Emotional Regulation after a stroke

Objectives of this presentation

  • Be able to articulate the impact of stroke on emotional regulation
  • Be able to recall the four different zones of regulation
  • Be able to articulate what emotions fit into the four zones of regulation
  • Be able to articulate the benefits of the zones of regulation
  • Be able to articulate techniques to aide when emotionally heightened

The impact of stroke on emotions

  • A stroke may cause biological or psychological changes which may result in varying emotional reactions.
  • For example, prior to having a stroke you may react to a situation in one regard but after having a stroke you may react in a totally different way to that same situation.
  • All of our emotions and behaviors are controlled by our brain. Emotional and behavioral changes are due to the damage that occurs within the brain.
  • Emotions may be more difficult to control, especially immediately after a stroke.
  • These emotional changes may be due to the damage and chemical changes that occurred in the brain. These changes may also be normal reactions to challenges, fears, and frustrations.

Common emotional changes after stroke

  • Rapid mood changes
  • Crying or laughing that doesn’t match a person’s mood
  • Crying or laughing at unusual times
  • Crying that lasts longer than seems normal

Depression after Stroke

  • Depression is very common after a stroke. This is caused by biochemical changes in the brain, resulting in not feeling positive emotions.
  • Depression may be a normal psychological reaction to the losses from stroke.
  • Depression may make the rehabilitation process more challenging, as a person may have decreased motivation to work hard and participate in therapy sessions.
  • Studies show that having a stroke increases the chance of having depression

Anxiety after Stroke

  • Anxiety is common, affecting about 25% of individuals who have had a stroke.
  • Anxiety around activities such as physical exertion, physical intimacy, being alone at home, fear of having a headache, fear of falling, or having another stroke are common reasons for anxiety post-stroke.
  • Anxiety can decrease stroke rehabilitation progress or effort and may also prevent participation from activities of enjoyment.

Phobic vs Generalized Anxiety

  • What is phobic anxiety?
  • What is generalized anxiety?
  • Treatment?
  • Phobic anxiety?
  • Generalized anxiety?

Anger after a stroke

  • Cognitive impairment: causes changes in the brain that alters ability to process info and understand others.
  • Things such as: lack of empathy or increased impulsiveness
  • Physical effects: Difficulty with movement is one of the most common secondary effects of a stroke, which can make it more difficult to engage in one’s typical daily activities.
  • When you struggle with everyday tasks or tasks that came easy to you prior to your stroke this causes anger and frustration.
  • Emotional disorders: when the stroke affects the emotion center of our brain, this my cause involuntary, inappropriate, and uncontrollable outbursts of emotions such as laughter, crying anger/yelling typically when the situation does not call for this type of emotion

Common triggers of anger after a stroke

  • Perceived lack of control
  • Being confronted with a task that is more difficult or that one can no longer perform
  • Fatigue and confusion
  • Other people’s behaviors
  • Overstimulation
  • Overstimulation

Pseudobulbar affect

  • The latest name for a neurological condition also known as emotional lability, reflex crying and involuntary emotional expression disorder, among others.

The zones of regulation

Regulation is something everyone continually works on whether we are cognizant of it.  We all encounter trying circumstances that test our limits from time to time.  If we can recognize when we are becoming less regulated, we are able to do something about it to manage our feelings and get ourselves to a healthy place.  This comes more naturally for some, but for others it is a skill that needs more attention and practice. This is the goal of The Zones of Regulation.”

– Leah Kuypers, Creator of The Zones of Regulation 

Techniques to help with emotional regulation

  • Understand your behavior
  • Take a break
  • Talk to your doctor about medication
  • Deep breathing
  • Listening to relaxing music
  • Meditation and prayer
  • Physical exercise
  • Closing your eyes
  • Expressing emotions through journaling or artwork

Different therapy options

  • Solution Focused Therapy
  • Problem Solving Therapy
  • Cognitive Behavioral Therapy
  • Attitude and Commitment Therapy
  • Interpersonal Therapy
  • Mindfulness Therapy