Depression is very common after a stroke. It may be the effect of both biological changes in the brain and reactions to the event. Both social support and psychotherapy can be very helpful, as alleviating depression not only aids physical, cognitive, and intellectual recovery but also makes stroke survivors more willing to engage in the often challenging work of rehabilitation.
Sadness and grief are also common reactions to the losses that may follow a stroke, which can include not only loss of mobility but also loss of confidence, loss of independence, and loss of a career. Guilt may accompany the grief, as survivors may feel they have become a burden to those around them, who often bear a large burden of care and support. Social support from family and friends, as well as from stroke survivor support groups, can help survivors manage the emotional upheaval strokes can create.
Difficulties getting around, difficulties communicating, and reactions to myriad losses can generate frustration and anger—often anger at the stroke itself, but also often expressed at the people closest to the survivor. Frustration and anger may even prompt the survivor to lash out verbally or physically at those around them. Anger can also be a direct result of the primary brain injury.
The many changes to one’s self and one’s life that may follow a stroke can radically upend a sense of self. Identity loss can be another psychological consequence of stroke. Psychotherapy can help. In addition, the work of post-stroke rehabilitation can create improvements in function that ameliorate identity loss and help survivors reshape their sense of self.