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

caregiver comforting patient with mood swings after stroke

Moodiness after a stroke can be a normal part of the recovery process. It can also be a sign of other complications such as pseudobulbar affect: a medical condition that triggers uncontrollable emotions.

It’s important to approach mood swings after stroke with interest, empathy, and compassion.

This article will help you understand why mood swings may happen after stroke along with tips to cope.

Causes of Mood Swings After Stroke

Generally, there are two causes of mood swings after stroke: biological changes and lifestyle changes. Each requires a different treatment approach, so it’s important to talk with your doctor and therapists if you are struggling with intense mood swings.

Biological Causes of Mood Swings

Emotional disturbances after stroke are most common after a right side stroke because  our emotions are mainly processed in the right hemisphere. Both the frontal lobe and the limbic system play large roles in emotions.

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. Pseudobulbar affect is also common following a brainstem stroke.

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.

If changes in emotion are sudden, extreme, and don’t seem to align with the situations at hand, mood swings may signify the presence of other medical complications like pseudobulbar affect. Talk to your doctor or therapist if you suspect this is happening to you.

Lifestyle Causes of Mood Swings

If your doctor does not diagnose you with pseudobulbar affect, then mood swings might be a secondary complication 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 secondary effects that may affect their independence or ability to participate in beloved hobbies. As a result, stroke survivors may struggle with mood swings, depression, anxiety, and even PTSD.

It’s important to approach these types of mood swings with compassion. Stroke recovery takes herculean strength, and it’s normal to struggle on some days.

Mood swings should not be viewed as a symptom to get rid of, nor are they a sign of weakness. Rather, it’s a sign that physical or emotional recovery is needed. We will discuss helpful steps for recovery next.

Overcoming Mood Swings After Stroke

The following steps can help improve mood swings after stroke for some patients. Since every stroke is different, every recovery will be different. It’s important to keep seeking different methods of recovery until you find what works best for you.

Here are 5 tips to cope with mood swings after stroke:

1. Train your brain

illustration of brain with electrical pulses showing neuroplasticity

If your doctor has diagnosed you with pseudobulbar affect, (s)he may recommend medication such as antidepressants. These 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, followed by shifting your posture. For example, if you are lying down when you feel your mood is changing, try sitting up right away. Notice if this shift changes your mood. This trick may help train your brain to notice mood swings and shift your perspective.

2. Participate in talk therapy

Stroke survivors are exactly that: survivors! A stroke is a life-threatening medical emergency that requires swift treatment and, in some cases, emergency surgery. Everything can change overnight, and this is something that everyone copes with differently.

If you’re struggling with your “new normal,” it could be worth participating in psychotherapy. A therapist can help you cope with the emotional strain that stroke rehabilitation may cause.

3. Look into “positive psychology”

woman smiling showing positive attitude

Post-stroke depression is often treated with medication. However, most stroke patients are already taking multiple medications to manage stroke risk factors such as high cholesterol, making it unattractive to add more medication 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.

4. Allow the stages of grief

Grief is common after a stroke, but not many survivors realize they are experiencing it. Many people assume that grief only happens when you lose a loved one — but a stroke survivor can experience grief if they sustain considerable loss in regards to their independence or identity.

It’s important to allow grief, not hurry it away. Grief is not a mood swing, rather it’s a process which may take a significant amount of time.

The five stages of grief include denial, anger, bargaining, depression, and acceptance. The path to acceptance is not linear, as many people experience the stages of grief out of order. For instance, someone may struggle with moving between anger and depression while they grieve.

It’s important to realize that this variety of emotion is the natural process of grief, and should be experienced fully and not suppressed. The only way out is through.

For more information, the book Healing & Happiness After Stroke goes through each stage of grief in greater detail.

5. Get plenty of sleep each night

Finally, mood swings after stroke can be caused by a common (and overlooked) 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. Many stroke patients crave excessive sleep after stroke as the brain requires more rest to recharge.

Lack of sleep can lead to irritability, outbursts, decreased patience, and low-grade mood swings. It’s important to listen to your body during stroke recovery. If your body wants rest, listen to it.

However, it is important to be aware that excessive sleepiness and fatigue may also be signs of depression. If you feel that you may be depressed, discuss this with your doctor to get help.

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. They could even be caused by a combination of the two. Talk with 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 discusses the process of emotional healing after a stroke in greater detail.

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