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Coping with Anxiety After Stroke: Methods and Treatments

senior woman looking out window, absorbed in thought because she has anxiety after stroke

Stroke can cause a number of different physical and emotional secondary effects. One of the most common emotional challenges after stroke is anxiety.

Coping with anxiety after stroke can be difficult. That’s why today’s article will walk you through the different options you can use to manage anxiety. These options will include both medications and natural alternatives.

Understanding Anxiety After Stroke

Anxiety is a physical and psychological response to a frightening situation. It can cause constant feelings of fear, worry or unease, in addition to various physiological effects.

After a stroke, you may experience anxiety connected to your health. In fact, a new study has found that 25% of stroke survivors experience moderate to severe anxiety. This anxiety can occur anywhere between two to eight weeks after a stroke.

Some of the most common worries that stroke survivors report include:

  • Having another stroke or TIA, especially when out in public or when asleep.
  • Being unable to communicate during an emergency
  • Feeling embarrassed in social situations
  • Being unable to drive
  • Worried about never feeling better

Most of these fears are understandable and are even normal and healthy. However, if anxiety persists and becomes overwhelming, you may have developed an anxiety disorder.

Identifying Anxiety Disorders After Stroke

man with glasses biting nails and looking nervous because he has anxiety after stroke

Anxiety disorders cause more than just a constant feeling of worry, even though that is part of it.

Instead, what distinguishes anxiety disorders from normal anxiety is their intensity. Everybody feels nervous at times, but for someone with an anxiety disorder after stroke, this nervousness overwhelms them. It can even stop them from doing the things they love.

Other signs that you might have an anxiety disorder include:

  • Feeling irritable
  • Difficulty concentrating
  • Constant fatigue and sleep problems
  • Persistent thoughts about the things that worry you
  • Continual feelings of impending danger, with physical sensations such as restlessness and rapid heart rate

Most anxiety disorders after stroke are caused by psychological and biological changes in the brain. This means they may require more complex treatment approaches.

Coping with Anxiety After Stroke

The first step you can take to better cope with anxiety after stroke is to seek out information. Talking to a doctor or psychologist about your feelings can help you clear away uncertainty and give you back some sense of control.

In addition, there are some more specific coping methods for anxiety, which we’ll look at below:

1. Mindfulness

senior man meditating near lake, with mountain in the background

One of the best ways to cope with anxiety after stroke is to practice a technique known as mindfulness.

Mindfulness simply means focusing on the present moment. This helps you to stop dwelling on what the future may hold, which is often the source of anxiety.

To do this, it helps to have a point of focus that pulls your attention to your body. For most people, this point of focus is their breath. When you focus on your breath, it’s much harder for thoughts and worries to sneak in.

To focus on your breath, close your eyes and inhale slowly. Imagine the air entering through your nose, filling your lungs, and expanding your abdomen. Then, as you exhale, picture the air flowing out the same way.

Once you’ve done this a few times, try expanding your awareness to take note of the sensations you feel. What sounds do you hear? How do your feet feel on the ground? What emotions do you feel?

During your time of mindfulness, you can also practice progressive muscle relaxation to increase awareness of your body and reduce muscle tension, which often builds up with anxiety. Progressive muscle relaxation involves the gradual tensing of muscle groups, followed by relaxing them. Starting at the feet, curl the toes and hold for a few seconds, then relax. Move to the ankles, bending them upward and holding, then again relaxing. Continue to move up the body until you reach the head. When you are finished, your muscles should feel more relaxed, and you will have spent time building awareness of each area of your body.

Try to keep yourself present like this for at least five minutes each day. If you have trouble practicing mindfulness independently, there are various apps and videos online that can help you remain mindful of your breath and guide you through progressive muscle relaxation. You should notice your anxiety decreasing the more you practice.

2. Cognitive-Behavioral Therapy

CBT therapist helping patient cope with anxiety after stroke

If practicing mindfulness is still too difficult, cognitive-behavioral therapy may help you cope with anxiety.

Cognitive-behavioral therapy (CBT) is the most scientifically verified treatment for anxiety disorders. In fact, there are over 1,000 studies on 10,000 patients, all demonstrating its effectiveness. It has been successively used on a wide variety of disorders, including stroke.

Cognitive-behavioral therapy is based on three core principles:

  • Beliefs create feelings
  • Feelings dictate behavior
  • Behavior reinforces beliefs

Therefore, to get to the root of anxiety, most CBT treatments focus on uncovering unhealthy thinking patterns.

For example, if you have anxiety after stroke, a cognitive therapist can help you identify the thoughts that are fueling your anxiety. Then, they will teach you helpful techniques to stop these thoughts from consuming you.

They can also show you effective ways to distract yourself from anxiety. Therefore, if you have struggled to find good coping methods for anxiety, try talking with a cognitive-behavioral therapist.

Some coping strategies they may suggest include:

  • Exercise
  • Spending time outdoors
  • Journaling
  • Yoga
  • Listening to music
  • Taking a break for personal time each day

3. Medications

pills with smiley faces drawn on spilling out of glass bottle

Sometimes your anxiety after stroke is caused by damage to the parts of the brain that control your emotions. In these cases, medications can be beneficial.

Some of the most common medications prescribed for post-stroke anxiety include:

  • Benzodiazepines, which treat anxiety directly
  • Buspirone
  • Antihistamines such as hydroxyzine

These medicines are usually used only on a short-term basis. For example, they can help get a person’s anxiety under control if it is severe. However, they are not suitable for extended use, as their effectiveness wears off fairly quickly.

They can also cause dangerous withdrawal symptoms that foster addiction. In addition, long-term use may even impair recovery.

Instead, for chronic anxiety, doctors prefer to prescribe antidepressants such as venlafaxine.

Because anxiety medications are so powerful, they should only be used when natural alternatives are not effective. Never start, alter the dosage, or stop any anxiety medication without consulting your doctor first.

4. Diet Changes

woman holding apple and smiling, because diet changes helped her cope with anxiety after stroke

Finally, certain foods can exacerbate anxiety. Therefore, changing your diet may help reduce or even eliminate anxiety after stroke.

Some common anxiety-inducing foods include sugary foods and others such as:

  • Processed foods
  • Gluten (wheat, barley, rye)
  • Caffeine
  • Dairy
  • Alcohol

However, not all of these foods will necessarily cause you anxiety. It’s possible that you have food sensitivities to only a few of them. The best way to determine which foods are affecting you is to try an elimination diet.

An elimination diet involves removing all possible trigger foods from your diet. Then, once you have eliminated all these foods for a few weeks, you can add one food back at a time.

For instance, if your anxiety subsides after eliminating gluten but returns when you add it back in, try following a gluten-free diet from now on. It is probably making your anxiety worse.

Check out our list of the best foods for stroke recovery to get ideas for foods that won’t trigger your anxiety.

Finding Relief From Anxiety After Stroke

Anxiety is a common emotional effect of stroke. In fact, most patients experience some feelings of worry after their stroke. However, if these feelings persist for weeks and affect your daily life, you may have developed an anxiety disorder.

The best treatment for anxiety disorders usually involves a combination of mindfulness, cognitive therapy, and diet changes. But medication may be necessary in severe cases.

We hope this guide to coping with anxiety after stroke helps you find peace.

©iStock/dragana991

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Mom gets better every day!

“When my 84-year-old Mom had a stoke on May 2, the right side of her body was rendered useless. In the past six months, she has been blessed with a supportive medical team, therapy team, and family team that has worked together to gain remarkable results.

While she still struggles with her right side, she can walk (with assistance) and is beginning to get her right arm and hand more functional. We invested in the FitMi + MusicGlove + Tablet bundle for her at the beginning of August.

She lights up when we bring it out and enjoys using it for about 20 to 30 minutes at a time. While she still doesn’t have enough strength to perform some of the exercises, she rocks the ones she can do!

Thanks for creating such powerful tools to help those of us caring for stroke patients. What you do really matters!”

David M. Holt’s review of FitMi home therapy

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