The damage that a stroke causes to your brain can impact on many aspects of your life and wellbeing, and depending on your individual circumstances, you may require a number of different treatment and rehabilitation methods.
Psychological Impact
The two most common psychological conditions found in people after a stroke are:
- depression: many people experience intense bouts of crying and feel hopeless and withdrawn from social activities
- anxiety disorder: where people experience general feelings of fear and anxiety, often punctuated by intense, uncontrolled feelings of anxiety (anxiety attack)
You will receive a psychological assessment from a member of your healthcare team within the first month after your stroke.
Feelings of anger, anxiety, depression, frustration and bewilderment are all common, although they may fade over time. Your healthcare team, family, friends can all provide you with support and care you need.
The person with stroke and their relatives and carers should be given some advice and help about dealing with the psychological impact of stroke. This includes the impact on relationships with other family members and any sexual relationship. There should also be a regular review of any problems of depression and anxiety, and psychological and emotional symptoms generally.
These symptoms tend to settle down over time but if symptoms are severe or last a long time, GPs can refer people for expert healthcare from a psychiatrist or clinical psychologist. For some people, medicines and psychological therapies, such as counselling or cognitive behavioural therapy (CBT) can help. CBT is a therapy that aims to change the way you think about things in order to produce a more positive state of mind.
Cognitive Impact
Cognitive is a term used by scientists to describe the many processes and functions our brain uses to process information.
One or more cognitive functions can be disrupted by a stroke. Cognitive functions include:
- communication: both verbal and written
- spatial awareness: having a natural awareness of where your body is in relation to your immediate environment
- memory
- concentration
- executive function: the ability to plan, solve problems and reason about situations
- praxis: the ability to carry out skilled physical activities, such as getting dressed or making a cup of tea
As part of your treatment, each one of your cognitive functions will be assessed and a treatment and rehabilitation plan will be created.
You can be taught a wide range of techniques that can help you re-learn disrupted cognitive functions, such as recovering communication skills through speech therapy.
There are also many methods to compensate for any loss of cognitive function, such as using memory aids or a wall planner to help plan daily tasks.
Most cognitive functions will return after time and rehabilitation but you may find that they do not return to their former levels.
The damage that a stroke causes to your brain also increases the risk of developing vascular dementia. The dementia may happen immediately after a stroke or it may develop some time after the stroke occurred.
Physical Impact
Strokes can cause weakness or paralysis in one side of the body. Also, many people have problems with coordination and balance. Many people suffer from extreme tiredness (fatigue) in the first few weeks after a stroke, and may also have difficulty sleeping, making them even more tired.
As part of your rehabilitation you should be seen by a physiotherapist, who will assess the extent of any physical disability before drawing up a treatment plan.
Treatment will normally begin as soon as your medical condition has stabilised. At first, your physiotherapist will work with you to improve your posture and balance.
After this, you will have short sessions of physiotherapy that last a few minutes. The sessions will then increase in duration as you start to regain muscle strength and control.
The physiotherapist will work with you by setting goals. At first, these may be simple goals like picking up an object. As your condition improves, more demanding long-term goals, such as standing or walking, will be set.
An paid careworker or an unpaid careworker, such as a member of your family, will be encouraged to become involved in your physiotherapy. The physiotherapist can teach you both simple exercises that you can carry out at home.
Sometimes, physiotherapy can last months or even years. The treatment is stopped when it is no longer producing any marked improvement to your condition.
