BEHIND THE STROKE SURVIVOR’S SILENCE

Wofa Kojo is a 33 year successful man who had a stroke the day after his wife delivered. His story gives us a brief understanding of the internal emotional processes a stroke survivor may experience.

The story

Earlier that night, I slept peacefully, with the pleasant thoughts of visiting my wife and the twins at the hospital in the morning. In the morning, I opened my eyes with joy in my heart, only to find out that I could not move my right limbs or even shout for help. “What is happening to me?” I thought to myself. Confusion flooded my mind, tears filled my eyes, “somebody help me” I shouted but no word came out of my mouth. Three hours later, the house help entered my room. I could see him and hear him but I could not speak to him. Quickly, he lifted me and drove me to the hospital.

At the hospital, I overheard my brother say “he has stroke”. “Stroke!!!” I shouted on top of my voice but all my siblings could hear were muffled sounds. From that moment on, I knew I had become useless; how will I play with my children, carry them in my arm or even speak to them, will my wife be happy with me – how will our sex life be like, will I lose my job, how will my friends relate with me, will I be treated like a child?…these were the thoughts which run through my mind.

It has been eight months since this traumatic event happened to me, even though I can speak some words are difficult to pronounce and also my speech has become slow and a bit slurred and I have some improvements in my right limbs. I am also learning to do some personal hygiene with the unaffected limbs, but I still cannot understand how a healthy eating, exercising and health conscious guy like me can have a stroke and on a day that was supposed to be a joyous one.

In the initial stages I did not want to be seen or be around anyone because I felt so useless and worthless. But as part of my treatment I went through psychotherapy and with the support of my family I am improving and beginning to find life worth living again.

What is Stroke?

stroke happens when blood carrying oxygen is unable to get to parts of the brain, this may lead to damaged brain cells and brain cells can die if left without oxygen even for a few minutes. If the stroke occurs in the left side of the brain, the right side of the body will be affected, and is likely to lead to; paralysis on the right side of the body, Speech/language problems.

How do I know someone is having a Stroke?

It is not immediately obvious when someone is having a stroke but any of these symptoms point to a stroke

  1. Sudden numbness or weakness in the face, arm or leg especially when it is on one side of the body
  2. Sudden confusion or trouble speaking or understanding speech
  3. Sudden vision problems in one or both eyes
  4. Sudden difficulty walking or dizziness, loss of balance or problems with coordinated movement
  5. Severe headache with no known cause

Medical and Psychological Implications of a Stroke

A Stroke may be fatal leading to death or can leave the survivor paralyzed, debilitated, and unable to speak/talk or care for himself/herself. But a stroke is not only a medical emergency that needs immediate medical attention but also has psychological consequences due to its devastating effects on the individual.

Depression and Anxiety

Research shows that quite a number of stroke survivors go through depression (Hackett & Pickles, 2014). Survivors may show symptoms of extreme continuous sadness or flat mood, restlessness, loss of appetite, insomnia, fatigue, loss of interest in things that made them happy before including sex, feelings of worthlessness and hopelessness, worry of the future and thoughts or attempts of suicide.

It is important to note that, when a stroke occurs, it affects the brains ability to control emotions and behaviour therefore most of the emotions and behaviours that a stroke survivor may exhibit, may be due to the changes in brain and could also be a reaction to all the sudden losses – speech, movement, thinking etc.

Feelings of loss of self

The unexpected nature of stroke makes it challenging for some survivors to accept who they have become. They feel a sense of loss and despair over the traumatic event which occurred suddenly in their life. Stroke survivors due to the change in their physiology and lifestyle struggle with self-identity usually they find it difficult accepting their new self and miss the old self. They may tend to express grief over the old self and deny the new self (Crowe et al. 2015).

Self-esteem

The idea of stroke and the disability following stroke may affect how some stroke survivors and their loved ones view their “self”. From the story, we find that Wofa Kojo viewed himself as useless.

Feeling of aloneness and isolation

Stroke survivors may not be able to participate fully in their previous roles and activities they were used to performing. This makes them feel a sense of loneliness and rejection. In some cases, the survivor will withdraw from friends and family because of these same feelings of isolation and aloneness (Crowe et al. 2015).

Anger/Aggression

Kim, Choi and Seo, 2002, in the paper “Inability to control anger or aggression after stroke” found that some survivors usually find it difficult to control the anger and the aggression they exhibit. This was closely related to the motor dysfunction, emotional incontinence and some dead cells in the thought processing and judgement area of the brain. This means that the stroke survivor is not intentionally being “difficult to handle” but is having an emotional experience that their “coping skills”, at that moment, is not able to handle.

Do all Stroke survivors exhibit these emotions?

Not all stroke survivors may experience these emotions. Why? Depending on which part of the brain that is affected, individual survivors will express different emotions, at different levels and intensities

Can One Lead a Normal Life after stroke?

Recovery from stroke may take a long time sometimes years; this depends on the extent of damage to brain cells, how quickly one seeks medical care and the social and emotional support as well as the will to live after stroke.

Stroke survivors would be able to cope better if they see a psychologist. Neuropsychologists, Clinical Psychologists, Developmental Psychologists, are some of the professionals who can help stroke survivors overcome their emotional challenges and to begin to build some basic cognitive and physical abilities that have been lost or become limited due to the stroke

There are a variety of aids and techniques for specific disabilities, which the therapist would discuss with you to choose the ones appropriate for your specific challenges

It is also important that, caregivers – relatives, family members, friends of stroke patients stay positive and supportive.

If you have found this blog helpful let us know. You can also contribute if you are a Stroke Survivor or you know someone who has survived a stroke and is willing to share his/her experience. Ensure that as much as possible the individual remains anonymous to protect his/her dignity and right to privacy. Remember also that not every patient develops intense emotional responses to a stroke

If you are a student and want to read more check out

Crowe, C., Coen, R. F., Kidd, N., Hevey, D., Cooney, J., & Harbison, J. (2016). A qualitative study of the experience of psychological distress post-stroke. Journal of health psychology, 21(11), 2572-2579.

Hackett, M. L., & Pickles, K. (2014). Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International Journal of Stroke, 9(8), 1017-1025.

Kim, J. S., Choi, S., Kwon, S. U., & Seo, Y. S. (2002). Inability to control anger or aggression after stroke. Neurology, 58(7), 1106-1108.

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