I want to speak about my emotional well-being because not a lot of people see me anymore and don’t catch a full glimpse of my emotions through the day. In all sincerity, I am easily affected, crying on the hour, for reasonableness and at times unidentified. On average I would guesstimate that I cry every hour. I either flashback to the horrific night, the surgery, the grief, the relief, what my family must feel and most of all my husband. I wonder if this is normal for people who have experienced trauma. Sadly, I don’t have support groups to help me sort these things out because of COVID19. I have a doctor I keep in touch with monthly to go over things, but it’s different through the lens of a computer. You don’t feel raw as you would in person. Periodically, during my time with my doctor I’m in denial and will state that I’m doing ok and things are great considering the circumstances because I’m afraid to cry in front of him. It’s not logical. This person is categorically there for me so I can be an emotional mess.
I admit fault. I don’t like to show weakness to anyone. I will show my jovial side or the strong woman who does not take mercy. I feel that tears are feebleness, and at surface show someone who is not put together. So, I’ve held back on tears for many years, and they will surface during appropriate situations. This stroke broke down the wall, and all I do is cry. Thank God we get to work from home. I wouldn’t want someone to see me typing away as the tears come down my face for NO reason. Right now, as I type this, I’m crying.
I decided to investigate the possible causation because that’s my nature to analyze. I came across an article about PBA. According to PBAInfor.org, “PBA is a condition that causes uncontrollable crying and/or laughing that happens suddenly and frequently. It can happen in people with a brain injury or certain neurologic conditions”. “A person having a PBA crying spell may cry when they don’t feel sad or when they only feel a little bit sad.” That information gave me pause, because it felt like a fit. So, I decided to take the test and scored 16/35. The results said that scores 13 or higher suggest PBA. Apparently, this disorder affects 2 million people, and stroke victims fall under this category. Something I will bring up at my next neurosurgeon appointment.
Next, I went to my trusted website that I frequently use for work, National Library of Medicine. In an article about crying after stroke they state, “Uncontrolled crying after stroke is a disturbance of the motor concomitants of emotional affect. It manifests as stereotyped outbursts of crying that are excessive to an appropriate emotional response. The episodes can be triggered by almost any kind of emotional stimulus (happiness, excitement, sadness, just being looked at or talked to, the sight of a doctor, etc.) and can even occur without any obvious external or internal stimulus. The condition is socially embarrassing, and in the most severely affected patients the crying episodes can be so violent that they interfere with rehabilitation” “Although frequent (1-year incidence is 20%), the condition often goes unrecognised because patients and relatives rarely complain about it spontaneously.” “There seems to be a rationale for the latter approach to treatment, in that post-stroke pathological crying may be attributable to stroke-induced partial destruction of the 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, and the need for further study is considerable, the present treatment possibilities can significantly improve quality of life for patients with this socially embarrassing and sometimes debilitating condition.”
There you have it, yet another issue that needs further study, but has been recognized as an issue. I don’t fall in the percentage of not acknowledging my emotions, because this blog is based on admitting my emotions and my experiences.
Next, I went to the American Stroke Association, which states “ After a stroke, survivors often experience emotional and behavioral changes. The reason is simple. Stroke impacts the brain, and the brain controls our behavior and emotions. You or your loved one may experience feelings of irritability, forgetfulness, carelessness or confusion. Feelings of anger, anxiety or depression are also common. The good news is many disabilities resulting from stroke tend to improve over time. Likewise, behavioral and emotional changes also tend to improve. Time is on your side”.
Ok, so this article gives me hope that improvement will come with time. I don’t feel anger in the sense of anger with everything. I feel anger that this happened to me but that’s it. I feel irritability constantly because I feel lost or not understood, or that someone has not fully grasped what I went through and is insensitive to my situation. I don’t have carelessness; in fact, I feel the opposite of that. I do get confused, but it’s only a moment, and then I’m back on track.
Last, I went to the Stroke Foundation. The gave more information about what I’m going through.
This is copied directly from their website: https://strokefoundation.org.au/About-Stroke/Help-after-stroke/stroke-resources-and-fact-sheets/Emotional-and-personality-changes-after-stroke-fact-sheet
Emotions and personality after stroke
Changes in your emotions and to your personality are common after stroke. It’s very normal to experience strong emotions after stroke, however these emotional reactions usually get better with time. Longer-term emotional and personality changes can be very challenging.
We generally value keeping ourselves and our emotions in check. Emotional and personality changes can also be difficult for the people around us, and can cause problems in social situations.
Emotional lability is common after stroke. This is when emotional responses don’t seem to make much sense or are out of proportion. You may cry or laugh uncontrollably. Your emotional responses may appear out of character or be out of context. This is also known as the pseudobulbar affect. (Another article pointing toward PBA)
So, after reading through these articles at length, I don’t feel alone or crazy for crying on a dime. It’s a transformational response after a stroke. It’s imperative for me to realize that my stroke is a severe brain injury, and I’m 4 months post-stroke and I can’t presume that my normal self will emerge. With candor, I admit that it’s distressing, tiresome, inconvenient, baffling and enigmatic. I have an obligation to myself to allow these tears to flow, accept help and tools to improve these emotions, and remind myself about time.
However, time is hard for most people. We are an indigent species that expect things to change instantaneously. So, when faced with something that is out of our control it’s hard to grapple. My tears are part of this equation. I will give you some examples, so it’s not a surface statement.
I wake up in the morning and take a shower. As the water hits me, I start crying because I can’t fully place myself under the water head because the pressure can’t hit my shunt. Now I have figured a way to wash my hair by filling a water pitcher with the warm water to feel that rush but it’s not the same.
I start getting ready and look in the mirror, unrecognizable and start crying. Now these are real tears, not tears that just come on for no reason. I try my best to put my makeup on and look as womanly as possible. Lately, I have clicking on my skull where the incision begins as I press my makeup on- bring on the tears. Then I get dressed.
Next, I make my coffee and sit down and turn on my computer and tears start rolling down. I’m not sad that I’m working, the waterworks come for no reason.
As the day goes on, more tears pour down, no reason, they just keep coming. My dogs come up to me and lick my tears away and I feel better.
After my day is over, I start crying. Again, no reason. I just sit on the sofa and cry myself to sleep from fatigue.
Night comes, and I start to feel impending doom for no reason. I cry.
Yet, there is beauty with these tears. I listen to music differently. There is more emotion when I hear the lyrics or listen to the score. When I watch a video of something special, I catch myself crying over a story that was touching when previously I would’ve watched it with no emotion. When my mom comes over to watch over me, it makes me cry because it’s so special to me that she is such a caring woman that loves her daughter so much that she wants to make sure that I’m ok. I cry when my husband comes home because he makes me laugh, takes care of me, makes me feel loved. I cry when my fur babies come over to me because they want to love on me. I cry when I see my Dad because he is there to save the day. I cry when friend's check-in on me. They don’t have to, but they do. So, there are a lot of special reasons to let these tears flow too.
Hopefully this is a sign of a softer side to me. I hope this is a new phase of me healing. With the unexplained tears that won’t stop, I must embrace it, become mindful and deal with it.
To anyone reading this that is going through this too- don’t feel alone if you are going through this. Admit it to someone. Heck, I’m admitting it to anyone reading this. The more you contain emotions all to yourself, it becomes an illness that festers to something fierce. There is something liberating letting people know how you are truly doing. I refuse to place a façade on my well-being. If I did, I wouldn’t be helping myself nor helping others. Society is to blame for this because it’s stigmatized. We fear that if we put it out there, we aren’t employable, looked at differently. If I was in a high position, I would trust the person who is honest, then the person who camouflages their authentic self.