Hi My husband suffered a left Frontal and Occipital lobe infarct on…

Hi Kidest,

Thank you for reaching out on Ask A Health Professional via EnableMe. I am sorry to hear about your husbands stroke and the impact it has had on his speech and now mood and motivation.

It is difficult to know what the cause of your husbands recent change in mood and motivation is and there are a number of factors that could be impacting this.

I have included some information on mood and fatigue post stroke for you, but would strongly encourage you to discuss your concerns with a medical professional.

You can also call us at StrokeLine on 1800 787 653 to have a more in detailed conversation around this.

After your stroke you may experience more long-lasting emotional difficulties, including depression and anxiety.

These are common at any stage after a stroke and can be treated. Depression is more than just sadness or a low mood,

it is a serious illness that can have severe effects on both physical and mental health. While everyone feels anxious from time to time, for some people these anxious feelings are overwhelming

and not easily controlled. Anxiety is more than just feeling stressed, it’s a serious condition that

makes it hard to cope with daily life. Depression and anxiety can go on for weeks or months if left

untreated. Research shows having depression can slow down the recovery from your stroke making

it hard to concentrate or stay motivated.

Treatment for depression and anxiety can vary from person to person. It may include lifestyle changes like exercise and diet, or psychological therapies. Medication may also be prescribed.

Enlisting the help of family and friends, external service providers, and making time to rest and relax is also important in your recovery.

You may find more information about emotions on our EnableMe website here, personality changes here, and a fact sheet on depression and anxiety here.

As mentioned it’s important to speak with your doctor or other health professional about your

concerns and how your husband is feeling as they may be able to provide a referral to a psychologist

or counsellor. He may be eligible for a Mental Health Treatment Plan which lets you claim several

sessions with a mental health professional each calendar year. When making the appointment, it is

important to ask the health professional about the costs as they set their own fees and Medicare may

only cover some of the cost. If they bulk bill, you won’t have to pay anything. If you have private

health insurance, you may be able to get some money back, so check with your insurer.

He or yourself may also call the following services if you need someone to speak to:

Beyond Blue: 1300 22 4636
LifeLine Australia: 13 11 14

Psychologists and Neuropsychologists

Psychologists and neuropsychologists are health professionals who can help with mood and thinking

changes after stroke. Psychologists are experts in human behaviour, having studied the brain,

memory, learning, human development and the processes of how people think, feel, behave and

react. A psychologist can help you manage difficult or overwhelming emotions or moods and can

provide treatment for depression and anxiety. They can also help you if you or your family are having

trouble getting used to life after stroke. A neuropsychologist may further be helpful for stroke

survivors, as a neuropsychology assessment may be required to establish a treatment plan or to

provide rehabilitation recommendations. This assessment can help clarify whether you are able to

return to work, study and driving, and what support you might need. For more information about

psychology or neuropsychology, please visit our EnableMe website here.

Another option may be the Australian Centre for Heart Health (australianhearthealth.org.au) who

provide a service called Cardiac Counselling, which is a face-to-face or online counselling service

for people who have had an acute cardiac event including stroke. You can contact them at Ph: (03)

9326 8544 | Email: wellbeing@australianhearthealth.org.au.

Fatigueis very common after a stroke and can be described as a feeling of weariness, tiredness or

lack of energy.Symptoms offatiguecan include headache, dizziness, blurred vision, increased pain,

aching muscles and reduced coordination and balance. Other symptoms include ‘brain fog’, impaired

memory and decision-making, moodiness or irritability, anxiety and depression or low motivation.

You may find more information about fatigue on our EnableMe website here or the Stroke Foundation website here.

It can be difficult to say exactly how long these feelings of fatigue will last and fatigue could also be a sign of depression. However, there are things that you can do to help managefatigue.

Pacing - Spread out the activities you do and take numerous shorter breaks instead of one long break after an activity.

Planning - Understand what activities you are doing and when, making sure not to group up too many similar activities together.

Prioritising - Uderstand what you need to do and what can wait. If you have a limit to what you can do each day you can plan to do those things which are important and save unimportant things for other days.

It is great he is accessing speech therapy for his communication changes and I would also

encourage you to speak to his Speech Pathologist about your concerns also. If you discuss your

concerns with the speech pathologist, he/she can also refer to an occupational therapist. An

Occupational Therapist can assist with energy conservationmanagementtechniques that may be

helpful to combatfatigue, especially when working.

You may find more information about speech and language on our EnableMe website here, or our

factsheet here.

Synapse (Australia’s Brain Injury Organization) also has information about speech deficits and speech pathologists here.

If you husband has Aphasia which occurs when the parts of your brain that contain language is

damaged. This can affect your speaking, listening, reading and writing. Please view our Aphasia

handbook for more information. You can also find more support or information about aphasia through

the Australian Aphasia Association or your local state aphasia association. There are also some tips

on living with Aphasia on our i-Rebound website here.

Joining an aphasia group may assist in practicing communication and connecting with a community for support. You may find a list of aphasia support groups here or stroke support groups here.

Carers or Family Members

Information for carers or family members who are supporting someone with aphasia may found

through this blog post here. You may also find some communication tips/strategies here and here for

those assisting people with communication difficulties.

We recognise the challenges that come with being a carer so we hope you are also looking after yourself during this time.

If you have just become a carer for a stroke survivor, you may be interested in our resources on EnableMe here. You may also find more carers resources and services here and here. There are organisations that can support you as a carer.

Carer Gateway (1800 422 737) is a place for carer support, services, resources, and education. They also provide free in-person or over-the-phone counselling for carers.

Synapse (1800 673 074) is the Australia's Brain Injury who provide information and support to people who have experienced a brain injury, such as stroke, and their carers and families. You may find support for carers here, including support groups available.

If you would like more information, please do not hesitate to contact us on StrokeLine 1800 787 653 or email strokeline@strokefoundation.org.au. We are available Monday to Friday 9am to 5pm AEST.

Wish you the best,

Bec (Stroke Line)

Hello Kidest. I’m a retired professor of speech pathology who helps the Australian Aphasia Association.

You are understandably worried about your husband. What does your speech pathologist say about the ‘I don’t know’ response? Aphasia can affect comprehension in subtle ways. Of course, it can also affect his ability to formulate verbal responses and he may be defaulting to ‘I don’t know’ a lot. You know him best though so you will know.

People who are further along have said they felt ‘out of it’ in those early stages. They struggled to process much at all.

Would talking with another wife/wives of a person with aphasia help? You can email us at questions@aphasia.org.au.

Hi Kidest,

Here are some comments from the community for you:

Fit ol boy: I know its tough for the person suffering as they recover and deal with the whole situation just as its tough for those close that are in a supportive role,

I can only draw from my own experience supporting my dad who suffered a stroke,

we would laugh with dad and make light of things and see the humorous side of things at the same time urging him to persevere with the harder things like eating and trying to stand but also telling him to rest, which is such a huge part of the recovery, we were conscious of not stressing him out.

There is no easy answer, but laughter, love and rest would be my top three things that i found were a huge benefit to dad, i hope this helped, sending love and best wishes for your husbands recovery.

Stroke mom: What worked for me is that my husband threw me a 'Spirit Week' where he gave me a different t-shirt (of one of my fav 80s bands...) every day for a week, it weirdly worked.

Brigitte Miller: I just had my first stroke this may as well! Just keep providing him emotional support and check in with what he needs to gain more motivation. Cognitive Therapy can be super helpful as having a stroke is a lot on the psyche.

Desney King: I have occasional dysarthria - can’t speak.

But I can sing!

Maybe you could try asking him to sing??

It can lead to lots of laughter too, especially if you sing back to him: conversations in singing.

Blade: I’ve survived 3 strokes since 2015. One is a lot! Please just keep encouraging him to continue moving forward. The sleep is natural, the brain is trying to heal. My wife of 27 years almost gave up to safe herself from the constant battles. Just keep loving him!

Post stroke recovery: I would also find a role model for him to inspire and give him hope. He might be feeling frustrated with his current progress . Why isn’t it as visible as before. Lastly I would say daily affirmations would be beneficial to make him feel loved and supported as it’s a lonely journey in post stroke recovery.

Helen: My dad had a stroke 3 years ago. I remember him saying how easy it could be to lose motivation and sleep into a dark place. For this reason we celebrate every moment of progress! We set goals and go large on celebrating when it happens! I can appreciate this might not work for everyone but to be honest, it has kept us all going! On a separate note, I am thinking of you and your family, the early days are tough on you all! Keep going x.

Hi Kidest,

Here are some more ansers and advice from the community. I hope this helps.

Kate Roadley

My dad had a stroke 20th may. A left frontal bleed which left him with expressive aphasia. I’m not sure what part of the brain your husband stroke was but that part of the brain is also in charge of initiative. I noticed that dad preferred to be sitting watching tv a lot and the things that were important to him such as, gardening, walking, etc were not anymore, this concerned me. Dad is still attending his extensive rehab program appointments and I mentioned this his OT so she made him a weekly schedule to initiate his ‘usual’ daily tasks.

I understand how exhausting and fatigued they feel but at the same time these couple of weeks and months are so crucial to the success of his recovery. I stayed with my parents for a couple of weeks after dad’s stroke and did extra speech sessions, I made them fun and we laughed at some of his ridiculous/incorrect answers. I understand everyone’s stroke is different but I would mention this to his dr because depression is too common after stroke. Best of luck to you husbands recovery.

Duncan Mitchell

I'm coming up to my 8 year anniversary and I still struggle with fatigue every day. This first few weeks and months in hospital were very hard, all I wanted to do was sleep. My only advice is to encourage but don't try and force it, every situation is different but when the body and brainneed to rest I think bits important to rest.

Sonia Mathews

Almost five years 5 years since I had my stroke it is a slow process. You get tired and want to rest. have come along way. My two kids were 12 and 14 when I had the stroke. Think positive and have faith. He can do it be positive. I saw a psychologist it helps. As it is difficult life is not the same only the person know it. Good luck and I will keep in my prayers.

Burns Shan

I had a ischaemic stroke may 2019 I know how he feels just let him sleep and rest.

Keith Marsh

May THIS year?! A stroke is a very serious and possibly life changing event. I’m 10 months in and can’t walk and I’m still getting very confused. Give it time and compassion.

Robin Bell

Fatigue has been my biggest legacy. I have numbness in my face,hand and foot after my stroke in May 2022- the only ongoing affects. I still get tired doing some work but not like a year ago, when afternoon naps were most days. My brain was damaged & as they said it was trying to heal itself. After a few weeks into my rehab, my physio said it would take me 2 years to get over my stroke.

Michelle Truman

Building new neural pathways in the brain is exhausting work. As is processing grief associated with a big life altering health episode.

How do you support him? By allowing him to set his own goals and drive his own recovery at his own pace. He’s an adult. It’s his stroke recovery journey to navigate.

May is the VERY recent past. Stroke recovery can be ongoing for years.

Just be there. If he shares his feelings, validate them. Trust that he’ll find his way in his own time.

Tracy Anne Ward

It took months (maybe a year) before we found a neuropsychologist who realised that my hubby didn’t like the word antidepressants and suggested “a mood stabiliser” 8 tough weeks whilst the medication stabilised and he looked up at me and said “depressed, no”! This is a lengthy road to recovery with many speed bumps along the way. But having a good mood always helps. Our men have lost a lot, depression sort of makes sense if you really think about it. See if you can add a neuropsych to your team. Good luck, be gentle on yourself xx

Cathy Zanella

This is so early days. I know it’s hard to take that in. My hubby was telling me, after my stroke, that it looks like it will be at least a year and my reply was, “don’t be ridiculous”!! It’s 14 months and it’s both fast and slow. I realise how much I’ve achieved, but also how much there is to do. Speech is something I do every day - my husband does it with me every morning because he knows how important it is to me. I see the speech therapist now every couple of weeks.

Let him rest; it’s all exhausting. But keep an eye on him so he doesn’t let that spark completely disappear. The fatigue is real - it’s another level of exhaustion that you could never imagine. For the first time in 14 months, I’ve had a couple of days when I haven’t had a long nap. So there is something changing. Good luck

Michael Szuster

From personal experience, you think you can take on the world and things will just become easy quickly…reality sets in and recovery takes time.

Give him time, give him space- keep encouraging him.

Sandra Lovell

Is your husband taking medication for depression if not might be a good idea to chat to your doctor.

My husband has days where he seems down, I find that a drive or catching up with an old friend lifts him.

We also attend a self help group of blokes with strokes that has been a good support group as they are all guys who have had strokes and they know what everyone is going through.

Sue Rewald

Fatigue is a legacy of stroke. I have found a year on it has improved, but something I have to constantly manage. Speech was also my main deficit- realisation that you now are living with a brain injury is huge.