The impact of stroke on controlling emotions

Why am I so emotional? The impact of stroke on controlling emotions

Why am I so emotional? The impact of stroke on controlling emotions ‘Emotional lability’ refers to fast, fierce and uncontrollable changes in mood. After stroke, survivors may find themselves laughing or crying for little or no reason.

Emotional responses don’t seem to make much sense or can be out of proportion. As we generally pride ourselves on keeping our emotions in check, especially in social situations, this effect of stroke can be very challenging.

Emotional lability is caused by damage to the parts of the brain that control our awareness of emotion and how our emotions are expressed and regulated. It is sometimes called the pseudobulbar affect and can last anywhere from a few weeks, to many years.

Stroke survivor Danny Furlong writes of his experience in his book Flat Out: “I’d cry at the drop of a hat and I felt humiliatingly ashamed at being so weak, at not being able to rise above my problems.” What made a difference for Danny was his neuropsychologist’s explanation that his emotional response was a manifestation of his brain injury. This brief discussion instantly alleviated some of his fears about being weak or worthless, and marked a turning point in his recovery.

Being aware of and managing triggers for emotional lability can help. What triggers lability will be unique to the individual, but things to be aware of include tiredness, stress, anxiety, and noisy, overcrowded environments. Being around emotional people, situations or events can also be a trigger, as can being put under pressure.

• Push through, or alternatively, take a break. You can try ignoring the emotional response. Try to get others to ignore it too and continue on with the conversation or task. Focussing on the lability can reinforce the problem. Alternatively, take a break from the situation to help regain control of emotions, and allow things to settle. Try taking a short walk or doing a different activity.
• Relaxation and cognitive techniques. Try techniques such as relaxation and breathing exercises. These are commonly described in books and on the internet. Psychologists can help with cognitive and behavioural strategies.
• Switch things up. If it’s really bothering you, you may want to consider making some changes to your routines. One-to-one, brief and pleasant activities in a quiet environment can be better than trying to constantly deal with stressful situations or environments.
• Deal with the awkwardness head on. Explain  to people what’s happening. Uncontrolled crying or laughing can be upsetting and confusing for other people. Tell people about your stroke and about what works best for you, for example saying “Just ignore it and it will stop”.

As Danny Furlong notes, “I take deep breaths  and try to stop my agonised sobbing, but the tears keep coming. I’m being hugged and hushed. No, I’m not crying at the utter futility of my existence, I’m crying because the radio is playing some slow and sad song! Now I know I’m far from unique in my tears and they are something I’m not responsible for, so I can take them in my stride.”

Call StrokeLine on 1800 STROKE (1800 787 653) to obtain further support, advice or information on emotional lability or start a conversation about emotional lability on enableme www.enableme.org.au