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How to Cope with 7 Puzzling Behavior Changes After Stroke

senior stroke patient with party clothes demonstrating behavior changes after stroke

Sometimes behavior changes after stroke are the result of emotional trauma from sustaining a life-threatening medical event. Other times, the neurological impact could be the source of certain changes.

This article will help you understand the causes and coping mechanisms for different behavior changes after stroke. If you’re a stroke survivor or caregiver, we hope you find the guidance you need during this time of transition.

Types of Behavior Changes After Stroke

There are many different types of behavior changes after stroke. Some are more drastic than others.

Here’s an explanation of the most common behavior changes after stroke:

1. Mood Swings After Stroke

There’s a spectrum of moodiness that can affect a stroke survivor’s behavior. Sometimes, moodiness is simply the result of coping with the intense challenges of stroke recovery.

Other times, moodiness can stem from damage to the emotion center of the brain, resulting in a condition known as emotional lability or pseudobulbar affect.

Pseudobulbar affect can cause uncontrollable emotional outbursts like laughter or crying, even if the situation isn’t comical or sad. This can seem like strange behavior, and it requires medical attention.

2. Inappropriate or Irrational Behavior After Stroke

woman looking at smartphone with surprise from inappropriate behavior


Some caregivers worry when their loved ones act inappropriately or irrationally after stroke. This behavioral change is trickier to diagnose, so be sure to enlist the help of your doctor.

Some irrational behavior stems from the general stroke after math, where regular tasks require more time and energy. In this case, behavior changes may naturally improve over time.

However, some irrational behavior stems from changes to the brain. For example, a frontal lobe stroke can impact the part of the brain responsible for making decisions and managing our impulses.

If these areas of the brain have become damaged by stroke, it could result in inappropriate or irrational behavior.

3. Strange Behavior After Stroke

Strange behavior may happen after stroke as a normal side effect of the demands of recovery. The “normal” activities of daily life are actually quite demanding of a stroke survivor with a healing brain.

It’s important to have empathy for stroke survivors during recovery. Remember that things that are “normal” to you (if you’re a caregiver) are actually exhausting for a recovering brain to digest.

However, if strange behavior doesn’t improve over time, it could be a sign of post-stroke dementia, formally known as vascular dementia. This condition impairs reasoning, planning, judgement, and memory after stroke.

It’s important to know that not all cognitive impairments are a sign of dementia.

4. Forgetfulness and Neglectfulness


Sometimes stroke affects memory and attention. This can cause a stroke survivor to act forgetful or neglectful.

Forgetfulness is often the result of impaired cognitive function after stroke. It can improve through time and practice.

Neglectfulness could be a sign of hemineglect after stroke, where a stroke survivor does not notice things in their environment on the affected side. For example, if you approach someone with left side neglect on their left side, they might not even notice you.

While this can seem like a change in behavior, it’s actually a cognitive deficit that should be formally diagnosed and addressed.

5. Anger, Depression, and Anxiety

Negative emotions like anger, depression, and anxiety are unfortunately common after stroke. These emotions often happen as a stroke survivor tries to cope with their new life.

When you put yourself in a stroke survivor’s shoes, it’s easy to see why negative emotions could bubble up. You’re essentially relearning how to perform activities of daily living, like walking and talking, as if for the first time — and it can be frustrating.

Exercise compassion for stroke survivors going through the recovery process. And if you’re a caregiver, don’t forget about compassion for yourself, too!

6. Childlike Behavior

child waking up mother in the middle of a nap


With childlike behavior after stroke, it’s important to understand that some people use this type of behavior as a coping mechanism. You may be able to find compassion when you consider how different and difficult life after stroke can be.

However, not all childlike behavior is a coping mechanism. Sometimes, when behavior becomes extreme, it’s a sign of vascular dementia or frontal lobe damage. Both are treated differently, so be sure to consult with a doctor for a formal diagnosis.

7. Aggressive and Combative Behavior After Stroke

Some stroke patients demonstrate dangerous and aggressive behavior after stroke, and this can be particularly worrisome. This behavioral change is also associated with frontal lobe damage and impaired impulse control. Medication often helps, which you will soon learn as we discuss various treatment options.

Before we dig into the methods you can use to cope with behavior changes, please remember that seeking help is crucial. If you are the victim of domestic violence, you must protect yourself. Call the domestic abuse hotline relevant to your country.

Diagnosis and Treatment for Behavior Changes After Stroke

There are various types of behavior changes after stroke, each with their own variety of possible causes. Therefore, it’s critical to get a formal diagnosis from your doctor.

Some steps your doctor may recommend to cope with behavior changes after stroke include:

  • Medication. If your doctor diagnoses your loved one with vascular dementia, pseudobulbar affect, or frontal lobe damage, they may recommend medication to help cope. Certain SSRIs may help improve a variety of behavior changes that stem from biological changes.
  • Psychotherapy. Another great step to help cope with behavior changes is therapy. When behavior changes are severe, therapy might not be enough treatment on its own, but it can certainly play a strong role in recovery.

Not all patients like the idea of adding more medication to their regimen, though. If you prefer alternative treatments before resorting to medication, read on.

Alternative Treatments for Behavioral Health After Stroke

The alternative treatments for behavioral health after stroke focus on the concept of neuroplasticity: the brain’s natural ability to rewire itself and build new skills.

This concept is most commonly applied to recovery of physical side effects, like movement. However, it has a place in behavioral health, too.

Here are more alternative treatments that may help with behavior changes after stroke:

  • Cognitive training/recovery. When frontal lobe damage is causing impulsiveness or other behavior changes, cognitive recovery may help. By practicing the skills that you want to rebuild (like impulse control), you can help rewire the brain and improve those skills.
  • Positive psychology. While psychotherapy attempts to address negativity, positive psychology aims to “enhance the good” by rewiring the brain for happiness. The book Healing & Happiness After Stroke dives deeper into this concept.
  • Meditation. The benefits of meditation are massive, and it might help with behavior changes after stroke, especially impulsiveness. When we train in sitting still with ourselves, we build that skill. Meditation isn’t comfortable, but it could be worth the effort.
  • Healthy diet. Finally, the foods that we eat play a role in the way we think and behave. By improving your diet, you can give yourself the best chance at feeling better. And when you eat foods specifically good for stroke recovery, it’s a win-win.

There are many options for coping with behavior changes after stroke. We hope you can work with your medical team to find a mixture of methods that work for you or your loved one.

The Full Picture: Assessing Behavior Changes After Stroke

There are many different ways that behavior can be affected by stroke, so it’s imperative to work with a doctor for an accurate diagnosis.

Your doctor may recommend medication or psychotherapy to help you cope with unfavorable behavior changes after stroke; but the options don’t end there.

Alternative treatments can help patients recover without the use of drugs. Instead, you can pull upon the brain’s natural ability to rewire itself to improve emotional and behavioral health after stroke.

We hope you can find creative ways to practice the skills that may have been compromised after stroke. We wish you good luck on the road to recovery and better behavioral health.

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Get Inspired with This Stroke Survivor Story

5 stars

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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