What is emotional and behavioral changes after stroke?

Depending on what part of the brain was affected, a person may not act the same after a stroke as they acted before the stroke.

In some cases, these behavior changes may be the result of an emotional or psychological problem. But they might also be linked to:

• A memory problem. For example, someone may need reminders to do daily tasks.
• A behavior problem. For example, a person may not respond the right way in social situations.

If the person you care for has these problems, talk with your doctor to see if treatment might help. And remember that nagging or getting angry only makes things worse. But giving praise for positive behavior can help.

Emotional reactions after a stroke may be different from the person's normal emotional reactions. The reaction may have little or no clear connection with what is happening around the person. Often reactions can be easily interrupted by diverting the person's attention.

Changes in emotions may be signs of the following conditions.

Pseudobulbar affect (PBA)

People who've had a stroke (usually in the front part of the brain or in the brain stem) may suddenly cry or laugh for no clear reason. When the behavior has nothing to do with what a person is feeling or doing, it is called pseudobulbar affect. It causes fits of crying or laughing that are out of a person's control.

PBA is caused by a brain problem. Some people take medicine to help control emotional responses.

Delirium

A sudden change in emotions or mental state may be delirium. For example, a person may:

• Become grouchy, confused, or restless.
• Sometimes have false beliefs (delusions).
• See or hear things that aren't there (hallucinations).

Call the doctor if you notice that your loved one has a sudden change in emotions or mental state.

Depression

It's common for a person who has had a stroke to feel sad and become depressed about the disabilities caused by the stroke. Sometimes the injury to the brain from the stroke can cause depression.

If you think you might be depressed, tell your doctor right away. The sooner you know if you are depressed, the sooner you can get treatment. Treatment can help you feel better.

If you think you might be depressed, tell your doctor right away. Depression is a serious condition that requires treatment. If it isn't treated, it can interfere with recovery. And it can have a big impact on how much a person enjoys life. Treatment can help you feel better.

After a stroke, some people feel like they have lost control of their emotions. These feelings can come from one or both of two causes.

A stroke can affect parts of the brain that control how you feel. You may have emotional reactions that are different from your normal ones. For example, you may have fits of crying or laughing that are out of your control.

Also, a stroke can leave you with upsetting body changes that take away some of your independence. For example, some people may feel:

• Sad or angry about the loss of the lifestyle they had before.
• Isolated by speech and language problems.
• Frustrated by the slow pace of recovery.
• Worried about the future.

These feelings are normal and expected. But if you think you might be depressed, tell your doctor right away. The sooner you know if you are depressed, the sooner you can get treatment.

Your loved ones can help you by following these tips:

• A person who has had a stroke may tend to have strong emotional reactions. Remember that these are a result of the stroke. Try not to become too upset by them.
• Don’t avoid a loved one who’s had a stroke. Contact with and support from family members is very important to recovery.
• Watch for signs of depression in people who have had a stroke. Urge them to talk to their doctor if they think they might be depressed.