Guest Post: Dealing with Depression and Anxiety During Stroke Rehabilitation


Editor’s Note: Today’s post is the first in a series of guest posts from survivors, caretakers, and medical industry professionals. They share their experiences with stroke and the stroke system. I’m thrilled to feature more of their stories and strategies. 

Today’s post comes from stroke survivor Peter Evans. I will also be talking with Peter on the podcast in the coming weeks.

— Thanks, Bill


As if working through the physical, financial, and logistical disruptions of stroke were not enough, many stroke survivors and their caregivers find themselves completely unprepared for the intense mental and emotional effects that this type of traumatic brain injury can cause. Depending on the recentness, location, and extent of their cerebral damage, many stroke survivors are hit with a “double whammy” of depression and anxiety. But, take heart! You are not alone. Effective treatments are available for both of these conditions. There are also steps you can take right now to start managing them. And… it almost always gets better with time.

1. Learn Your Triggers and Develop Strategies to Avoid or Minimize Them

Be alert and keep an open mind for your emotional triggers. Activities and environments that were once neutral or even pleasurable, might now have become emotional triggers. Examples include large social gatherings, exploring the supermarket aisles as you try to figure out what’s for dinner, listening to music as you complete other tasks, talking to certain people, or discussing certain topics.
Take note of your feelings and what triggers preceded them, so you can develop strategies. Discuss with caregivers, trusted family members, or your doctor. They may have additional ideas on appropriate coping strategies.

2. Take Ownership of How You Frame the Situation

Remember that any situation is whatever we make of it, and that what we make of it is subject to change… at any point. So take care when characterizing your situation. Yes, stroke is awful—it’s a scourge! But that doesn’t mean everything is awful. There are stroke survivors who recount examples of relationships strengthened, priorities revisited, and truths uncovered as a result of stroke and their journey through recovery. Remember that, as you rebuild and relearn, you now get a free do-over—another chance to get it right, to mend tattered relationships, to reorganize priorities, and to be happy once again..

And while there may be no conclusive medical study yet, it’s anecdotally acknowledged that a large number of stroke survivors report prior to stroke they were typical “Type A” personalities, fiercely driven and often ignorant of all the wonderful things surrounding them, and who later report almost a sense of gratitude for the care they received and the second chances that life had in store for them.

3. Entertain the Possibility…

It’s often difficult for stroke survivors to acknowledge all the impacts and deficits their stroke has engendered. Maybe it’s a coping mechanism, or perhaps even a case of “living in the feeling of the wish fulfilled.” But either way, it can lead to tensions and unnecessary disagreements with care providers or family members. Here are some possibilities you could start entertaining now…

  • Remember that your loved ones are there to help you. They have no incentive for making you “wrong” or keeping you down.
  • Avoid unnecessary conflict, even if you don’t see it… even if you think what they’re saying is completely wrong.
  • Entertain the possibility that the caring person in front of you, the person who did not suffer a traumatic brain injury, just might have a perspective or some information that might be of help to you.
  • Remember: it’s not an indictment of you. Even the kindest, most mild-mannered milquetoast has been known to become a stubborn or pigheaded terror after suffering a stroke.
  • Now it’s time to let that go, to say Thank you, and entertain the possibility that you’re not seeing things as clearly as you might have otherwise.

4. Be Kind to Yourself

Reaching out and helping someone else is a strong motor to pull us out of depression, but right now the person who needs attention and your loving kindness is most likely you. By helping yourself, you’re making more of yourself available to give back to the rest of the world. If you’re tired, then rest. Take a nap. Fatigue is not a sign of weakness. It’s a common after-effect of stroke recovery. If you can’t get the lid off the pill bottle, remember that they’re designed to be difficult, and ask your spouse to give to give you a hand.

5. Eliminate (or Reduce) Alcohol Consumption

Alcohol has a sedative effect on the brain. And while a couple of beers or a few glasses of wine can help ease a worrisome mind, or dull the edge of negative thoughts, in the end they actually increase the risks and the effects of depression and anxiety during recovery.
Keeping alcohol to a minimum or eliminating it entirely during recovery is an excellent strategy for reducing the effects of depression and anxiety as you recover.

6. Talk to your Doctor

It has multiple names: post-stroke emotionalism, emotional lability, pseudobulbar affect. And it’s real. Don’t be shy. Talk to your doctor if your heightened emotional states last longer than two days or seem out of proportion or inappropriate to the situation. Your inhibition to ask for help may be part of the problem. Your condition deserves to be heard.

7. Stay Open to Ongoing Improvements

Don’t give up on continued improvement. You’re not the first, nor the last. You’re not alone. You’re not at fault, and you’re not to blame. You need loving kindness. You’re counting on you. No situation, no matter how glorious, no matter how grim or how hopeless—no situation lasts forever. No feeling is ever permanent. It’s time to throw on the cape and come flying to your own rescue. Remember, you’re counting on you.

What are your thoughts on these tips? Let us know in the comments below.

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