Many of the patients’ relatives whom I keep contact with, aside from the usual questions about the walking recovery, the grip, and the speech, insist quite a bit in the behavior they should have with them, since they have noticed some changes in their behavior.
Sometimes they are light changes, while others are more evident, that even makes them uphold that they have a new personality.
WHICH ARE THOSE CHANGES THAT THEY HAVE BEEN NOTICING?
Depression signs and a lack of humor, or in the contrary, extreme euphoria and lightness when facing their problem, ire attacks or extreme irascibility or sometimes extreme sensitivity and easily emotional. In some cases it is also feasible that in the past, they were very reserved and balanced but after their stroke; begin to show themselves irreverent, and even out of context.
Others simply toughen some parts of their personality, for example an obstinate attitude which can even reach a whim level, while others soften behavioral features (although these are the least).
The first thing to face up to, is to consider two basic aspects of the CVA and the behavior topic. The first is the biological one.
All that we are, we know, we do, and we try, are product of our experiences, which up to the current moment have molded the biology of our body, and particularly our brain.
Hence our brain with its umpteenth interconnected neurons is a unique mode in each individual, it represents our ¨being¨, our person; it is a continuous evolution based on the experiences lived and in accordance to the material changes produced.
Any damage to the cerebral tissue which does not modify our biology, changes in a more or less evident manner, our personality, our ¨being¨.
In reality, it is not just a biological aspect, but also psychological, because our behavior is also guided by our way of living, and how we react to the emotions, since those emotions are perceived thanks to our body signals.
That is to say, we cannot think of an emotion without associating a corporal feeling to it. Let us use love as an example, with its ¨stomach¨ repercussions, or the fright, which are impossible to imagine without associating the heart beats or the adrenaline sensation that soaks our body.
A biological modification of our brain due to a cerebral injury can have repercussions over our manner of elaborating and giving sense to the base information of our body, thus also implying an alteration of the emotional acts.
The second is in the psychological aspect. Surviving a stroke means that death was touched for a moment or more.
It is an experience which changes each human being who is provided with sensitivity. Who survives a plane crash or a car accident narrates these events as very strong experiences, thus it is not possible that they do not have a repercussion in our personality.
We should also add that after surviving the worst, we found ourselves in a hospital bed many times ignorant of what happened, and with a body that we cannot move as we used to before. We are confused and with fear.
In case of a right hemiplegia, which has also compromised the speech, we also have difficulty understanding what the relatives and the doctors tell us, plus the difficulty of expressing what we feel; a sort of ¨air disaster in the air disaster¨.
Hence a CVA is one of the strongest experiences and emotional burden that nature can subdue and to quickly think of attributing any change of behavior to such an event.
But also in this case it is not only the psychological aspect which is dealt with, but also the biological one, since our brain modifies itself based on the experience.
Therefore any psychological change goes together with a biological one in our brain.
As you may have noticed, the aspects which we have reasoned up to now have been divided, not only to simplify the problem, but because mind and body are indivisible aspects which are considered as a unique integrated ensemble.
Depression after a stroke.
Let us analyze the examples of behavioral change mentioned at the beginning of the article and let us start with the most disseminated one; the depression after a stroke. Anybody who sees that everything he has built in his life and that all he knew about his body falls before him adds up to depression.
Some are prompt to quickly go out and find the adequate energy in order to face the recovery, others are more sensible to the change thus face more difficulties.
Therefore, we all know this difference even in the absence of a stroke. Each one of us faces the problem in a different manner, and this is a topic which I daily deal with the relatives and patients who are with me. I also realize that aside from the personal attitude, the recovery has a lot of influence overcoming the depression.
In fact, the patient who sees all his efforts made in the physiotherapy materialize, is able to feed his determination through his own recovery; thus the recovery will be more intense while more alive the patient’s determination is; a classic vicious circle.
In the same way but the other way around, if there is a big gap between the efforts and the obtained recovery, then a declined state of mind will have to be dealt with.
Even worse yet, if the professionals around us and our own relatives are the first ones who do not believe in our recovery.
In this case, sometimes happens that the same phenomenon can be treated with medication that will involve the entire cognitive sphere, therefore, it is often more difficult to carry out a quality job. Let us remember that a CVA affects the brain and the cerebral functions with it, so you should act in its betterment in order to obtain a movement recovery; if they aside from the injury are also altered by external stimuli, then the work could even be more difficult.
This topic will require a complete site due to its importance and extensiveness and not just a simple article, thus for this reason, I invite our directly interested readers in getting deeper into the topic, to place your valuable comments in the bottom part of this article. And considering then that the depression after a stroke, often also affects the survivor´s family as it is described in another article.
LACK OF ATTENTION TO THE PATHOLOGY
This case is relatively rare, and it is almost exclusive of patients who have suffered a cerebral injury in the right hemisphere, thus a left hemiplegia. The term used to name this clinic case is anosognosia, which is the negation or unawareness of the pathological condition. To those who have a relative with the illness it is important to go deeper into the topic since the risk of blaming the patient for his behavior exists when in all reality it is a problem exclusively of the type of injury suffered.
Change in the memory and the attention
The difficulties to concentrate, pay attention, and remember, can inevitably change the features of our personality and the way we relate with others. Even in this case, we should take into account that the attention and the memory are usually the target of the cerebral injuries, especially in the first stages after a CVA.
Hence, let us consider them for what they are, alterations caused by the injury that should be the objective of our attention as well as the recovery of the non intentional attitudes of the patients or we could end up blaming a relative for one of their problems.
IMPROPER CONTEXT BEHAVIORS.
Once again we are faced with a possibility sometimes given by specific cerebral injuries, especially the ones that involve the frontal brain lobes. It is a very important topic and due to that I prefer to send you back to the more specific article, where I explain it in a more detailed way.
Once you read it, you will understand why some emotionally stable and reflexive people can become opposed after an injury in the frontal lobes.
Extreme emotional sensitivity
On this topic, you will surely be more precise and detail oriented than me once you write your comments because sometimes the problems dealt with are not reported to the professional, just as an anecdote how we are touched in a movie different than before, and sometimes relatives describe them as how to better the character.