotional instability and personality changes

The effects of a stroke depend on which area of the brain is damaged. A person who has had a stroke may experience emotional instability and may find it hard to control their emotions. They may feel depressed or anxious, and may need treatment for a serious mood disorder.

The sooner a person having a stroke receives treatment, the better their outcome is likely to be. Prompt treatment can prevent brain damage, long-term disability, or death.

Physical therapy

A stroke occurs when there is an interruption in the blood flow to the brain, which can be due to a blocked or ruptured blood vessel. This interruption deprives brain cells of oxygen, causing them to start dying within minutes. As a result, the functions controlled by the affected areas of the brain may be lost or impaired. These functions include movement, walking, using the hands, and controlling the bowel and bladder.

• Evaluation and Assessment: Physical therapists conduct a comprehensive evaluation that includes taking a health history, discussing symptoms, identifying risk factors, reviewing lab tests and images, and observing the patient's ability to move, stand, and walk.
• Improving Movement and Function: Through various techniques such as task-oriented training, strength training, walking and balance training, and electrical stimulation, physical therapists help stroke patients regain movement patterns and improve their overall functionality.
• Addressing Disability: Physical therapy aims to reduce disability and enhance independence. This may involve recommending mobility aids like braces or wheelchairs and teaching patients how to use them effectively.
• Pain Management: Physical therapists work to address any pain the patient may be experiencing as a result of the stroke.
• Prevention of Complications: Therapists provide guidance on preventing problems that may arise after a stroke, such as muscle pain, spasms, or stiffness.
• Relearning Upper Body and Daily Activities: Physical therapists design exercise and strengthening programs tailored to the patient's daily tasks. This may include task-oriented and functional training, such as getting up from a chair or climbing stairs.
• Balance and Walking Ability: Therapists help improve balance and walking ability through different training methods, including gait training and activities that challenge balance.
• Constraint-Induced Movement Therapy: This approach involves constraining the patient's strong arm to encourage the use of the weak arm, helping to build strength and control.
• Virtual Reality and Interactive Tools: Therapists may utilize virtual reality, robotics, and interactive video games to provide experiences that mimic real-life activities, aiding in the "rewiring" of brain and nerve connections.
• Biofeedback: This technique helps patients gain a better understanding of their muscle function and explore ways to improve control over their muscles.
• Aquatic Therapy: Some therapists incorporate aquatic exercises, which have shown potential in improving a range of stroke-induced disabilities.
• Duration and Frequency: The duration and frequency of physical therapy depend on the severity of the stroke and the patient's level of disability. Sessions typically occur several times per week and may continue for months or even years.

Speech therapy

A stroke is a life-threatening medical emergency that occurs when the blood supply to the brain is interrupted or reduced, cutting off vital oxygen and nutrients. Brain cells can begin to die within minutes, so immediate medical attention is critical to prevent permanent damage or death.

The impact of a stroke depends on which parts of the brain are affected. It can cause weakness, paralysis, an inability to speak properly, and difficulty swallowing or seeing. It can also lead to emotional changes, with many survivors experiencing depression.

The most common type of stroke is an ischemic stroke, where the blood supply to the brain is reduced or cut off, causing brain cells to die due to lack of oxygen. This often results in disabilities, including problems with speech and language, known as aphasia. A less common type is a hemorrhagic stroke, where a blood vessel in the brain ruptures and floods the brain tissue, causing damage through increased pressure.

Aphasia can affect how someone speaks, their ability to understand what is being said, and their reading and writing skills. There are three types: receptive, expressive, and mixed (or global) aphasia. Receptive aphasia causes problems with understanding speech, while expressive aphasia makes it difficult to express oneself, and mixed aphasia is a combination of the two. A person with aphasia may also be unaware of their condition and think that they are communicating effectively.

SLPs use various techniques to improve communication, including one-on-one sessions and group settings. Group therapy can be particularly beneficial as it provides a low-stress environment to practice communication skills such as starting a conversation and taking turns. SLPs may also recommend computer programs and mobile apps to aid in relearning words and sounds, and suggest props and communication aids such as pictures, notecards, and pen and paper.

Family members can also play a crucial role in their loved one's recovery by including them in conversations, giving them time to talk, and minimizing distractions. It is important to be patient, as recovering language skills can be a slow process, and complete recovery may not be possible. However, with patience and persistence, significant progress can be made, improving the survivor's ability to communicate and reducing the risk of embarrassment, relationship problems, and depression.

In addition to aphasia, stroke survivors may also experience dysarthria and dyspraxia, which affect the muscles used for speech. Dysarthria causes weakness in these muscles, resulting in slurred speech, while dyspraxia affects muscle movement and coordination, making correct pronunciation difficult. Speech therapy can help improve these conditions by focusing on neuromuscular re-education and cognitive language exercises to restore or adapt language skills.

Some specific speech therapy exercises include:

• Tongue side-to-sides, ups-and-downs, and in-and-outs to improve tongue strength and coordination
• Smiling to improve oral motor skills
• Puckering and relaxing the lips to enhance muscle control
• Word games to improve language processing and comprehension
• Phonological processing exercises, such as guessing the number of syllables in a word, to improve speech production
• Singing therapy, which utilizes the undamaged right side of the brain, to help regain conversational speech

Cognitive therapy

A stroke is a life-threatening medical emergency that occurs when the brain is deprived of oxygen due to a blocked or ruptured blood vessel. This can lead to physical changes in the brain tissue and cognitive deficits, including problems with attention, memory, executive functioning, and information processing.

• Card matching: This visual memory game can improve mental recall and visual scanning abilities.
• Alphabetizing sentences: Rearranging the words in a sentence in alphabetical order can enhance analytical reasoning skills.
• Counting money: Handling and counting coins can stimulate the brain and improve quantitative reasoning abilities.
• Brain teasers: Activities like Sudoku, word searches, and crossword puzzles can enhance analytical and quantitative reasoning, concentration, attention, and memory.
• Visuospatial processing games: These games help improve perceptual skills and the ability to identify visual differences and their positioning in space.
• Classic board and card games: Games like Checkers, Connect Four, and Rumikub can stimulate cognitive skills such as deductive reasoning, divided attention, and organization.
• Cooking: Following a recipe can improve sequencing, memory, and problem-solving skills, as well as engaging multiple senses.
• Cognitive therapy apps: Apps specifically designed for stroke survivors offer a range of exercises to improve visual/spatial processing, quantitative reasoning, and analytical thinking.
• Meditation: Focusing on one's breath and the present moment can enhance concentration, mental flexibility, and information processing while reducing stress and anxiety.
• Arts and crafts: Creative activities like drawing, colouring, painting, scrapbooking, and knitting can stimulate analytical skills, hand-eye coordination, and emotional expression.

It is important for stroke survivors to consistently practice these cognitive exercises to promote neuroplasticity and maximize their potential for recovering cognitive functions. Additionally, seeking therapy with a speech-language pathologist can help create a personalized treatment plan that targets specific areas of need.

Occupational therapy

A stroke is a life-threatening medical emergency that occurs when there is an interruption in blood flow to the brain. It can be caused by a blocked artery or bleeding in the brain, and requires immediate medical attention to prevent permanent damage or death.

• Improving Motor Control and Hand Function: Occupational therapists work to improve motor control and hand function in the upper limb affected by the stroke, helping individuals regain control and function.
• Maximizing Independence in Daily Tasks: Occupational therapy helps individuals maximize their ability to perform personal self-care tasks, such as showering, dressing, toileting, grooming, and eating, as well as domestic tasks like meal preparation, cleaning, and managing finances.
• Cognitive and Behavioral Strategies: Occupational therapy assists patients in learning strategies to manage the cognitive, perceptual, and behavioral changes associated with stroke. This includes addressing memory, attention, and executive functioning to enhance daily functioning.
• Home and Work Environment Adaptations: Therapists assess the patient's home and work environments and recommend modifications or equipment to facilitate their return. For example, installing grab rails, raising chair heights, or providing wheeled mobility trays.
• Visual and Perceptual Impairment Management: Therapists employ strategies such as visual scanning training to assist individuals with visual impairments or neglect in locating items and navigating their environment more accurately.
• Constraint-Induced Movement Therapy: This approach involves restraining the non-affected limb to promote the use of the affected limb, stimulating the brain and encouraging neuroplasticity.
• Electrical Stimulation: Electrical stimulation is used to reactivate muscles affected by the stroke, improving mobility and reducing spasticity.
• Mirror Therapy: This intervention is beneficial for individuals with hand paralysis or severe hand impairments. It involves using a mirror to reflect the non-affected side while completing exercises, helping individuals visualize their affected side moving typically.
• Mental Practice and Motor Imagery: Mental rehearsal of movements can stimulate neuroplasticity and strengthen neural connections, making it easier to physically execute tasks.
• Adaptive Equipment and Education: Occupational therapists recommend and educate individuals on the use of adaptive equipment, such as sock aides, reachers, or long-handled sponges, to enhance safety and independence in daily tasks.
• Sensory Re-education: Therapists retrain the brain to process and respond to different sensations, such as textures, temperatures, and pain, addressing sensation deficits like numbness.
• Cognitive Training and Adaptation: When cognitive effects of the stroke impact daily tasks, occupational therapy provides cognitive training exercises and adaptive techniques to improve attention, sequencing, and problem-solving skills.
• Fine Motor Activities: Fine motor skills are commonly affected by strokes, making it challenging to write, type, or complete fasteners. Occupational therapy interventions include fine motor coordination and strengthening activities, such as manipulating small objects or using hand therapy balls.
• Work Accommodations: Occupational therapy helps individuals relearn skills needed to return to work, including recommending shorter work hours, breaks, ergonomic equipment, flexible scheduling, and task simplification.

Frequently asked questions