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You are in: Home > Stroke Information > Your Stroke Journey > Coming To Terms

Coming To Terms

• Emotional impact
• Don't be hard on yourself!
• 'Why me?'
• Feelings of loss
• Feelings of fear
• How you feel about yourself
• Effects on other people in your life
• Pattern of accepting change
• Talking about how you feel

Emotional impact

Having a stroke is a major life event which often happens out of the blue and brings unexpected changes to your life.

The immediate focus is usually on your initial recovery period, finding any possible causes for your stroke, and reducing any risk factors you may have.

• The emotional impact of your stroke may come later in your recovery.

Coming to terms with what has happened is another important stage in your recovery process and can take time.

Don't be hard on yourself!

• Nobody else really knows what it is like for you to have had a stroke apart from you: your experience is unique and there is no right or wrong way about how you are feeling. Do not be hard on yourself.

People will try to understand and help but it can be very difficult for you to explain how it feels, especially if you have communication problems.

You need to be able to express yourself and establish some form of communication so it is important to seek the help of a speech and language therapist and utilise anything that may be of help e.g. stroke groups, supported conversation, computers and communication devices.

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'Why me?'

• 'Why me?' is the most commonly asked question of all. Hopefully you may have found out the cause of your stroke but not everybody does. Asking is often the first step in coming to terms with having a stroke and the beginning of making adjustments after a stroke.

A Stroke often happens suddenly, without warning, and can cause overwhelming feelings of shock and loss. Some people who have had a stroke say they feel 'like part of them has died'.

Many people affected by stroke, and their families, experience similar emotions to a grief reaction such as:

• Shock: you may feel that what is happening is not real.
• Denial: initially protects you from being overwhelmed by the changes in your life. Some people may become 'stuck' in denial.
• Anger: a normal emotional response. Often directed at those closest to you.
• Guilt: feelings of guilt can be powerful and destructive and can be completely irrational.
• Fear: you may be scared about what is going to happen to you. Anxiety after a stroke is often related to feelings of fear.
• Depression: feeling down sometimes is natural after a stroke but if you are feeling low most of the time you could be depressed.

It is important to recognise that these feelings are normal responses to a major life event. In time most people move forward in adjusting to life after a stroke and accepting the changes in themselves.

• Note: denial can also be a lack of insight into what has happened due to damage to thinking processes, or cognitive effects, because of a stroke. This is not an emotional response.

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Feelings of loss

• You may feel a sense of loss during your recovery process. Accepting that your life cannot be exactly the way it was and overcoming feelings of loss and fear are a big part of your emotional recovery.

You may feel a loss of physical ability, decision making, identity, confidence, dignity, sexuality, control, sense of purpose, independence and income.

These losses may not be that obvious to other people but they are part of what makes up your personality and sense of self worth.

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Feelings of fear

• You may have a fear of dying, fear of having another stroke, fear of the unknown, fear of loss, fear of failing. Sometimes you may not even know what it is you are afraid of.

Life after a stroke is made up of ups and downs and fear can catch you out when you are not expecting it.

Recognising how you feel and learning to control your anxiety is an important step in overcoming your fears.

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How you feel about yourself

Having a stroke can affect your self confidence and how you feel about yourself. You may:

• Feel that you look different
• Feel dependent on other people and that you are a burden
• Struggle with the transition from being able bodied to disabled
• Feel low in mood or depressed
• Feel that you have lost your sexual identity
• Constantly feel that you are waiting to get back to 'normal', to take up your life where you left off

All of these feelings are perfectly understandable, and are a reaction to what has happened to you. However these feelings can change.

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Effects on other people in your life

Relationships are complex and we have very different relationships with different people.

Our relationships with other people can be affected by the way we feel about ourselves. Try to remember that other people may:

• Lack understanding of how you are feeling
• Benefit from sharing your thoughts and feelings
• Have been affected by your stroke too
• Be too scared to talk about their own fears and worries

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Pattern of accepting change

• Any big change in life brings about emotional reactions.
• Psychologists have identified key stages of how people feel going through change or transition. It is normal to feel worse before being able to adapt and adjust.

• Recovery from stroke is usually a gradual one made up of small but significant goals / achievements.
• Even though a new goal may seem frightening at first, you can achieve it slowly or adapt it to one you can achieve.
• Try to remain as optimistic as possible throughout your recovery. You will have good days and bad days.
• Recognising and treating depression is important.
• Letting go happens when you can see yourself as you are now and not as you used to be, accepting the loss of your 'old self'.
• You will reach a period where you are able to start looking at your 'new' identity.
• You may start to reflect on what has happened, how things have changed, and to look at your recovery. Then you might find yourself imagining situations and visualising yourself in places as you are now and not as you used to be.
• This process leads to acceptance of your new identity and living with stroke.

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Talking about how you feel

• Coming to terms and adjusting to effects of your stroke will not mean an end to other problems in your life. This can be a harsh reality for some people. Pre–existing difficulties will still be there, e.g. relationships, marital problems, financial, work and other unresolved issues.
• Remember life is unpredictable and uncertain, with or without a stroke.

Being able to talk about how you feel is healthy but not always easy!

Some people find they just cannot talk to family members about how they really feel. Some find they can open up to a stranger or stroke nurse / therapist much more easily.

Some people benefit from talking to someone with special training. This kind of help is called talking therapy and it includes counselling and cognitive behavioural therapy (CBT).

• Counselling: generally allows you to explore aspects of your life and feelings that are causing you distress. Bottled up feelings such as anger, anxiety, grief and embarrassment can become very intense and counselling offers an opportunity to explore them, with the possibility of making them easier to understand. Counselling does not include giving direct advice.
• Cognitive Behavioural Therapy (CBT): focuses on how you think about yourself, the world and others and how your thoughts and actions affect your feelings. Working with a therapist can help you to change how you think (cognitive) and what you do (behaviour). These changes can help you to feel better. CBT focuses on 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

If you go for any talking therapy remember to let the person know if you have poor concentration or fatigue. If you have memory problems ask for a written summary of the sessions and any actions to be taken.

• The British Association for Counselling and Psychotherapy provides information about different types of therapy as well as details of therapists in your area.

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