Risk Factors And Aftermaths Of Stroke
Stroke is one of the leading causes of death and disability in Australia. (Australia Institute of Health and Welfare, 2018). A stroke occurs when bloody supply to the brain is suddenly interrupted and as a result, brain cells are deprived of oxygen and important nutrients. When brain cells stop receiving oxygen and nutrients, they die. There are two main types of stroke, ischemic stroke and haemorrhagic stroke. Ischemic stroke occurs when a blood clot or cholesterol plaque blocks a blood vessel whereas a haemorrhagic stroke occurs when a blood vessel leaks or breaks. A stroke can occur at any time and can affect a range of individuals. However, there are certain risk factors that increase the likelihood of a stroke occurring.
For instance, an individual’s age, medical history, genetics and lifestyle choices can impact greatly on the incidence of stroke. Other risk factors include high blood pressure, being overweight, sex and high cholesterol. A stroke can impact an individual’s life in many ways, yet the effects depend on the part of the brain that has been damaged. Specifically, stroke can have a significant impact on one’s personality and emotions. Existing personality traits, emotions and behaviours are likely to have a major influence on how individuals adjust to certain lifestyle changes after stroke (Dwan, T. , Ownsworth, T. , Donovan, C. , Lo, A. H. Y. , 2017). As a result of such adverse lifestyle changes, certain individuals may suffer from depression and anxiety. Some stroke survivors are unaware of changes in their personality and therefore, are reluctant to change or improve their behaviour. This can affect their relationships and social life, contributing further to negative emotions. After a stroke, individuals may experience feeling such as fear, anxiety, frustration, sadness and a sense of loss due to the changes experienced. These emotional changes are common among post stroke survivors. Emotional changes after stroke can be caused by the physical effects of brain damage, particularly damage to the limbic system which controls our emotional reactions. Additionally, post stroke depression (PSD) is a common and well researched emotional response to stroke that often results in many negative outcomes for stroke survivors (Robinson, 2003).
For example, PSD leads to a less efficient use of rehabilitation services, decreases quality of life and increases mortality (Gillen, R. , Tennen, H. , McKee, T. E. , Gernert-Dott, P. & Affleck, G. 2001). Through research, it has been found that both biological and psychological factors contribute to PSD. Talk more here about location of the brain injury and depression Another common effect of stroke is generalised anxiety disorder (GAD). GAD is characterised by frequent and uncontrollable worry that includes feelings of restlessness, impaired concentration, muscle tension and sleep disturbance (American Psychiatric Association, 1994). Experiencing anxiety after stroke can have a significant impact on one’s recovery and may lead to a decrease in quality of life and social dysfunction (Astrom, 1996). Stroke may also cause an emotional reaction called the pseudobulbar affect, which is characterised by emotional responses that are sudden and uncontrollable. The pseudobulbar effect is caused as a result of injury to the neurological pathways that regulate the expression of emotions. Specifically, there is a disruption in how the frontal lobe, temporal cortex, brain stem and cerebellum are working together (Salinas, 2017). Stroke survivors may also experience very strong emotional displays or reactions but do not actually feel these emotions that intensely, this is called emotional lability.
In addition to emotional changes after stroke, changes in personality are also common. Adjusting to personality changes may be one of the most difficult aspects of a stroke and can have a significant impact on the survivor’s recovery. In some cases, individual’s existing personality traits come become exaggerated while others can behave in ways that are out of character for them. Other personality changes that can occur after a stroke include lack of motivation, aggression, saying or doing things that are inappropriate, acting impulsively and becoming easily frustrated. Often, stroke survivors are not aware that their behaviour and personality is different and feel there is nothing wrong with them. This leads to a lack of motivation for the stroke survivor to seek help and can make it difficult to address these changes. Personality is a combination of our thoughts, emotions and behaviour and each area can be largely affected depending on the part of the brain that is damaged. Sometimes stroke affects the part of the brain that is responsible for memory, thinking and reasoning this is called the frontal lobe.
As a result of damage to the frontal lobe after stroke, a survivor’s thought patterns may change. For example, someone who is considered a positive, outgoing person may become quite negative due to changes in their thought patterns. As mentioned previously, a stroke can affect part of the brain that controls emotions and lead to emotional lability. Additionally, emotions can also be affected by stroke recovery due to the profound change in lifestyle that a survivor experiences. When thoughts, feelings, mobility and reasoning are all impacted by brain injury, it can have a significant impact on someone’s behaviour and personality.
