Sunday, September 21, 2014

Emotions - Dealing with the Five Disabilities Resulting from Stroke Part II

In last week's article written by Walt Kilcullen you read about two more of the five disabilities caused by a stroke. This week's article concludes the series and deals with the remaining disability: emotion. Part 2 was originally posted in its entirety in the September issue of the StrokeNet Newsletter at:
http://www.strokenetwork.org/newsletter/articles/disability02.htm

If you wish to contact Walt, he may be reached at:
newsletter@strokenetwork.org

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by Walt Kilcullen

Part 2.

V. Problems with Emotion


V. Problems with Emotion: Many people experience a range of emotional changes after a stroke. These changes can cause the person’s personality to change and can be disruptive and problematic.

Depression is a common condition after a stroke. It can be mild or it can be all consuming. Although depression is a normal part of grief after a stroke, if it continues for the long run, professional help is
called for.

Anger is also common after a stroke. In my support group, once every two months we split into two groups; one for survivors and one for caregivers. Many times I have heard a caregiver complain about fits of anger from their loved one for no apparent reason.

Emotional Lability is a condition of the brain that causes sudden, uncontrollable crying or inappropriate laughter. Of course this can result in embarrassing situations for both the survivor and the caregiver.

Apathy is not the same as depression even though the behavior is similar. The survivor, who is apathetic, cannot seem to get motivated. He stays in bed too long, sits or lies on the couch for hours, and often will not leave the house.

Anxiety is an unpleasant feeling which often includes nervous behavior such as wringing the hands or pacing about. It is a feeling of fear or distress over something that is unlikely to occur such as a heart attack or car accident.

Treatment options for problems with emotion:

● Antidepressants, drugs that control mood, psychological counseling, and psychiatric therapy are treatments for depression, anxiety, and anger management.

● Apathy is more difficult to treat because there are no drugs available to treat it. However, therapists and counselors have had success by developing a routine for the patient to follow. This includes getting up every day at the same time and scheduling events or activities at certain times each day. The focus is on action which will later lead to motivation toward everyday life.

● I could not find any treatment for emotional lability, but fortunately after a few months, it usually (but not always) fades away.

I wrote an article in the September, 2012 issue of strokenetwork.org on anger and aggressive behavior. There are drugs that are sometimes successful in treating this problem, but there is much the caregiver can do to lessen anger.

● Remember that anger and aggressive behavior are a result of the stroke. Your loved one cannot always control this behavior.

● Stay calm. Do not over react to your loved one’s outbursts. Speak slowly and softly without raising your voice until your loved one calms down.

● Avoid arguing or confrontation with your loved one. Redirect her attention to something else.

● After you identify things that create anger in your loved one, avoid them as much as possible. For example, if you observe that being around a large group of people sets her off, avoid that environment.

● If you as a caregiver become angry or frustrated, back off and cool down. Chances are she will also calm down after you step back and remain calm.

● Stay safe. If your loved one becomes violent, back away keeping a safe distance, and seek help if need be. 
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