The Fear Factor
December 09, 2014
A very common question that arises after having a stroke is “will it happen again?
Many callers to StrokeLine speak of the crippling anxiety and worry that comes with having a stroke and ask “could I have another stroke and what if it is more severe next time?” For younger stroke survivors in particular who don’t always have a known reason for their stroke, this anxiety and worry can prevent them from leading a happy, fulfilling life. The fear can be paralysing.
Here are our top tips to deal with the fear of having another stroke.
Know why you had the stroke in the first place.
It is essential that you know the risk factors that contributed to your stroke (if there were any) so you can work towards reducing these risks. Speak to your doctor and health professionals about your risk factors. For example if you have atrial fibrillation, consider is it well managed, are you on the right medication and do you need any follow-up appointments to have it reviewed? If you have high blood pressure be aware of how you can manage it through diet, exercise, stress management and medication.
Be stroke safe and practice stroke prevention.
Read as much as you can on stroke prevention to educate yourself and your family, then practice it. We know that eating a healthy diet, exercising for 30 minutes a day and limiting alcohol to no more than two standard drinks per day minimises your risk of stroke. Get help to cease smoking and speak to a dietitian or nutritionist about your diet if you are overweight, have diabetes, high blood pressure or high cholesterol. Don’t forget to address stress as this also impacts on your overall health and wellbeing.
Be aware of the statistics (only if you think it will help you).
There are some statistics around recurrent stroke and for some people knowing these figures helps put things into perspective. About four in ten people who have had a stroke, go on to have another one within ten years. It is important to note that the statistics don’t break down prevalence of second stroke in terms of age, other medical conditions that may exist or lifestyle factors. The advice we give is to focus on what you CAN do to reduce your risk. Knowing you are doing your best to prevent stroke will help put your mind at ease. There is evidence that anxiety and stress can lead to chronic illness, high blood pressure, increased inflammation and reduced immune function. Therefore, these symptoms also need addressing to lower your risk of having an additional stroke. It is good to know that mortality rates (death caused by stroke) have continued to reduce due to the improvements in the acute treatment of stroke and our emphasis on prevention.
Speak to a professional.
Talking about your fears, anxiety and worries can help to reduce them. Sometimes all that is needed is a safe place to explore your fears and say them out loud to get them off your chest. You can access psychology through the rehabilitation team or by asking your GP to refer you for Medicare subsidised sessions. Stroke support groups and online forums are other good places to talk about your fears with others who understand.
De-catastrophy.
De-catastrophying is a cognitive behavioural technique used by considering the worst-case scenario of a feared event or object. It encourages you to examine whether the effects of the event or worry have been overestimated (magnified or exaggerated) and considers whether your coping skills have been underestimated. There are many risks to life, it is useful to reflect if you are the type of person who tends to catastrophy situations so you can learn strategies to help you manage this.
Try mindfulness.
Being fearful of something occurring (whether it is likely to occur or not) is not living in the present moment. Mindfulness exercises allow you to be able to identify, tolerate and reduce difficult, painful and even frightening thoughts, feelings and sensations such as fear of having another stroke. Mindfulness gives you back some sense of control over your thoughts, fears and feelings. By anchoring yourself in the present moment you can achieve a greater sense of peace. Research has suggested that mindfulness relieves stress, lowers blood pressure, reduces pain, improves memory and concentration and relationships.
Be prepared.
Have a plan in place to increase your sense of security if you were to have another stroke. Ensure your family and friends know the FAST and other signs of stroke and know the location of your nearest stroke unit. Make sure you have a personal alarm or pendant alert if you live alone or always carry a phone. Having relatives phone to check on your regularly throughout the week can also reduce stress and anxiety around having a stroke while at home alone. Ensure you take your medication as prescribed and do your best to minimise your risk factors. Having an up to date will and making your wishes known if you did have a severe stroke can also help your peace of mind. It is a good idea to have these discussions about your wishes if anything was to happen to you with your family, regardless of your stroke risk.
Practice acceptance and be kind to yourself.
Having a stroke is a traumatic and scary event. It can take many months and sometimes years to fully accept that you have had a stroke and to come to terms with the potential challenges the stroke have left you with.
Know that your emotional response to fearing another stroke is normal and very common. Acknowledge these emotions in a gentle way and ensure you seek help to manage these emotions.
If you are experiencing fear and anxiety about having a further stroke you can call StrokeLine 1800 STROKE (787 653) to discuss a number of strategies to help you manage these fears and to discuss secondary prevention to ensure you are doing everything possible to help prevent a further event.
Many callers to StrokeLine speak of the crippling anxiety and worry that comes with having a stroke and ask “could I have another stroke and what if it is more severe next time?” For younger stroke survivors in particular who don’t always have a known reason for their stroke, this anxiety and worry can prevent them from leading a happy, fulfilling life. The fear can be paralysing.
Here are our top tips to deal with the fear of having another stroke.
Know why you had the stroke in the first place.
It is essential that you know the risk factors that contributed to your stroke (if there were any) so you can work towards reducing these risks. Speak to your doctor and health professionals about your risk factors. For example if you have atrial fibrillation, consider is it well managed, are you on the right medication and do you need any follow-up appointments to have it reviewed? If you have high blood pressure be aware of how you can manage it through diet, exercise, stress management and medication.
Be stroke safe and practice stroke prevention.
Read as much as you can on stroke prevention to educate yourself and your family, then practice it. We know that eating a healthy diet, exercising for 30 minutes a day and limiting alcohol to no more than two standard drinks per day minimises your risk of stroke. Get help to cease smoking and speak to a dietitian or nutritionist about your diet if you are overweight, have diabetes, high blood pressure or high cholesterol. Don’t forget to address stress as this also impacts on your overall health and wellbeing.
Be aware of the statistics (only if you think it will help you).
There are some statistics around recurrent stroke and for some people knowing these figures helps put things into perspective. About four in ten people who have had a stroke, go on to have another one within ten years. It is important to note that the statistics don’t break down prevalence of second stroke in terms of age, other medical conditions that may exist or lifestyle factors. The advice we give is to focus on what you CAN do to reduce your risk. Knowing you are doing your best to prevent stroke will help put your mind at ease. There is evidence that anxiety and stress can lead to chronic illness, high blood pressure, increased inflammation and reduced immune function. Therefore, these symptoms also need addressing to lower your risk of having an additional stroke. It is good to know that mortality rates (death caused by stroke) have continued to reduce due to the improvements in the acute treatment of stroke and our emphasis on prevention.
Speak to a professional.
Talking about your fears, anxiety and worries can help to reduce them. Sometimes all that is needed is a safe place to explore your fears and say them out loud to get them off your chest. You can access psychology through the rehabilitation team or by asking your GP to refer you for Medicare subsidised sessions. Stroke support groups and online forums are other good places to talk about your fears with others who understand.
De-catastrophy.
De-catastrophying is a cognitive behavioural technique used by considering the worst-case scenario of a feared event or object. It encourages you to examine whether the effects of the event or worry have been overestimated (magnified or exaggerated) and considers whether your coping skills have been underestimated. There are many risks to life, it is useful to reflect if you are the type of person who tends to catastrophy situations so you can learn strategies to help you manage this.
Try mindfulness.
Being fearful of something occurring (whether it is likely to occur or not) is not living in the present moment. Mindfulness exercises allow you to be able to identify, tolerate and reduce difficult, painful and even frightening thoughts, feelings and sensations such as fear of having another stroke. Mindfulness gives you back some sense of control over your thoughts, fears and feelings. By anchoring yourself in the present moment you can achieve a greater sense of peace. Research has suggested that mindfulness relieves stress, lowers blood pressure, reduces pain, improves memory and concentration and relationships.
Be prepared.
Have a plan in place to increase your sense of security if you were to have another stroke. Ensure your family and friends know the FAST and other signs of stroke and know the location of your nearest stroke unit. Make sure you have a personal alarm or pendant alert if you live alone or always carry a phone. Having relatives phone to check on your regularly throughout the week can also reduce stress and anxiety around having a stroke while at home alone. Ensure you take your medication as prescribed and do your best to minimise your risk factors. Having an up to date will and making your wishes known if you did have a severe stroke can also help your peace of mind. It is a good idea to have these discussions about your wishes if anything was to happen to you with your family, regardless of your stroke risk.
Practice acceptance and be kind to yourself.
Having a stroke is a traumatic and scary event. It can take many months and sometimes years to fully accept that you have had a stroke and to come to terms with the potential challenges the stroke have left you with.
Know that your emotional response to fearing another stroke is normal and very common. Acknowledge these emotions in a gentle way and ensure you seek help to manage these emotions.
If you are experiencing fear and anxiety about having a further stroke you can call StrokeLine 1800 STROKE (787 653) to discuss a number of strategies to help you manage these fears and to discuss secondary prevention to ensure you are doing everything possible to help prevent a further event.