A stroke is an interruption in the blood supply to the brain, causing damage or death to brain cells and, often, loss of function in some part of the body. Even when the loss of function involves a part of the body distant from the brain, such as the inability to control the movement of a foot, there are often many direct and indirect mental health consequences. Stroke is considered a neurological condition, not a psychiatric one, but it can cause perceptual, cognitive, and emotional impairments
Understanding a Stroke
The damage caused by a stroke depends on where in the brain the incident occurs. If the involved blood vessel is in the right hemisphere of the brain, noticeable symptoms show up as impaired movement—weakness or paralysis—affecting the left side of the body; the reverse is true if the stroke occurs in the left hemisphere. The right hemisphere also handles an individual’s sense of their position in space (and other perceptions in three dimensions), awareness and consideration of music and art, imagination , intuition , insight, and holistic thinking. A person may experience memory problems, visual problems, or an inability to recognize body parts.
Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes. While strokes are most common among the elderly, the U.S. Centers for Disease Control report that 38 percent of people hospitalized for stroke in 2014 were less than 65 years old. Stroke rates in the U.S. are increasing among the young, largely because conditions that put people at risk for stroke—high blood pressure, high cholesterol levels, diabetes, and obesity—are increasing among the young.
The risk for stroke varies by race as well as age. In the U.S., the risk of having a first stroke is nearly twice as high for non-Hispanic Black adults as for White adults. Non-Hispanic Black adults and Pacific Islander adults have the highest rates of death due to stroke.
The risk for stroke also varies by geographic region. Globally, the lifetime risk of stroke among men and women over age 25 is 25 percent. But the risk varies from a low of 8 percent in sub-Saharan Africa (where both younger and older people are at greater risk of dying from other causes) to 39 percent in East Asia and Central and Eastern Europe. In the U.S., the lifetime risk of stroke is 21.1 percent among women and 16.9 percent among men.
Mental Health Effects of Stroke
Many psychological changes may occur in the wake of a stroke. Some are the direct consequence of changes in the brain; others are reactions to the changes, such as loss of function, that may follow a stroke. They can add up to personality change and also add to the hard work of rehabilitation.
Depression is very common after a stroke. It may be the effect of both biological changes in the brain and reactions to the event. Both social support and psychotherapy can be very helpful, as alleviating depression not only aids physical, cognitive, and intellectual recovery but also makes stroke survivors more willing to engage in the often challenging work of rehabilitation.
Sadness and grief are also common reactions to the losses that may follow a stroke, which can include not only loss of mobility but also loss of confidence , loss of independence, and loss of a career . Guilt may accompany the grief, as survivors may feel they have become a burden to those around them, who often bear a large burden of care and support. Social support from family and friends, as well as from stroke survivor support groups, can help survivors manage the emotional upheaval strokes can create.
Difficulties getting around, difficulties communicating, and reactions to myriad losses can generate frustration and anger —often anger at the stroke itself, but also often expressed at the people closest to the survivor. Frustration and anger may even prompt the survivor to lash out verbally or physically at those around them. Anger can also be a direct result of the primary brain injury.
Explore More About Stroke
For a comprehensive understanding of stroke, read our complete guide: