Why Am I Sobbing All The Time After Suffering A Stroke?

Pseudobulbar affect (PBA) is a condition caused by stroke that damages areas in the brain that control how emotion is expressed, leading to short circuits in brain signals and involuntary episodes of laughing or crying. This post-stroke symptom can be caused by other neurological disorders like amyotrophic lateral sclerosis (ALS). Uncontrolled crying after stroke is a disturbance of the motor concomitants of emotional affect, manifesting as stereotyped outbursts of crying that are excessive to an individual’s liking.

Depression, anxiety, anger, frustration, lack of motivation, or crying or laughing for the wrong reasons may also occur due to the stroke. Most people have some residual neurologic effects from the stroke, which is a neurological disconnect between the brain’s nerve connections or chemistry that interferes with accurate emotional expression. Uncontrolled crying after stroke can be a common complication in the first few weeks and months after having a stroke.

Neurologist Sidonie Ibrikji, MD, breaks down the 14 most common complications people encounter in the aftermath of a stroke and offers tips for managing symptoms. PBA involves sudden, unpredictable changes in emotions, such as laughter, which can take the form of exaggerated or excessive outbursts. Both transient and focal brain insults, as well as chronic and diffuse brain disease, may cause crying spells, presumably by the presence of chemical changes associated with the stroke.

Antidepressants have been shown to reduce the frequency and severity of crying or laughing episodes after a stroke, often within days. A case reported in 2017 suggests that thalamic lesions may also cause crying spells under special circumstances. By understanding and supporting individuals with PBA and providing helpful tips, individuals can better manage their symptoms and cope with the challenges they face after a stroke.

Why do I cry so much after my stroke?

Stroke affects the brain, which is responsible for regulating behavior and emotions. Such consequences may manifest as irritability, forgetfulness, carelessness, inattention, confusion, fear, frustration, anger, grief, sadness, anxiety, and depression, which may be experienced by individuals or loved ones.

How to stop a stroke patient from crying?

Uncontrolled crying after stroke is a disturbance of emotional affect and can manifest as excessive outbursts of crying, triggered by various emotional stimuli. The condition is socially embarrassing and can interfere with rehabilitation in severely affected patients. Although it is frequent, it often goes unrecognized due to patients and relatives rarely complaining about it spontaneously. Effective treatment has been documented in three controlled studies using tricyclic antidepressants and the selective serotonin reuptake inhibitor citalopram.

The latter approach is suggested because post-stroke pathological crying may be attributable to stroke-induced partial destruction of serotonergic raphe nuclei in the brainstem or their ascending projections to the hemispheres. Although our knowledge of the aetiology and treatment of the condition is limited, the current treatment possibilities can significantly improve the quality of life for patients with this socially embarrassing and sometimes debilitating condition.

Is it normal to feel sad after a stroke?

Post-stroke depression (PSD) is a condition that affects one-third of stroke survivors, requiring treatment. It is a result of brain damage and emotional impact, and can also be a reaction to physical and mental limitations and sudden loss of independence. It is crucial to diagnose and treat PSD, which is often not properly noticed or treated. Women may have a slightly higher risk of developing depression after a stroke.

It is unclear whether the causes of PSD are mainly physical or psychological, as the brain damage can also affect emotions. It is essential to take any signs seriously and take proper care of the affected individual.

What heals the brain after a stroke?

Brain exercises can aid in regaining thinking, reasoning, and memory skills after a stroke, along with other brain-strengthening activities like a heart-healthy diet, regular exercise, and limiting alcohol consumption. Stroke recovery begins before leaving the hospital, and many people begin various therapies to help them transition from the hospital to their home. Brain exercises can help recover some of the brain’s capabilities, as blood flow to the brain is cut off during a stroke, leading to changes in communication, movement, thinking, and feelings.

What neurological condition causes crying?

Pseudobulbar affect (PBA) is a neurological condition causing uncontrolled or inappropriate laughter or crying episodes, which do not match the individual’s internal emotional state. It develops from brain injuries or underlying neurological conditions like ALS. PBA episodes are difficult to restrain, intense, and last longer than expected. Other terms for PBA include emotional lability, pathological laughing and crying, involuntary emotional expression disorder, compulsive laughing or weeping, and emotional incontinence.

How long does post-stroke depression last?

Following the commencement of therapy, patients are monitored for a period of several months, with treatment typically initiated within a timeframe of two to four weeks. The response to treatment for post-stroke depression is comparable to that observed in other patients with depression.

Can you be more emotional after a stroke?

Stroke can significantly impact an individual’s ability to control their mood and emotions, particularly during the early stages. This can lead to unexpected emotions, such as increased upsetness, inappropriate laughter, and swearing. Other symptoms may include crying or laughing unnecessarily, expressing emotions more intensely than they actually feel, feeling powerless over emotions, feeling triggered by even the smallest thing, and experiencing emotions that seem out of place. The signs of emotionalism depend on the individual’s natural emotional preferences, as some individuals may be more emotional than others.

What is a neuro cry?

Neuro-crying is a prevalent phenomenon among children with profound neurological impairments, characterized by the spontaneous onset of crying without an evident trigger. Typically, these infants exhibit distress vocalizations due to feelings of discomfort, hunger, or a need for attention. The analysis of these cries has been demonstrated to offer insight into the neurological and medical status of the infant.

How long does it take for the brain to settle after a stroke?

Stroke survivors typically demonstrate a rapid recovery within the initial three-to-four-month period, with some continuing to exhibit positive outcomes well into the first and second year post-injury.

What is the crying syndrome after a stroke?

Poststroke emotional incontinence (PSEI) is a condition characterized by excessive and inappropriate crying or laughter, often uncontrollable and impacting an individual’s quality of life. PSEI has a reported prevalence of 6-34 and often goes undiagnosed. In this case, a 67-year-old patient with PSEI was diagnosed as severely depressed.

Mr. A was hospitalized for an ischemic stroke in December 2017, and a month after discharge, he developed episodes of uncontrollable crying. His internal medicine doctor prescribed escitalopram 10 mg, which was later increased to 20 mg due to no improvement. He presented with dramatic emotional incontinence in September 2018, crying after any small stimuli, including courteous manners and family mentions.

Despite admitting feeling depressed shortly after the stroke but not being depressed for several months, Mr. A denied experiencing a low mood, loss of pleasure in daily activities, psychomotor, concentration, sleep, or appetite changes. He reported no feelings of hopelessness or suicidal ideation and had no loss of functionality.

The patient was upset with not being able to control his crying and bothered with unwanted attention from family and friends, who thought he was severely depressed. Concordance between the patient and his daughter-in-law regarding the inappropriateness of crying outbursts established the diagnosis of PSEI according to Kim and Choi-Kwon’s criteria. When asked about medication proper, Mr. A confirmed that he was taking it properly, and there were no reports of inappropriate laughter.