A stroke is sudden and shocking. It can affect every part of your life and have a big impact on your emotional wellbeing.

Everyone’s experience of stroke is unique. But for many people, it may feel like they’ve lost the life they had before. Feelings of shock, denial, anger, grief and guilt are normal when you’re faced with such a devastating change. Dealing with them can be hard and everyone does it in their own way.

Changes to how you feel can sometimes be due to the psychological impact of your stroke. For example, you might feel anxious about having another stroke, or feel low if you cannot do some things you used to. You may find different emotions surface over time, as you go through your recovery journey.

Sometimes, the damage to your brain from the stroke can cause emotional problems. Different parts of your brain control all aspects of your body and mind, including senses and emotions. If part of your brain controlling emotions is damaged, it can affect how you experience and express emotions.

All of this can be hard to cope with. Noticing how you’re feeling, and finding ways to get support, can help stop it becoming overwhelming.

Behaviour changes can be due to stroke damage in your brain. Or they might be linked to emotional changes, thinking problems, or physical factors like pain or fatigue after stroke.

A stroke is sudden and shocking and there are many emotions to deal with. It’s normal for this to affect your behaviour. The way we behave often depends on the way we feel.

But it’s not just about the way we feel. We’re constantly receiving information from the world around us. Our brain has to understand, organise and store this information. This is called cognition.

Our brain uses this information to adjust the way we think and react. If a stroke damages the parts of your brain that do this, this can change the way you behave.

Other effects of stroke can also affect your behaviour. Pain can make you irritable, for example. Frustration at not being able to do things can make you angry or even aggressive towards others. Fatigue (tiredness that does not improve with rest) can make you avoid social situations, or become irritable more easily.

It’s common for behaviour to change in some way after a stroke. As you begin to recover, you might feel your behaviour changes or improves. You may start feeling better physically and emotionally. But some changes can be long-term. You’re still the same person, but a stroke may change the way you respond to things.

Emotional problems can also affect your recovery, for example, if you are not feeling motivated to take part in rehabilitation.

It’s not always possible to go back to the way you were before a stroke. But you can get help and support to make the best recovery possible for you.

It can be hard for your family and friends too if they feel you’ve changed. They may need some support to help them understand how a stroke has affected you.

However, if you or people around you notice you’re behaving aggressively or inappropriately, it’s vital to do something about it.

People often talk about their loved one’s ‘personality’ changing after a stroke or claim they’ve ‘become a different person’. It can feel upsetting if your family or friends say this about you. However, what they’re really noticing are changes to your behaviour after the stroke, not who you are as a person. Try to talk to your loved ones about how you’re feeling.

Mental health and emotional wellbeing support

• The British Association for Behavioural and Cognitive Psychotherapies is a professional association which accredits CBT practitioners in the NHS and privately and has an online directory you can search.
• The British Association for Counselling and Psychotherapy is a professional association which has a register of qualified and accredited counsellors and psychotherapists and an online directory you can search.
• The British Psychological Society (BPS) is a representative body for psychologists, with searchable online directories.
• The Health and Care Professions Council (HCPC) is an independent UK-wide regulator, which keeps a register of health and care professionals who meet their standards. Tel: 0300 500 6184
• The Hub of Hope provides a UK-wide search tool to look for mental health support organisations in your area.
• Inspire Wellbeing (Northern Ireland) offers support with mental health and wellbeing. Tel: 028 9032 8474
• Mind (England and Wales) is a charity with information and support around mental health. Infoline: 0300 123 3393
• The Scottish Association for Mental Health is a charity offering services to support with mental health.
• Samaritans offers confidential, non-judgemental emotional support over the phone. Free helpline open 24 hours a day, 365 days a year. Tel: 116 123

NHS services for mental health and emotional wellbeing

• NHS (England)
• NHS Inform (Scotland)
• NHS (Wales)
• NI Direct (Northern Ireland)
• NHS 111 service (online in England only). This is an NHS triage service which can direct you to sources of medical help and advice, including with mental health. Phone: 111

Help with behaviour changes

• The Brain Charity offers counselling and mental health support to people with neurological conditions, their families and carers. Tel: 0151 298 2999
• Carers UK provides information and support for anyone caring for a family member or someone else close to them. Helpline: 0808 808 7777 (England, Scotland and Wales), 028 9043 9843 (Northern Ireland).
• Headway is a charity with information for people who have had a brain injury, their family, friends and carers. They produce a free ‘brain injury ID card’, which can help you explain to others how your stroke affects you. Helpline: 0808 800 2244