Coping With Stroke Effects

Coping with stroke requires adjustments, whether the effects are comparatively minor and short-lived, or the complications cause severe impacts to speech, mobility, mental health, and more. Lifestyle changes after stroke impact entire families, not just the person with the stroke.1

Recovery, rehabilitation, and care team support are essential to making the quality of your post-stroke life the best it can be. In addition to physical, occupational, and speech therapy, coping can involve support groups and talk therapy with a psychologist or social worker.

Emotional

Sadness, anxiety, anger, and grief are all common responses to a stroke. This can be due to physical or biochemical changes in the brain as well as the emotional response to post-stroke life.2

Talk to your healthcare provider about your emotional health and any changes in mood or behavior, as they may be a serious side effect of the stroke. Medications and treatments may be able to help you. Your practitioner might also recommend that you see a mental health professional for specialized treatment.

Different psychological approaches for treating post-stroke emotional disorders include:3

• Solution-focused therapy (SFT)4
• Problem-solving therapy (PST)5
• Cognitive behavioral therapy (CBT)6
• Attitude and commitment therapy (ACT)
• Interpersonal therapy
• Mindfulness therapy, also called mindfulness-based cognitive therapy

Group therapy can also be helpful, and many people report that the social interaction of a group helps to relieve feelings of isolation following a stroke.

Grief

Some people experience a grieving process after a stroke. As you begin to come to terms with new limitations and mourn the loss of your life before stroke, you may experience periods of denial, anger, bargaining, and depression before finally coming to acceptance.

Journaling, talking with a friend, or seeing a therapist can help your emotional healing. Faith leaders often can provide pastoral care to those who value spiritual insights within their tradition.3

Self-Esteem

The effects of stroke can also challenge your self-esteem. It can be especially hard to adjust if your stroke has impaired your mobility and limited your independence—affecting, perhaps, what formerly made you feel like a confident individual.

Be gentle with yourself, avoid being self-critical, and try to reframe negative self-talk with positive thoughts.7

Behavioral and Personality Changes

After a stroke, new behaviors can include a lack of inhibition, which means that people may behave inappropriately or childlike. Other changes in behavior include a lack of empathy, loss of sense of humor, irrational jealousy, and anger.3 Talk to your healthcare provider about these changes in behavior, as there may be medications that can help.

Pseudobulbar affect (PBA), also known as emotional lability, reflex crying, and involuntary emotional expression disorder, is more common following a brainstem stroke. In PBA, there is a disconnect between the parts of the brain that control emotions and reflexes.

People with PBA may briefly cry or laugh involuntarily, without an emotional trigger, and in ways that are not appropriate to the situation.8 Friends and caregivers can help to limit or prevent episodes, using strategies like deep breathing techniques or distractions, Antidepressants may be helpful in treating PBA but more study is needed.9

Depression

Depression is common after a stroke. Studies report a wide range of results reaching as high as about two-thirds of all stroke survivors who experience depression, especially within the first three months.10

A 2023 research report finds a slightly higher risk of suicide after a stroke when compared with the general population.11 If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.‎

Some studies suggest that the brain location that’s affected by stroke can influence depression, and treatment depends on the individual symptoms.10 Talk with your healthcare provider about medication, talk therapy, and group support to help with post-stroke depression and recovery.

A set of exercises for rehabilitation of post-stroke patients. Set No1 is  aimed at improving the functions associated  with mobility in bed.

For additional information about the rehabilitation after a stroke you can watch a video demonstrating exercises and rehabilitation recommendations.

Physical

Coping with physical limitations after a stroke can be a struggle. While many of these challenges will improve over time, it can help to know what you can expect during recovery and where to turn for help.

Many long-term physical complications from a stroke can be helped with therapies, while others may be managed with medication or adaptive technologies and other tools that can help improve independence and quality of life.

Weakness

Most of the time, weakness caused by a stroke affects one side of the body, known as hemiparesis. This commonly affects the face, arm, or leg or a combination of the three. While the weakness may linger long-term, physical therapy can help you to regain strength, and occupational therapy can help you develop alternative strategies for everyday activities.13

Balance

Many stroke survivors report feeling off-balance, dizzy, light-headed, or as if the room is spinning. These sensations may come and go but may eventually stabilize. Physical therapy is the most effective way to combat balance impairment after a stroke.

In addition to step training, trampoline work, and other exercises, some techniques include:1415

• Task-specific training, including walking exercises
• Whole body vibration therapy
• Mirror therapy
• Acupuncture and other Traditional Chinese Medicine (TCM) practices
• Compression therapy devices to improve circulation

Your therapist can show you safe, at-home balance exercises or yoga poses to improve balance and combat dizziness.

Vision Changes

Vision problems that may result from a stroke include:

• Double vision (diplopia)
• Visual field loss (hemianopsia) 16
• Jerking of the eyes (nystagmus)
• Loss of vision
• Dry eyes17

Ophthalmologists and occupational therapists can advise you on the best method to manage vision changes, including therapy to compensate for vision loss, prism lenses, sunglasses, an eye patch, or eye drops.

Communication Problems

About 30% of stroke survivors will experience aphasia, which is difficulty speaking or understanding words due to brain injury. Speech therapy can help with aphasia and dysarthria a difficulty articulating words due to muscle weakness or the coordination of face and mouth muscles.18

A small 2021 study shows benefits in treating aphasia with solution-focused therapy meant to help people cope with stroke and the fears and frustration of their communication challenges.4

Cognitive Deficits

Cognitive changes after a stroke include memory glitches, trouble solving problems, and difficulty understanding concepts. While the severity varies from one stroke survivor to another, studies suggest that cognitive remediation and lifestyle hacks can help significantly.

These interventions include exercises to improve memory, processing speed, and attention, and teaching compensatory strategies, such as making lists and keeping a planner.19

Hemispatial Neglect

A stroke on one side of the brain can lead to difficulties with the field of vision or movement on the other side of the body, known as hemispatial neglect. For example, a stroke in the right cerebral cortex can lead to the diminished ability to notice and use the left side of the body.

Depending on the part of the body affected, an optometrist, neuropsychologist, or physical or occupational therapist can help you cope with hemispatial neglect. A 2025 study suggests that adding music therapy to an existing treatment plan can help draw attention to the neglected side of the body, too.20

Pain

Many stroke survivors experience new-onset pain after a stroke. Common locations for post-stroke pain include:

• Shoulder
• Head
• Muscles (widespread or in a small area)21
• Nerves22
• Joints
• Lower back

Rest, physical therapy, and medication can help you to cope with the pain. Post-stroke headaches require special attention from your healthcare provider, but they can improve with the right treatment.23

Fatigue and Sleeping Problems

In studies, up to half of stroke survivors report experiencing long-term fatigue following a stroke.24 For some, this manifests as excessive sleep or the inability to feel rested, while others wake in the middle of the night, have difficulty falling or staying asleep, and nap sporadically throughout the day.

These problems may be due to the stroke itself or a secondary cause, such as depression, pain, or nutritional deficiencies. If you experience fatigue or trouble sleeping, talk to your healthcare provider, who can run additional tests, prescribe medication for insomnia, or offer other coping strategies.

Swallowing Difficulties

A speech and swallow evaluation can identify problems with chewing and swallowing, a common stroke complication known as dysphagia. 25 Most patients see improvement within the first few weeks after a stroke. However, swallowing problems can be quite dangerous.

Choking due to stroke-induced muscle weakness may cause serious illness, such as aspiration pneumonia or even life-threatening breathing obstruction and infection problems. Feeding therapy may help you to regain the ability to swallow safely, although some patients may require a feeding tube to get adequate nutrition.

Trouble With Urination

After a stroke, many stroke survivors experience incontinence, which is urinating when you do not want to. Some stroke survivors also experience bladder retention, which is the inability to urinate on demand. Both of these problems can be managed with medical treatment and physical therapy.26

Urination problems can be embarrassing and inconvenient. Discrete bladder-leak protection products like pads for both men and women, disposable underwear, and leak-proof underwear can help you feel more confident going out in public.

Muscle Changes

Post-stroke muscle weakness can lead to a lack of movement. Muscle atrophy can be prevented through post-stroke physical therapy and rehabilitation.

Muscle spasticity and a painfulness stiffness also can occur. Your physical therapy team can provide exercises you can do throughout the day at home to prevent and ease spasticity.27

Seizures

Some people experience post-stroke seizures due to erratic electrical brain activity. Seizure prevention may be part of the post-stroke care program, and seizures are typically managed with medication. Cortical stroke survivors may be at higher risk of developing seizures.28

EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №2 IS AIMED AT IMPROVING THE MOBILITY AND STABILIZATION OF THE PELVIC COMPLEX

Social

Whether your stroke left you with minor physical limitations, speech difficulties, or serious mobility challenges, many people feel isolated after a stroke. Getting back into the flow of life can take time.

Many patients and caregivers find that joining a support group can offer both social engagement and emotional support. Your local hospital or rehabilitation center likely hosts a regular support group, or you can check the American Stroke Foundation’s website.

For people with limited mobility, joining an online support group that holds regular online meetings, a Facebook community group, or message boards to talk with other stroke survivors and caregivers can be a lifeline keeping you connected to others. Online support is available through the Stroke Network.

A SET OF EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №3 IS AIMED AT IMPROVING THE MOBILITY AND FUNCTION OF THE UPPER LIMB, STABILIZING THE SHOULDER GIRDLE

Practical

The after-effects of a stroke can present unique individual challenges. Lingering weakness, mobility challenges, difficulty communicating, and visual problems can lead to a lack of independence.

Help With Daily Living

Depending on the degree of your stroke, you may require help with activities of daily living, including cooking, cleaning, and grooming. In some cases, family members step up to help, while others may require a visiting nurse, a part-time aide, or even live-in help like a housekeeper, companion, or nurse.29

According to the American Stroke Association, 10% of stroke survivors recover almost completely; about 25% recover with minor impairments; and 40% have moderate to severe impairments. Another 10% need care in a long-term care facility.30 Some people choose to move to retirement complexes that provide varying levels of care or assisted living facilities.

Getting Around

Some people lose the ability to drive and experience other physical changes that make it difficult to get around. If you do drive, equipment modifications and extra precautions may be needed.31 Some stroke survivors find getting a mobility scooter can help them get out in the world independently.

Many communities offer senior or disability buses to help you go shopping or offer car services to bring you to your healthcare provider and therapy appointments. You can also use a ride service like Uber or call a taxi to get from place to place.

Employment

Strokes do occur in younger people who have not yet retired. If you were working full-time at the time of your stroke, you should be able to apply for temporary disability until you are able to resume working.

If the stroke has left you with minor impairments, but you can still perform some of your former duties, the American Stroke Association recommends entering into a Reasonable Accommodations Agreement with your employer. If you are unable to work, you may qualify for long-term disability.

A SET OF EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №4 IS AIMED AT IMPROVING THE MOBILITY AND FUNCTION OF THE LOWER LIMB, STABILIZING THE PELVIC GIRDLE

Summary

A stroke leaves a lasting impact on most people, even among those with minor impairments. People who recover completely can still experience depression after the episode. About two-thirds of people coping with stroke effects may have long-lasting challenges with speaking, mobility, and more.

Your healthcare team can assist with medication, physical therapy, and other interventions. Adaptive strategies at home can help you and your caregivers adjust to these changes. Ask about therapy if you need mental health assistance and consider connecting with others through support groups.

By Heidi Moawad, MD
Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.