Aggression and psychosis after a stroke: why do outbursts of anger occur and what to do about it?

Victoria Popova

Cardiologist

Higher education:
Cardiologist
Saratov State Medical University named after. IN AND. Razumovsky (SSMU, media) Level of education - Specialist 1990-1996

Additional education:
“Emergency Cardiology”
1990 - Ryazan Medical Institute named after Academician I.P. Pavlova

Contacts

The process of rehabilitation after a stroke, along with somatic complications, is complicated by a disorder of cognitive functions and pathological emotional reactions of the patient to the consequences of the disease. For this reason, there is a need for psychological adaptation of patients who have suffered an acute cerebrovascular accident. Full psychological rehabilitation of patients after a stroke consists of several areas.

Stroke

Every year, millions of people around the world die from a stroke or its consequences; in Russia, this figure is about 450 thousand. According to statistics, cardiac ischemia alone causes a large number of deaths.

Doctors distinguish two types of stroke: hemorrhagic and ischemic .

For reference. The most dangerous, but relatively rare, is hemorrhagic stroke. It is associated with a violation of the integrity of the vessel and the effusion of blood into the brain. Affects mainly older people.

The disease is caused by hypertensive crises, persistent increases in blood pressure, vascular pathologies, atherosclerosis, impaired blood viscosity, and tumors.

Ischemic occurs more often and affects older and younger people.

The disease develops due to blockage of blood vessels by blood clots, cholesterol plaques, and vascular spasms. As a result, there is a disruption of blood circulation, a deterioration in the supply of brain tissue in the affected area with nutrients, and their death. The pathology is sometimes called cerebral infarction.

Separately, they talk about micro-stroke . It is characterized by transient disturbances and minor damage, which are not always possible to detect during examination. Symptoms disappear on their own or under the influence of medications within one day.

For reference. Among the main factors that provoke the occurrence of both types of stroke are excess weight, bad habits, physical inactivity, diabetes mellitus, cervical osteochondrosis, and some medications. It has been noted that the likelihood of developing the disease increases in women after 80 years of age.

The pathology is associated with lesions in different areas of the brain. A significant factor in the prognosis of the development of the disease is their localization and extent of the lesion. The most dangerous damage is to the brainstem and cerebellum. Most often they lead to death within a few days.

Psychoemotional disorders as consequences of stroke

A significant number of people experience psychological difficulties, psycho-emotional problems and depression after a stroke. Many sufferers need mental health restoration and relief from depression, anxiety, frustration or anger.

According to statistics, psycho-emotional disorders after a stroke occur in the majority of patients – in 30–65% of cases. The dominant positions are occupied by disorders of the depressive and anxiety spectrum (in 20–45% of patients). These concomitant neurotic and psychotic diseases have a strong negative impact on both the quality of life and the functional abilities of the body.

In a sample of more than 50,000 stroke patients, those patients diagnosed with depression or other mental health problems had a 3-fold increased risk of death within 10 years of the first episode, even after the effects of other negative chronic conditions was statistically controlled.

Consequences of a stroke

There are two main types of stroke - ischemic and hemorrhagic, each of them is caused by specific causes and has specific consequences.

Man after hemorrhagic stroke

This type of stroke is considered to be the most dangerous, because it is associated with hemorrhage in the brain, which means that the affected area can have a significant area. Patients who have suffered a hemorrhagic stroke experience serious problems with movement, speech, memory and clarity of consciousness. Partial paralysis is one of the most common consequences; it affects the right or left side of the body (face, arm, leg) depending on the location of the brain lesion. There is a complete or partial loss of motor activity, a change in muscle tone and sensitivity. In addition, behavior and psychological state change: speech after a stroke becomes slurred, incoherent, with obvious violations of the sequence of words or sounds. There are problems with memory, symbol recognition, as well as depression and apathy.

Man after ischemic stroke

The consequences of this type of stroke may be less severe; in the mildest cases, after a short period of time, complete restoration of body functions occurs. Nevertheless, doctors do not give positive forecasts very often - problems with blood circulation in the brain rarely go away without leaving a trace. After an ischemic stroke, problems with swallowing, speech, motor function, information processing and behavior occur. Often a stroke of this type is accompanied by subsequent pain syndromes that have no physiological basis, but are caused by neurological problems.

Throughout the recovery period after a stroke, you need to carefully monitor the upper limit of the patient’s blood pressure in order to take timely measures in case of a dangerous increase. The normal value is 120–160 mmHg. Art.

What types of stroke can cause aggression?

Based on the causes of brain damage, doctors divide strokes into ischemic and hemorrhagic. Each type of pathological condition is characterized by its own consequences. Thus, with the ischemic type, motor function is impaired. One side of the body is affected by paralysis. This type of stroke causes difficulty breathing, swallowing, and moving.

In case of ischemic stroke, doctors prescribe bed rest due to the high probability of hearing, vision, and speech impairments. Loss of control over one's own body leads to changes in mental and psychological aspects.

One of the disorders of brain functioning is memory loss, which manifests itself in the form of difficulty in reconstructing the events of one’s own life; patients find it difficult to remember the names of household objects and their purpose. Such conditions may be accompanied by mental instability, manifested by mood swings and disorders, aggression, and apathy.

Damage to brain tissue and rupture of blood vessels cause hemorrhagic stroke. In cases of untimely assistance, a person’s death or disability occurs.

This type of pathology is characterized by a long recovery process and severe consequences that appear in the loss of the following functions:

hearing;
vision;
physical activity;
sensitivity of nerve endings and receptors;
basic reflexes.

In behavioral terms, a large number of changes are noted, including a slow pace of activity, outbursts of aggression, and a depressive state. Emotional disorders can occur with any type of stroke.

Main characteristic complications

Let's consider what a stroke is and what its main consequences and complications are, as well as what type of this disease accounts for the largest number of cases. Stroke is an acute disruption of the blood supply to the brain , which is characterized by the sudden appearance of focal symptoms. Of the two types of strokes, ischemic and hemorrhagic, ischemic ones account for 87% of cases (what is the difference between ischemic stroke and hemorrhagic stroke?).

The cause of ischemia is blockage of a cerebral vessel by a thrombus or atherosclerotic plaque, resulting in impaired blood flow. A severe lack of oxygen leads to the death of nerve cells and disruption of various parts of the brain.

After a stroke, the following may be impaired:

perception;
speech;
movement;
understanding;
equilibrium.

In men

Men suffer from stroke at a younger age and are 30% more likely than their peers. Typical consequences of ischemic stroke:

sensory disturbance;
facial asymmetry;
weakness or paralysis of body muscles;
damage to speech function;
cognitive impairment.

Among women

Although men become victims of strokes more often than women, in older people over 60 years of age, the incidence rate in women is higher than in men. The reason for this is long life expectancy. In fact, many men simply do not live to see their stroke.

The consequences of stroke are similar for women and men . However, women also have unique symptoms:

dizziness;
fainting;
hiccups;
hallucinations;
disorientation;
dyspnea.

Important. Women suffer from migraines more often than men, so they do not always associate headaches with the onset of a stroke. The most common complaints during cerebral ischemic attack in women are dizziness, weakness and fainting.

In children

Contrary to the stereotype, stroke develops not only in adulthood, but also in children. Typically, these children or adolescents are initially predisposed to developing a stroke.

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Possible risk factors for the child:

suffered birth trauma;
congenital anomalies of cerebral vessels;
diseases associated with blood clotting disorders;
genetic and chromosomal mutations;
drug addict;
family predisposition.

Consequences:

muscle weakness of one side (hemiparesis);
unilateral paralysis (hemiplegia);
loss of balance;
impaired use of hands;
incontinence;
difficulty communicating with others (slurred speech, failure to understand someone else’s speech by ear);
cognitive impairment (difficulty concentrating and remembering).

The brain injured by ischemia makes further development difficult. Children who have suffered an ischemic stroke require comprehensive rehabilitation, including the assistance of a pediatric neurologist, physiotherapist, ophthalmologist, speech therapist, and psychotherapist.

In older people

Typical consequences:

hemiplegia or hemiparesis;
incontinence;
deterioration or loss of vision;
aphasia (impaired speech with preserved mental abilities);
mental disorders (depression, anxiety, sudden mood swings).

In the elderly, the consequences of a cerebral ischemic attack are superimposed on age-related changes (atherosclerosis, hypertension, joint diseases), and their body has less potential for recovery. They have a high risk of recurrent stroke, so during treatment it is necessary to pay attention to its prevention.

Features of caring for patients after a stroke: advice from experts

If the result of a stroke is paralysis, then the patient needs bed rest. In this case, the patient’s body position should be changed every 2–3 hours to avoid the formation of bedsores. It is necessary to monitor the regularity and quality of discharge, change underwear in a timely manner, and monitor any changes in the skin and mucous membranes. At later stages, one should practice first passive and then active gymnastics, massage, and it is necessary to restore the patient’s motor functions, if possible. During this period, psychological and emotional support from family and friends is very important.

Psychological recovery program

The condition after a stroke requires mandatory psychological rehabilitation and understanding from others, which is impossible without constant communication and contact with the outside world. Psychological recovery after a stroke is aimed at developing an adequate attitude towards health and illness, focus and strong motivation for a speedy recovery, and a return to social and work life. For each patient, an individual psychological rehabilitation program should be drawn up, which would take into account:

state of psychological status, which can be uncomplicated or aggravated (neuroses, depression, psychopathic character traits, psychoses, etc.);
the presence of mental complications caused by cerebral hemorrhage or the peculiarity of the patient’s personality response to the disease.

Explanatory, persuasive and informational conversations are important when communicating with a patient. It is extremely important to teach a frail person to re-evaluate values and try to switch his attention to other aspects of life: the interests of friends, family, team, hobbies and social life. In such situations, the rehabilitation doctor works not only with his patient, but also with his environment.

The home environment promotes faster recovery. The patience and gentleness of family and friends helps the patient adapt to his condition and allows him to avoid severe depression. The ability to learn to enjoy life again, enjoy communication, and make plans for the future life helps one to tune in to the need to patiently and regularly follow all the recommendations of doctors and understand that the disease worsens the quality of life, but is not a threat to it, but requires combating the consequences of the disease .

Life expectancy after stroke

Although treatment and rehabilitation options improve every year, stroke is still one of the top three leading causes of death worldwide. A person who survives a stroke is still at risk of having another stroke.

Factors influencing life expectancy:

patient's age;
focus and location of brain damage;
giving up bad habits, eating healthy, controlling blood pressure, doing physical exercise;
the formation of blood clots and blockage of blood vessels, which is especially common in patients with paralysis;
stress.

Risk factors and causes of mental disorders

The main problems are metabolic disorders mainly in brain tissue and blood vessels, a sedentary lifestyle, and poor nutrition.

Risk factors include people aged thirty to sixty years, that is, the working population in the prime of life. According to statistics, men are more susceptible to the disease than women. It occurs more often in people with bad habits, especially smokers.

Taking medications in a toxic dose, chemical products, and vapors of toxic gases can have a negative effect. There may be a hereditary predisposition.

There are two main causes of stroke: spasm of the cerebral arteries and blockage of the vessel. The first depends on the functioning of the autonomic nervous system. If there is a failure in impulse transmission or severe stress, the muscle layer of the vessel contracts sharply.

Blockage of a vessel can be a consequence of the development of atherosclerotic lesions both in the head and somewhere in another part of the body. Over time, the atherosclerotic plaque ulcerates and a blood clot forms in its place. It is able to break away from the wall of an artery, for example, a lower limb, and reach the brain.

Compression of the vessel from the outside by a developing malignant or benign formation cannot be excluded as a cause.

Rehabilitation

You need to start rehabilitation as soon as possible. The severity of stroke complications and each person's ability to recover varies greatly. People who participate in a targeted rehabilitation program do much better than people who don't. The recovery program is drawn up taking into account the specifics of the case, so it is impossible to talk about exact timing.

The main goal of rehabilitation is to improve the patient's condition and prevent another stroke.

Rehabilitation includes:

speech therapy: speech restoration program;
physiotherapy: exercises to strengthen muscles and coordinate movement;
occupational therapy: helps a person improve their ability to perform routine daily activities such as bathing, cooking, dressing, eating and reading;
support from friends and family;
proper nutrition.

Drug treatment

It is used to relieve pain, with increased or decreased tone of the muscles of the limbs affected by paresis, as well as with visual, speech and cognitive impairment. In some cases, drug therapy is necessary to overcome depression and emotional disturbances.

Exercise therapy

An indispensable set of exercises to restore motor functions, muscle tone and sensitivity. It is performed using simulators with biofeedback. At first, gymnastics can be passive in nature, then you can move on to special equipment designed for rehabilitation.

Massage

Massage should be used exclusively as prescribed by the attending physician and performed only by a specialist! Self-indulgence in this matter can lead to a deterioration in the patient’s condition and cause a recurrent stroke.

Physiotherapy

Physiotherapeutic procedures may include electrophoresis, electrical myostimulation of muscles, darsonvalization, magnetic therapy for paralysis of the limbs, heat and cold therapy, various types of baths and applications. As a result of a full course of physiotherapy, blood circulation in the brain improves and the intensity of vascular manifestations of the disease decreases.

Reflexology

Needless to say, acupuncture should only be performed by a professional, experienced specialist, since one unsuccessful movement can lead to complications after a stroke. Reflexology includes acupuncture, electropuncture and laser puncture, which are especially useful for muscular-tonic syndromes, spastic hemi- and paraparesis.

Healthy approach to nutrition

The diet includes consuming plenty of fruits, vegetables, whole grains and nuts. There is a limit on cholesterol and saturated fat intake. You need to minimize your salt intake to maintain healthy blood pressure.

Must eat:

Lots of vegetables and fruits contain antioxidants, which can help reduce damage to blood vessels. They also contain potassium, which helps control blood pressure. Fiber from fruits and vegetables lowers cholesterol levels. Folic acid found in greens reduces the risk of recurrent stroke.
High fiber grains such as rice, pasta, oats and barley.
Lean meat and poultry, fish, eggs, nuts, seeds, legumes.
Milk, yogurt, and low-fat cheese are sources of potassium along with calcium.

Limit consumption:

Foods high in saturated fat - cookies, cakes, pastries, pies, meat products, pizza, fried foods, potato chips.
Products that contain mainly saturated fats - butter, cream, coconut and palm oils.
Salty foods that increase blood pressure.
Drinks containing sugar: soft drinks and liqueurs, soda and energy drinks. Too much sugar can damage blood vessels.
Alcohol.

Sometimes the patient has difficulty swallowing or chewing food. Food should be easy to swallow and soft. Do not prepare viscous food for the patient, such as jam, jelly, bananas - they can cause choking. Food should be finely chopped and not given in solid form. It is better to chew on the healthy side of the mouth. Cups and cutlery should have thick handles - they are easier to use.

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Refusal of medications

Some patients refuse to take medications. There may be several reasons for this:

the person feels well and does not see the need for medication;
the medicine caused a side effect;
laziness, reluctance to change habits and follow routines;
disappointment from the lack of quick results.

Regardless of what form of stroke a person has suffered, his brain is faced with irreversible consequences, which in the future can lead to a second attack. The purpose of taking medications is to prevent the spread of the lesion to healthy brain cells, prevent a recurrent stroke, and restore damaged areas of the brain.

It is necessary to explain to the person that without taking medication his life is in danger. Some drugs do not have a visible clinical effect, but keep the body normal (for example, drugs that lower blood pressure). Recovery is a long process that requires patience and perseverance.

Ways to manage post-stroke mood disorders

Post-stroke emotional disorders have nothing to do with severe mental disorders - psychoses. A stroke victim retains the ability to control and manage their thinking and behavior. Therefore, he is able to take simple steps to help overcome depression, anxiety and emotional lability.

Check your condition daily

Every morning and evening, evaluate how you are feeling. Pay attention to your mood. If you are in a bad mood, try to improve it: talk to a positive person, take part in an activity that brings joy. If you feel good, share your good mood with others or write down how you feel to remember your happy day.

Educate yourself and others

Learn the symptoms, effects and consequences of stroke. Share your knowledge with those you love and trust. Use scientific information to educate other survivors about how stroke can affect life. You should recognize and reassure others that many of the effects of stroke are reversible.

Learn the difference between anxiety and depression

Anxiety and depressive disorders can occur simultaneously and make progress in therapy difficult. Pathological anxiety involves groundless feelings of worry and fear. Anxiety can be disabling and affect all aspects of life, from social interactions to participation in therapy. Irrational anxiety should be diagnosed by a doctor, as some depression medications may not be effective for anxiety disorders or may have a negative effect on people with illogical fears.

Be active

Hormonal levels may change after a stroke, leading to increased cortisol synthesis. High cortisol levels can cause lethargy and fatigue, trigger weight gain, affect blood pressure and lead to emotional lability. Exercise can help counteract this. Research shows that even a half-hour workout every day has a beneficial effect on your mood.

Protect your immune system

Deficiency or excess of certain biologically active substances - neurotransmitters - is a characteristic phenomenon of post-stroke mood disorders. An imbalance of neurotransmitters inhibits immune function. Therefore, it is necessary to take measures to activate immune resources. Regular exercise, staying in the fresh air, good nutrition, and taking vitamin complexes prescribed by a doctor will strengthen the body’s immune function.

Stay socially engaged

Full interaction with society is an essential component for emotional stability. Consider participating in group activities. Attend foreign language courses. Join book clubs. Get involved in community projects. Do charity work.

Get enough cognitive load

Think about increasing the activity of all mental functions - attention, thinking, memory. Play chess, do crossword puzzles, learn a new scientific discipline. Meditation, tai chi, and yoga can reduce stress levels and eliminate mental fatigue.

Stay in touch with your doctor

Mood disorders can occur at any time after a stroke. It is necessary to inform your doctor or get advice from a specialized specialist if unusual sensations and experiences arise.

Get the treatment you need

Consider how you might benefit from medication, counseling, psychotherapy, or a combination of these. Timely treatment and rehabilitation measures will have a positive impact on how quickly you recover from a stroke, not only emotionally, but also physically.

Clinical picture of dementia

Mental disorders after a stroke can be divided into several groups:

Asthenic;
Explosive;
Apathetic;
Euphoric.

Based on the time of occurrence, we can distinguish early ones, those that arise several months after the development of the pathology, and late ones.

The asthenic type of mental disorder is characterized by low interest in the outside world, increased sensitivity to external stimuli, and decreased performance. There is a disorder of memory, attentiveness, and speech inhibition.

The asthenic type includes dementia - a sharp decrease in cognitive ability and loss of once acquired skills, in other words, dementia. With dementia, patients complain of constant depression, dizziness, general malaise, and weakness.

The extreme stage of the disease is forgetting one’s own name, place of residence, date of birth, and the names of the most basic things.

Explosive psychopathy is the complete opposite of asthenia in emotional terms. Patients are highly agitated, quick-tempered, aggressive, and can make noise over the slightest reason. After an emotional outburst, a person feels much better, describing the current situation as a “loss of self-control.”

Apathy differs from the other two types of disorders in its complete indifference to the world around it. The patient feels neither aggression, nor sadness, nor joy. The absence of any emotions is accompanied by loss of appetite, constant drowsiness, and laziness. Against the background of apathy, schizophrenia can develop - a disorder of thinking and perception of the surrounding world, combined with delusions, manic ideas, paranoia and hallucinations.

Causes of aggression

There are many reasons that influence changes in the behavior of a person who has suffered a stroke. Neurologists consider the following factors to be the most common:

emotional instability;
sharp decrease in vision;
paralysis.

Sick people experience panic and psychosis after a stroke due to the inability to lead a normal lifestyle and dependence on other people.

From a physiological point of view, aggressive behavior is explained by a disruption in the production of hormones responsible for a state of joy. These hormonal substances are dopamine and serotonin. There are also internal factors that provoke aggression - constant stress and fatigue, acute infectious diseases, various types of chemical dependency.

Only a doctor can determine the true cause of aggression after conducting an examination and collecting all the necessary tests.

Signs of abnormalities

Changes in the psyche depend on the disturbances in the body systems caused by cerebrovascular disease. Due to severe emotional shock, some patients completely refuse help, scream and attack others. Often a person experiences apathy, a lack of interest in all activities. Such a patient is ready to spend all his time lying on the bed.

Many people who have had a stroke have some common symptoms, including the following:

inappropriate behavior;
sleep disturbance;
weight loss;
depressed state;
desire to say goodbye to life.

The formation of a state of psychosis may be accompanied by excessive motor activity, delusional ideas, hallucinations, and tearfulness. Aggression is paroxysmal in nature. Most often, such outbreaks are recorded by medical specialists in the autumn-spring period.

Signs of vascular dementia

Vascular dementia combines cognitive and neurological disorders. Cognitive impairment occurs within one month after a stroke attack. In the case of many small strokes, symptoms of cognitive impairment appear within six months. Symptoms and their degree of manifestation depend on which part of the brain and how severely it is damaged. Typical symptoms of vascular dementia are:

reduction in the number of human interests;
depression of mental functions (thinking, perception);
deterioration in flexibility of thinking.

Negative changes in a person’s memory appear already at the beginning, but more mildly in comparison with their manifestation in Alzheimer’s. A person forgets some episodes and has difficulty learning new material. However, passive memory comes easily to him. Difficulties arise when a person tries to remember certain things (active memory). People in the early stages of dementia have difficulty speaking and writing. They forget some words or do not understand their meaning. During a conversation, they may make mistakes in spoken words because they do not understand their meaning.

As they progress, mental disorders after a stroke worsen. A person cannot remember how to use things that are familiar to him. It becomes difficult for him to navigate in space, especially in places where he has never been before. It is difficult for such a person to make a purchase on his own and draw up documents. People with late stage dementia need constant care, since without outside help they are not able to feed and clothe themselves.

Vascular dementia is characterized by a wave-like progression. The patient may experience inexplicable rage, irritability, and mistrust, but after a while these emotions disappear without any reason. It is also possible to develop depression or psychosis after a stroke.

Diagnostics

The diagnosis of mental disorders against the background of cerebrovascular disorders is made on the basis of the patient’s complaints, the presence of a stroke, objective studies of the doctor himself, and through instrumental confirmation.

The psychiatrist must externally assess the patient’s behavior, his body movements, speech, conduct psychological tests and talk in more detail about complaints, about what causes certain deviations in the psycho-emotional status.

Instrumentally, one can only confirm the presence of a stroke and cerebrovascular accident. For this purpose, magnetic resonance and computed tomography, Doppler sonography, and fundus examination are performed.

In a biochemical blood test, a decrease in the amount of lipids is possible.

After making a diagnosis and determining the type of mental disorder, the doctor must first prescribe medications that improve cerebral circulation. These include Vinpocetine, Sermion, Phenilin.

If there is a risk of developing blood clots, it is necessary to use anticoagulants, for example, aspirin with constant monitoring of the INR. Nootropics such as Piracetam, Aminalon, and Pantogam are recommended for treatment.

In the case of explosive psychopathy, therapy with sleeping pills, anti-anxiety drugs, and sedative medications is necessary: Valocordin, bromides, tablets based on motherwort, St. John's wort and valerian.

For asthenia and apathy, adaptogens have a good effect: ginseng, eleutherococcus, radiola rosea, lemongrass. In some countries, loading doses of B vitamins are used.

Treatment for dementia includes not only the use of medications, but also psychotherapy. You need to talk to the patient, listen to his personal experiences, reassure, encourage, explain what’s what. Psychotherapeutic methods are used, including autogenic training, hypnosis, and psychoanalysis.

Features of treatment

If disturbances in the emotional state persist over a long period, then it is necessary to seek the help of a psychotherapist or medical psychologist. After clarifying the clinical manifestations and individual characteristics of the patients, specialists prescribe a course of antidepressants, sleeping pills, and psychotherapy methods. The period required to restore mental health directly depends on the timing of seeking qualified help.

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Eliminating depression

A stroke is often accompanied by depression, which requires mandatory correction. One of the ways to treat this condition is medication. The main drug used is antidepressants aimed at increasing hormone levels. In some cases, psychostimulants are prescribed to bring the patient out of a state of apathy.

Non-drug therapy uses psychological treatment methods, massage, gymnastics, and alternative medicine methods.

What drugs help in such cases

After collecting the necessary data and clarifying the characteristics of the disease, the doctor prescribes therapy, which in most cases does not require hospitalization. The recovery process is based on the use of antidepressants and antipsychotics. The first group of drugs is aimed at restoring brain cells and suppressing cognitive impairment.

Neuroleptics are intended to correct emotional disorders. This therapeutic effect involves suppressing the patient’s motor activity. Only a qualified doctor can decide whether to use a particular drug.

How to help a patient who has become aggressive after a stroke

One of the most effective ways to correct aggressive behavior is to provide the patient with positive emotions. For the purpose of rehabilitation, a visit to a specialized sanatorium is recommended. This treatment combines a healthy diet, individually selected medications, physical therapy, and 24-hour medical supervision provided through anonymous assistance.

As a physiotherapeutic intervention for patients suffering from aggression after a stroke, the following are indicated:

treatment using medicinal herbs;
oxygen cocktails;
physiotherapy;
massage;
acupuncture;
salt therapy;
treatment with leeches.

Over the course of many years of the existence of sanatorium-resort institutions, it has been proven that a patient’s positive attitude, friendly environment and qualified assistance can significantly speed up the body’s recovery process.

Exercises for a stroke survivor

A person who has had a stroke should try to do the exercises on their own, because... his future life depends on it. Muscles and joints need movement to stay in shape. And mental exercises will help the brain recover faster.

Exercises for a person who has had a stroke:

Train your facial muscles in front of the mirror: puff out your cheeks, push air from one cheek to the other, stretch out your tongue, show your teeth, smile, laugh, wrinkle your forehead.
Flexion-extension, rotation of the limbs, clenching the hand into a fist, swinging the arms and legs. Be careful not to overtire the person.
If a person used to love to sing, then try to sing with him. Some people can sing after a stroke even if they cannot speak because singing and speaking are controlled by different parts of the brain.
Breathing exercises. Exhale air through closed lips or through a straw into the water. As your strength increases, you can try inflating balloons.
Talk and discuss the news, ask for his opinion.

When should psychiatric treatment begin?

It is important to understand that the treatment of certain disorders of the mental state of a post-stroke patient (especially if such a patient was prone to depression before the attack) is best coordinated with a neurologist and psychiatrist.

Sometimes such treatment should begin simultaneously with general rehabilitation therapy, literally, from the very first day of hospital stay, sometimes such treatment can begin after discharge.

At the same time, depending on the specific clinical picture, doctors try to select those medications that have the necessary restorative (for the psyche) properties, possibly antidepressants or sleeping pills.

Naturally, the prescription of such drugs can only be individual, and the dosage of such drugs can often change during the treatment itself.

Prevention

Prevention of pathology is timely diagnosis and treatment of stroke, constant monitoring of the sick person. It is important to explain to the patient how to control his own emotions. All physical activity must be eliminated and an adequate work and rest regime must be established.

If you have a stroke, you should regularly undergo examinations, visit a cardiologist, neurologist, therapist, and, if you have the first symptoms of mental disorders, a psychiatrist.

It is very important to follow a diet aimed at reducing the consumption of fats and salt. This helps to avoid the growth of atherosclerotic plaque and the occurrence of a recurrent stroke.

The patient is required to constantly take general and biochemical blood tests, regularly check blood pressure levels, monitor breathing and heart rate, engage in physical therapy and spend more time in the fresh air.

Recommendations for the patient's loved ones

Relatives of a patient after a stroke need to learn to anticipate those tasks that are difficult for a patient who has not yet been fully rehabilitated.

As a rule, it is difficult for such people, especially in the morning, to get up or get out of bed, take large pieces of bread and bring them to their mouth, or drink from a cup. In such cases, you can offer them finely chopped pieces of bread and a drinking straw.
It is important to be able to help the patient maintain self-esteem in any situation and always refrain from criticizing his condition.
The daily routine must necessarily include familiar activities that instill in the patient a sense of security and self-confidence. For example, if he is used to working in the garden, then engaging him to the best of his ability will help normalize his emotional state and bring pleasure from his favorite activity.
Conflicts with the patient should be avoided in every possible way, as this can lead to a deterioration in his well-being and cause him to feel resentful and withdrawn. You definitely need to remain calm, try to joke kindly more often, and not argue or criticize in a negative way.
You should not refuse the help of friends, relatives, co-workers and neighbors. Such communication will benefit both the patient and his loved ones.
You need to leave time for yourself. Such minutes and hours of rest will help to overcome heavy psycho-emotional and physical stress and continue caring for the patient in a good mood.
To prevent overwork caused by overestimating your capabilities, you need to think in advance about who can help and replace you. Many relatives who care for such patients overestimate their capabilities and patience - this can lead to neuroses, nervous breakdowns and depression.

Advice to others

Relatives of a patient who has suffered a stroke must follow certain rules of behavior in the event of an attack of aggression:

ensuring the safety of the patient and surrounding people;
an acute attack requires prompt medical attention;
maintaining your own peace of mind;
reducing the influence of psychotraumatic factors;
continuous monitoring of the patient.

After the team of specialists arrives, it is necessary to explain to the doctors what caused this state of aggression and describe in detail the patient’s behavior.