Anger After Stroke

After a stroke, it’s common for the patient to experience a range of emotions, including anger. One study by the Asian Medical Center found that 32 percent of a group of 145 stroke patients reported that they felt an inability to control their anger and aggression up to a year after their strokes. While angry and aggressive behavior in a patient can be stressful for caregivers, it’s important that they understand possible causes of the anger and what they can do to minimize it.

The three most common causes of anger after a stroke are grief, depression and the brain damage caused by the stroke. The treatment method for the anger will depend on its cause.

A stroke can result in a significant loss for the patient. While some patients make a full recovery or end up with only minimal impairment, others have a significant loss in motor skills, speaking ability and vision. When a patient has lost some of their physical or mental abilities, it can cause the same type of grief as any other significant loss. The traditional five stages of the grieving process are denial, anger, bargaining, depression and acceptance. However, people often don’t go through these stages in a linear fashion, instead bouncing from stage to stage.

The only way for a patient to handle anger caused by grief is to go through it. Caregivers can help with this by talking to the patient about their feelings, giving them a therapeutic outlet.

Depression is common after a stroke, and it can manifest itself with a wide range of symptoms, such as a pessimistic attitude, anxiety, insomnia, a hopeless feeling and anger. It’s important to treat depression and not assume it will simply go away. One of the first ways to treat post-stroke depression is through social support. Loneliness is a common cause of depression, and just spending time with friends and family members can make a patient feel better.

Lifestyle changes can also treat post-stroke depression and, consequently, the anger that results from it. The patient should eat a nutritious, balanced diet, get at least some form of physical activity and take 10 to 20 minutes per day to meditate, which can be very calming. The patient should have some sort of hobby or activity that they enjoy doing, to make their life more fun and exciting. Even if the patient can’t return to previous activities they enjoyed because of their impairment, they can still pick up a new hobby.

Brain damage can also result in anger after a stroke or other mood swings. In this case, all that caregivers can do is help the patient with their treatments and wait to see if the anger improves. Stroke patients tend to make the majority of their improvements within the first six months after the stroke occurs, and then continue to make smaller improvements over the course of the next couple years.

It is possible that the patient continues to experience anger and make outbursts well after their stroke, especially if it’s brain damage that’s causing the anger. Unfortunately, there is no cure for this, but caregivers can help the patient by handling the situation appropriately.

No matter the cause of the anger, if the patient is feeling angry or lashing out, there are several things a caregiver should do. The first and most important is that the caregiver stays calm and doesn’t meet the patient’s anger with intense emotions of their own. This can be difficult, especially when the patient is a loved one who is making hurtful comments or acting aggressively, but responding emotionally will only escalate the situation. The caregiver should remember that the patient’s behavior is a result of the stroke, which can cause them to say things that they don’t mean.

Gently redirecting the patient’s attention away from the source of their anger often helps defuse the situation. If the patient is upset because of a physical activity that they can no longer do, it may help to mention new hobbies that they enjoy. Once the caregiver has determined a source of the patient’s anger, they should take steps to avoid situations that will trigger it. For example, if the patient is easily agitated among a crowd of people, it’s best to avoid those types of situations entirely.

If the patient becomes violent, the caregiver should exit the situation immediately and get help from someone else. Otherwise, when a caregiver remains calm and doesn’t engage with the patient, it typically results in the patient eventually calming down as their anger subsides.

Anger is normal after a patient has suffered a stroke. While a caregiver can help the patient deal with this anger, in some cases, it may benefit the patient to see a therapist or a psychiatrist. Working with a professional may make it easier for the patient to determine the cause of their anger and find ways to reduce it.