Irritability and aggressive behaviour

Hi Eddie, 

Like you, I had a stroke and I have found behaviour has changed, especially if I am tired, or the room or place is too noisy. I have to get out as quickly as possible, otherwise, I can before cranky. I don't think I am aggressive, but my family members do say that I am being aggressive, that is, a little loud or shouting ... I have aphasia so it is difficult comprehend and listen to everyone's conversations at the same time. That is a problem I am working on. 

1. Remove yourself from the situation.

2. Sit back and relax - 'mindfulness' 

3. When you are ready, go back to what you were doing. 

Hopefully it works for you. 

Marcus

Thank you so much Marcus,

I found your comments very similar to my situation, as with you i don't think i am being aggressive but my family members do i.e. " A little loud or shouting". I am new to this group and actually hadn't heard of Aphasia until i googled it after reading your post, i have been a little naive with my recovery and i don't think i have taken full grasp of the post event conditions. I am going implement your 3 steps into my daily routine.

Regards

Eddie

Hi Eddie, 

I am glad you found my reply useful. As for aphasia, it look me about 3-4 months to be able to read, write and remember this word. I am a 'walking and talking' afflicted-stroke person. People see and talk to me, and so think I am fine. Yet, inside my brain there a some problems - aphasia, mood, depression and anxiety. I am not sure if you have mild aphasia but you can join these groups on Facebook, TBI survivors (Traumatic Brain Injury) and The Stroke Foundation. There are a lot of stories to read that might help you. My stroke was 2 years and 6 months ago, yet I am still trying to understand and accept the things I can and can't do. One thing I have learnt since my stroke is that it is important to seek people who have the same problems and to share their stories.

All the best,

Marcus 

Eddie, 

This is the link for the Traumatic Brain Injury 

https://www.facebook.com/groups/186712754690242/

Hi Eddie,

Thanks for starting such an important conversation. Marcus has some excellent suggestions and experience to share. In addition to his tips here are some others to consider:

1. Identify and know your triggers well so you can prepare or avoid them (noisy, crowded environments, lack of sleep, stress, etc).

2. Once you remove yourself take 10 deep breaths. (Practice mindfulness as Marcus suggests, notice any sensations in the body, the chest/tummy rising with each breath, feel your feet on the ground, etc).

3. Regular routines can help.

4. Be consistent in your approach. Trying a strategy here or there is unlikely to have much impact unless you practice it regularly to see if it is working.

5. Request regular feedback from close family and friends.

6. Try to be open and communicate clearly if you're struggling.

7. Keep a diary to increase awareness and monitor what strategies are working best. Note down day/time of the event, rate your anger/aggression/frustration out of 10 or note how you felt at the time (sensations, thoughts, feelings), what happened just prior (identify any triggers), what strategies were used and their effectiveness, how you felt afterwards (sensations, thoughts, feelings). 

8. Practice self-care. Eat a healthy, balanced diet of whole foods, get plenty of sleep. Avoid processed and packaged foods, excessive amounts of caffeine, alcohol and other potential stimulants or depressants.

9. Exercise! Move your body, get the good endorphins going and release any pent up frustration or energy through exercise.

10. Seek support. See a psychologist or talk to a health professional to monitor progress, provide feedback and debrief. There may be frustrations or negative/limiting beliefs that you're not consciously aware of that can be explored in therapy to help work through so they don't build up over time. The outbursts or behaviours may carry an important message or information. Ask yourself what is behind that response? Why was I triggered? Am I tired? Feeling deflated at lack of progress or difficulty adjusting to life after stroke? Feeling misunderstood? Unhappy at work or in a relationship, etc? Sometimes what is underneath the frustration is worth exploring, but sometimes the trigger may be as simple as being overtimulated by too many people or noise.

The Synapse fact sheets have some great ideas around behaviour and personality changes that you might find helpful.

http://synapse.org.au/information-services/anger-angry-outbursts-after-a-brain-injury.aspx

http://synapse.org.au/information-services/abc-approach-to-understanding-behaviour.aspx

http://synapse.org.au/information-services/what-is-the-message-behind-a-behaviour.aspx

Please let us know how you get on with some of the strategies. It would be wonderful to hear, like Marcus, what helps you the most. It will definitely help others going through the same thing too.

If you would like to chat further please don't hesitate to call StrokeLine on 1800 787 653 (Mon-Fri 9am-5pm) to discuss.

Best wishes,

Simone (Occupational Therapist for StrokeLine)

Thank you so much for the advice Simone, as with Marcus's advice i will enter these into my daily routing. Im glad i have actually asked for some advice, it has really been good to talk to people about this, it has been a few years since my stroke but as Marcus said, i can walk and talk but there are still a few problems that people can't see. Cognitive fatigue i believe is one of my biggest triggers, this is one of the hardest things to explain to people as allot of the time they don't understand what it really means. Thanks for the tips and advice.

Hi Eddie,

You might also want to take a look at this conversation about cognitive fatigue check it out here.

Diana