Trevor has been in the ward a few days when his wife Barbara approaches nursing staff, anxious that her husband is still weeping. Tom (their son) is now refusing to visit finding it difficult to cope with this unusual behaviour in his father. Barbara questions whether this is happening at other times or just when she and the family visit. Why might Trevor be behaving like this?
Common emotional reaction to having a stroke
A stroke can be a sudden and devastating life event. It is not uncommon for people to feel upset or low or angry after a stroke as they come to terms with having had the stroke and its consequences. If these symptoms persist then it is important to check whether the person has a significant mood disturbance.
Emotional lability
Stroke can cause people to have unpredictable episodes of crying or laughing. Frequently these episodes can come on quickly without warning and with an intensity that is more than would be expected for the situation. Sometimes the person reports no specific feelings of sadness or happiness accompanying their laughing or crying.
Depression
Depression is common after a stroke (approx 33% of people suffer depression in first 12 months). It can be difficult to distinguish from other consequences of a stroke but may lead the person to feel upset, to have no interest in activities, to lack motivation and to have changes to appetite and sleeping patterns. There are varying levels of depression with mild, moderate or severe depression being recognised.
Physical problems
It is important when people seem low in mood or anxious that any physical causes such as infection, incontinence, or significant pain are ruled out as reasons for the person feeling lower in mood than normal.
Anxiety
Increased anxiety after a stroke may be related to increased worrying about a host of situations e.g. the possibility of falling, of having another stroke, of not being as able as before. Anxiety can result in increased worry and fear and is often accompanied by avoidance of certain activities or situations.
Trevor’s named nurse, Nurse Jones, reassures Barbara that the staff are aware of Trevor’s tearful outbursts and tells her that the multidisciplinary team (MDT) will be discussing this further at their weekly meeting tomorrow when they will explore the possible causes. Nurse Jones says that she will let the MDT know that Barbara is concerned and will meet with her in the afternoon.
Page last reviewed: 21 Feb 2020
