Coping With Stroke

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Everyone has a different way of coping after stroke. While some effects of a stroke may be immediately apparent and, perhaps with therapy, relatively short-lived, others may take months or even years to develop and could be long-lasting.

Having support and getting proper rehabilitation from your care team is essential to making your post-stroke life as good as possible. In addition to physical, occupational, and speech therapy, coping can involve talk therapy with a psychologist or social worker and support groups—online or in-person.

recovering after a stroke

Verywell / Ellen Lindner


Sadness, anxiety, anger, and grief are all common responses to a stroke. This can be due to physical or biochemical changes in the brain as well as the emotional response to post-stroke life.

Talk to your healthcare provider about your emotional health and any changes in mood or behavior, as it may be a serious side effect of the stroke. Medications and treatments may be able to help you. Your practitioner might also recommend that you see a mental health professional for specialized treatment.

Different psychological approaches for treating post-stroke emotional disorders include:

  • Solution-focused therapy (SFT)
  • Problem-solving therapy (PST)
  • Cognitive behavioral therapy (CBT)
  • Attitude and commitment therapy (ACT)
  • Interpersonal therapy
  • Mindfulness therapy, also called mindfulness-based cognitive therapy

Group therapy can also be helpful and many people find the social interaction of a group helps to relieve feelings of isolation following a stroke.


Many people go through a grieving process after a stroke. As you begin to come to terms with new limitations and mourn the loss of your life before stroke, you may experience periods of denial, anger, bargaining, and depression before finally coming to acceptance. This is perfectly normal.

Journaling, talking with a friend, or seeing a therapist can help your emotional healing.


The effects of stroke can also challenge your self-esteem. For example, it can be especially hard on you if the stroke has impaired your mobility and limited your independence—affecting, perhaps, what formerly made you feel like a confident individual.

Be gentle with yourself, avoid being self-critical, and try to reframe negative self-talk with positive thoughts.

Behavioral and Personality Changes

After a stroke, new behaviors can include a lack of inhibition, which means that people may behave inappropriately or childlike. Other changes in behavior include a lack of empathy, loss of sense of humor, irrational jealousy, and anger. Talk to your healthcare provider about these changes in behavior, as there may be medications that can help.

Pseudobulbar affect (PBA), also known as emotional lability, reflex crying, and involuntary emotional expression disorder, is more common following a brainstem stroke. In PBA, there is a disconnect between the parts of the brain that control emotions and reflexes.

People with PBA may briefly cry or laugh involuntarily, without an emotional trigger, and in ways that are not appropriate to the situation.

While there are helpful PBA medications and strategies, such as preventing episodes with deep breathing, distractions, or movement, some people find simply alerting those around them in advance can help reduce embarrassment and make it easier to cope.


Depression is common after a stroke, with some studies saying about 25% of stroke survivors become depressed and other estimates putting that number as high as 79%.

Stroke survivors are twice as likely to attempt suicide as the general population. If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.‎.

Treating depression with a combination of medication, talk therapy, and group support may improve your mood and also boost physical, cognitive and intellectual recovery. 

Clinical Guidelines: Post-Stroke Depression

The American Heart Association and the American Stroke Association jointly recommend periodic reassessment of depression, anxiety, and other psychiatric symptoms in stroke survivors to help improve outcomes. Medications, therapy, and patient education about stroke can all be helpful.


Coping with physical limitations after a stroke can be a struggle. While many of these challenges will improve over time, it can help to know what you can expect during recovery and where to turn for help.

Many long-term physical complications from a stroke can be helped with therapies, while others may be managed with medication or adaptive technologies and other tools that can help improve independence and quality of life.


Most of the time, weakness caused by a stroke affects one side of the body, known as hemiparesis. This commonly affects the face, arm, or leg or a combination of the three. While the weakness may linger long-term, physical therapy can help you to regain strength, and occupational therapy can help you develop alternative strategies for everyday activities.


Many stroke survivors report feeling off-balance, dizzy, light-headed, or as if the room is spinning. These sensations may come and go but may eventually stabilize. Physical therapy is the most effective way to combat balance impairment after a stroke. Your therapist can show you safe, at-home balance exercises or yoga poses to improve balance and combat dizziness.

Vision Changes

Vision problems that may result from a stroke include:

Ophthalmologists and occupational therapists can advise you on the best method to manage vision changes, including therapy to compensate for vision loss, prism lenses, sunglasses, an eye patch, or eye drops.

Communication Problems

Difficulty speaking or understanding words is one of the most well-known results of a stroke and among the most impactful.

Speech-language therapy can help people cope with aphasia (which is trouble speaking or understanding words due to a disease or an injury of the brain) and dysarthria (difficulty articulating words due to muscle weakness or diminished coordination of face and mouth muscles).

Cognitive Deficits

Cognitive changes after a stroke include memory glitches, trouble solving problems, and difficulty understanding concepts. While the severity varies from one stroke survivor to another, research shows cognitive remediation can help significantly.

These interventions include exercises to improve memory, processing speed, and attention, and teaching compensatory strategies, such as making lists and keeping a planner.

Hemispatial Neglect

A stroke on one side of the brain can lead to difficulties with the field of vision or movement on the other side of the body, known as hemispatial neglect. For example, a stroke in the right cerebral cortex can lead to the diminished ability to notice and use the left side of the body.

Depending on the part of the body affected, an optometrist, neuropsychologist, or physical or occupational therapist can help you cope with hemispatial neglect.


Many stroke survivors experience new-onset pain after a stroke. Common locations for post-stroke pain include:

  • Shoulder
  • Head
  • Muscles (widespread or in a small area)
  • Nerves
  • Joints
  • Lower back

Rest, physical therapy, and medication can help you to cope with the pain. Post-stroke headaches require special attention from your healthcare provider, but they can improve with the right treatment.

Fatigue and Sleeping Problems

In studies, up to half of stroke survivors report experiencing long-term fatigue following a stroke. For some, this manifests as excessive sleep or the inability to feel rested, while others wake in the middle of the night, have difficulty falling or staying asleep, and nap sporadically throughout the day.

These problems may be due to the stroke itself or a secondary cause, such as depression, pain, or nutritional deficiencies. If you experience fatigue or trouble sleeping, talk to your healthcare provider, who can run additional tests, prescribe medication for insomnia, or offer other strategies to help you cope.

Swallowing Difficulties

A speech and swallow evaluation can identify problems with chewing and swallowing, a common stroke complication known as dysphagia. Most patients see improvement within the first few weeks after a stroke. However, swallowing problems can be quite dangerous.

Choking due to stroke-induced muscle weakness may cause serious illness, such as aspiration pneumonia or even life-threatening breathing obstruction and infection problems. Feeding therapy may help you to regain the ability to swallow safely, although some patients may require a feeding tube to get adequate nutrition.

Trouble With Urination

After a stroke, many stroke survivors experience incontinence, which is urinating when you do not want to. Some stroke survivors also experience bladder retention, which is the inability to urinate on demand. Both of these problems can be managed with medical treatment and physical therapy.

Urination problems can be embarrassing and inconvenient. Discrete bladder-leak protection products like pads for both men and women, disposable underwear, and leak-proof underwear can help you feel more confident going out in public.

Muscle Atrophy

Post-stroke muscle weakness can lead to a lack of movement. A recent stroke patient may need assistance getting up and around in the days following a stroke, and staying in bed too long can result in the muscles shrinking and becoming weaker.

Muscle atrophy can be prevented through pre-emptive post-stroke rehabilitation methods that engage weakened muscles before they shrink. It is difficult to recover from muscle atrophy, but rehabilitation techniques can help improve the situation and slowly rebuild muscle.

Muscle Spasticity

Sometimes weakened muscles become stiff and rigid after a stroke, possibly even jerking on their own. Muscle spasticity and rigidity is often painful and can result in diminished motor control of the already weakened muscles.

Active post-stroke rehabilitation can prevent this, and there are a number of effective medical treatments. Your physical therapy team can provide exercises you can do throughout the day at home to prevent and ease spasticity.


Some people experience post-stroke seizures due to erratic electrical brain activity. Seizure prevention may be part of the post-stroke care program, and seizures are typically managed with medication. Cortical stroke survivors are at especially high risk of developing seizures years later.


Whether your stroke left you with minor physical limitations, speech difficulties, or serious mobility challenges, many people feel isolated after a stroke. Getting back into the stream of life can take time.

Many patients and caregivers find that joining a support group can offer both social engagement and emotional support. Your local hospital or rehabilitation center likely hosts a regular support group, or you can check the American Stroke Foundation's website.

For people with limited mobility, joining an online support group that holds regular online meetings, a Facebook community group, or message boards to talk with other stroke survivors and caregivers can be a lifeline keeping you connected to others. Online support is available through the Stroke Network.


The after-effects of a stroke can present unique individual challenges. Lingering weakness, mobility challenges, difficulty communicating, and visual problems can lead to a lack of independence.

Help With Daily Living

Depending on the degree of your stroke, you may require help with activities of daily living, including cooking, cleaning, and grooming. In some cases, family members step up to help, while others may require a visiting nurse, a part-time aide, or even live-in help like a housekeeper, companion, or nurse.

Some people choose to move to retirement complexes that provide varying levels of care or assisted living facilities.

Getting Around

Some people lose the ability to drive and experience other physical changes that make it difficult to get around. Some stroke survivors find getting a mobility scooter can help them get out in the world independently.

Many communities offer senior or disability buses to help you go shopping or offer car services to bring you to your healthcare provider and therapy appointments. You can also use a ride service like Uber or call a taxi to get from place to place.


Roughly one-quarter of strokes occur in people who have not yet retired. If you are working full-time at the time of your stroke, you should be able to apply for temporary disability until you are able to resume working.

If the stroke has left you with minor impairments, but you can still perform some of your former duties, the American Stroke Association recommends entering into a Reasonable Accommodations Agreement with your employer. If you are unable to work, you may qualify for long-term disability through Social Security.

Frequently Asked Questions

  • How long does stroke recovery take?

    You may find the quickest improvements happen in the three or four months after the stroke. Recovery may continue for one or two years afterward.

  • What percentage of stroke patients make a full recovery?

    According to the American Stroke Association, 10% of stroke survivors recover almost completely, about 25% recover with minor impairments, and 40% have moderate to severe impairments. Another 10% need care in a long-term care facility.

35 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Stroke Association. Emotional & behavioral effects of stroke.

  2. Wichowicz HM, Puchalska L, Rybak-Korneluk AM, Gąsecki D, Wiśniewska A. Application of Solution-Focused Brief Therapy (SFBT) in individuals after stroke. Brain Inj. 2017;31(11):1507–1512. doi:10.1080/02699052.2017.1341997

  3. Visser MM, Heijenbrok-Kal MH, Van't Spijker A, Lannoo E, Busschbach JJ, Ribbers GM. Problem-solving therapy during outpatient stroke rehabilitation improves coping and health-related quality of life: Randomized controlled trial. Stroke. 2016;47(1):135–142. doi:10.1161/STROKEAHA.115.010961

  4. Wang SB, Wang YY, Zhang QE, et al. Cognitive behavioral therapy for post-stroke depression: A meta-analysis. J Affect Disord. 2018;235:589–596. doi:10.1016/j.jad.2018.04.011

  5. American Stroke Association. Post stroke mood disorders.

  6. Renner CIe, Outermans J, Ludwig R, Brendel C, Kwakkel G, Hummelsheim H. Group therapy task training versus individual task training during inpatient stroke rehabilitation: A randomised controlled trial. Clin Rehabil. 2016;30(7):637–648. doi:10.1177/0269215515600206

  7. American Stroke Association. Grief and acceptance.

  8. American Stroke Association. Self esteem post stroke.

  9. American Stroke Association. Personality changes post stroke.

  10. American Stroke Association. Pseudobulbar affect (PBA).

  11. Hadidi NN, Huna Wagner RL, Lindquist R. Nonpharmacological treatments for post-stroke depression: An integrative review of the literature. Res Gerontol Nurs. 2017;10(4):182–195. doi:10.3928/19404921-20170524-02

  12. Mohd Zulkifly MF, Ghazali SE, Che Din N, Singh DK, Subramaniam P. A review of risk factors for cognitive impairment in stroke survivors. Scientific World Journal. 2016;2016:3456943. doi:10.1155/2016/3456943

  13. Winstein CJ, Stein J, Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.

  14. Stroke Association. Physical effects of stroke.

  15. van Duijnhoven HJ, Heeren A, Peters MA, et al. Effects of exercise therapy on balance capacity in chronic stroke: Systematic review and meta-analysis. Stroke. 2016;47(10):2603–2610. doi:10.1161/STROKEAHA.116.013839

  16. American Stroke Association. Visual disturbances.

  17. Stroke Foundation. Vision loss after stroke fact sheet.

  18. Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2016;(6):CD000425. doi:10.1002/14651858.CD000425.pub4

  19. Spencer KA, Brown KA. Dysarthria following stroke. Semin Speech Lang. 2018;39(1):15–24. doi:10.1055/s-0037-1608852

  20. Virk S, Williams T, Brunsdon R, Suh F, Morrow A. Cognitive remediation of attention deficits following acquired brain injury: A systematic review and meta-analysis. NeuroRehabilitation. 2015;36(3):367-77. doi:10.3233/NRE-151225

  21. Scholarpedia: The peer-reviewed open-access encyclopedia. Hemineglect.

  22. American Stroke Association. Coping with pain.

  23. Stroke Foundation. Pain after stroke fact sheet.

  24. Paolucci S, Iosa M, Toni D, et al. Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study. Pain Med. 2016;17(5):924–930. doi:10.1093/pm/pnv019

  25. Harriott AM, Karakaya F, Ayata C. Headache after ischemic stroke: A systematic review and meta-analysisNeurology. 2019; doi:10.1212/WNL.0000000000008591

  26. Stroke Association. Fatigue after stroke.

  27. González-Fernández M, Ottenstein L, Atanelov L, Christian AB. Dysphagia after stroke: An overview. Curr Phys Med Rehabil Rep. 2013;1(3):187–196. doi:10.1007/s40141-013-0017-y

  28. Rofes L, Arreola V, Almirall J, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract. 2011;2011:818979. doi:10.1155/2011/818979

  29. Stroke Foundation. Incontinence after stroke fact sheet.

  30. Scherbakov N, Doehner W. Sarcopenia in stroke-facts and numbers on muscle loss accounting for disability after stroke. J Cachexia Sarcopenia Muscle. 2011;2(1):5–8. doi:10.1007/s13539-011-0024-8

  31. Bethoux F. Spasticity management after stroke. Phys Med Rehabil Clin N Am. 2015;26(4):625–639. doi:10.1016/j.pmr.2015.07.003

  32. Graham NS, Crichton S, Koutroumanidis M, Wolfe CD, Rudd AG. Incidence and associations of poststroke epilepsy: the prospective South London Stroke Register. Stroke. 2013;44(3):605–611. doi:10.1161/STROKEAHA.111.000220

  33. Wang G, Jia H, Chen C, et al. Analysis of risk factors for first seizure after stroke in Chinese patients. Biomed Res Int. 2013;2013:702871. doi:10.1155/2013/702871

  34. American Stroke Association. 15 things caregivers should know after a loved one has had a stroke.

  35. American Stroke Association. Rehab therapy after a stroke.

Additional Reading

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.