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Mood Swings After Stroke: Why They Happen & How to Cope

caregiver comforting patient with mood swings after stroke

Do you or a loved one suffer from mood swings after stroke – even if you weren’t necessarily a “moody” person before?

Moodiness can be a normal part of the recovery process, or a sign of other conditions like pseudobulbar affect (also called emotional lability).

To help you understand what’s happening, you’re about to discover the causes and treatments for mood swings after stroke.

Causes of Mood Swings After Stroke

There are generally two causes of mood swings after stroke: biological changes and lifestyle changes.

Biological Causes of Mood Swings

Emotional disturbances after stroke are most common after a right side stroke because the emotion center of the brain resides in the right hemisphere.

When a stroke damages the emotion center of the brain, it can result in a condition known as pseudobulbar affect, which causes uncontrollable emotional outbursts.

Patients with pseudobulbar affect may laugh at spilled milk, for example, or may find themselves crying for no apparent reason. Sometimes they may jump from one emotion to the next.

In these cases, mood swings may signify the presence of other medical complications like pseudobulbar affect. Talk to your doctor for an accurate diagnosis.

Lifestyle Causes of Mood Swings

If your doctor does not diagnose you with pseudobulbar affect, then mood swings might be caused by lifestyle changes. The best way to understand this is to put yourself in the shoes of a stroke survivor.

After a stroke, patients can sustain a variety of serious side effects that may affect the ability to talk, walk, or live independently. These side effects might take away beloved hobbies that once contributed to the patient’s identity.

As a result, stroke survivors may struggle with mood swings, depression, anxiety, and even PTSD.

Overcoming Mood Swings After Stroke

First and foremost, it’s important to find compassion for stroke patients that struggle with mood swings. Stroke recovery can be a difficult time, and it’s important to find compassion for individuals that are struggling.

Furthermore, it can help to use certain tools to cope with mood swings.

Here are 5 ways you can overcome mood swings after stroke:

1. Try Positive Psychology

Useful for: post-stroke depression and anxiety

woman smiling showing positive attitude

Post-stroke depression is often treated with medication. However, most stroke patients are already taking a slew of medications (often to manage stroke risk factors), making it unattractive to add more medications to the mix.

If you’re interested in an alternative approach, try researching positive psychology. It’s a new aspect of psychology that focuses on enhancing the good. The book Healing & Happiness After Stroke digs deeper into that concept.

One example of positive psychology includes gratitude journaling. By writing down things you’re grateful for on a daily basis, it helps train the brain to naturally gravitate towards gratitude.

This seemingly small step can go a long way towards helping with mood swings after stroke.

2. Harness “Emotional Plasticity”

Useful for: emotional lability / pseudobulbar affect

illustration of brain with electrical pulses showing neuroplasticity

If your doctor has diagnosed you with pseudobulbar affect, treatment will look different. Your doctor might recommend new medications like antidepressants, which have been shown to help with pseudobulbar affect, even in low doses.

However, medication isn’t the only hope for recovery. Sometimes emotional disturbances go away on their own — a phenomenon known as spontaneous recovery.

You can also try “training your brain” to control your emotions again. This plays on the phenomenon of neuroplasticity: the brain’s natural ability to rewire itself and learn new skills.

One trick involves noticing your body posture when you have an intense mood swing. Then, shift your posture. Notice if this shift changes your mood. This trick may help train your brain to notice mood swings and shift your perspective.

3. Develop Emotional Intelligence

Useful for: stroke patients with PTSD

woman giving hug to a patient struggling with mood swings after stroke

Although PTSD is often associated with war or traumatic events – stroke is considered a traumatic event, too.

Stroke survivors are exactly that: survivors! To overlook this aspect means overlooking an entire cause of mood swings after stroke.

Some of the characteristics of PTSD are irritability, anxiety, trouble sleeping, or outbursts of anger – among others. If you match any of those symptoms, then you may want to look into PTSD after stroke.

Interestingly, PTSD can be treated by increasing your emotional intelligence. It can be a useful coping mechanism to learn how to label your emotions during your mood swings.

Our article on PTSD after stroke explains this further.

4. Allow the Stages of Grief

Useful for: stroke patients in grief

woman looking into the distance and demonstrating grief

Grief is triggered by loss. And unfortunately, stroke often creates loss within a stroke survivor’s life, like the loss of motor skills or hobbies.

Not many people are aware that recovering from stroke also includes dealing with grief after stroke. Grief includes 5 stages: denial, anger, bargaining, depression, and acceptance. It’s possible for these stages occur out of order.

If a stroke patient “swings” from depression to anger, they might not have an emotional disorder. Rather, they could just be grieving.

In this case, it’s important to allow yourself or your loved one to move through the stages of grief instead of trying to avoid it. Often, the only way out is through.

The book Healing & Happiness After Stroke goes through each stage of grief in greater detail.

5. Sleep!

Useful for: all stroke patients

woman stretching in bed after a nap to help mood swings after stroke

Finally, mood swings after stroke can be caused by a common (and overlooked) side effect of recovery: exhaustion. During stroke recovery, the brain utilizes more energy to heal itself, which reduces the available energy you have to move about your day.

If you crave lots of sleep after stroke, this is the reason why. Lack of sleep can lead to irritability, outbursts, decreased patience, and, yes, mood swings.

Get some much needed sleep. And if sleeping disorders (like insomnia or sleep apnea) are keeping you up at night, then talk to your doctor about treatments that may help.

Don’t be afraid of taking naps throughout the day — a recovering brain needs it!

Understanding Mood Swings After Stroke

Overall, mood swings can be tricky to self-diagnose because they could be caused by biological or lifestyle changes, which are vastly different. Talk to your doctor for a formal diagnosis.

Your doctor may recommend medication to help cope with mood swings after stroke. While these may be effective, there are other ways to help treat the symptoms, like positive psychology. The book Healing & Happiness After Stroke is perfect for that.

Always listen to your doctor, and listen to your body. Never give up hope for recovery.

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