Post-stroke anxiety (PSA) and post-stroke depression (PSD) can strike anytime after a stroke. Mine showed up about eight weeks into my recovery as I was trying to go back to work. The stress of the daily grind was a contributing factor, but the stroke is what caused my mental health problems. I was unprepared for the havoc they’d wreak on my life, and the inevitable crisis I would find myself in.
About two months after I returned to work, I had what I call a “nervous breakdown.” I lost my grip on reality and couldn’t perform the easiest of tasks without panicking. I found myself dreading each day, and feeling lost and broken. Sometimes I’d end up in the fetal position at the bottom of the stairs, wishing it would all just go away. That someone or something would put me out of my misery. I often wondered why I survived the stroke only to be left hating my life and wishing I hadn’t survived.
One scary night, I even considered taking my own life. I had so much to live for, yet in that moment, I thought everyone would be better off without the burden of me. But my brain was lying to me! Thankfully, I thought, “ending my own life is not the legacy I want to leave behind.” And I chose to let myself live instead, despite how painful life had become.
I was fortunate that I could seek (and afford) mental health therapy. I received crisis intervention services, twice, by being admitted to in-patient mental health facilities. Those stays helped get me through each immediate crisis, but the real work started when I entered an intensive outpatient program (IOP) for anxiety and depression. It was a six-week, three-days-a-week, for three hours at a time, program that gave me the tools and resources to manage my mental health. If I hadn’t gone through that program, I’m not sure where I’d be today.
While I’m not a professional therapist, I’m grateful I can share the lessons I’ve learned by coaching other stroke survivors live their best lives, reclaim their confidence, and unleash their own legacies. Because we survived for a reason, even if we don’t know what it is. It’s up to us to uncover that reason and work toward building a great life in support of it. It’s not easy, but it IS possible.
If you or someone you know is struggling from PSA or PSD, below are the 10 best tools and techniques that help me manage my own mental health. These alone may not get you out of a deep, clinical depression or heightened, pervasive anxiety. Instead, I recommend seeking the advice and help of a medical professional. Personally, I needed prescription medication to help me get my mental health under control (and I still do). I sought the care of a psychiatrist who specializes in mental health medications, vs. relying on my primary care physician alone. And I sought weekly talk therapy to help me process my thoughts and emotions.
Regardless of where you are in your recovery journey, here are some simple things you can do at home, on your own, if you want to improve your mental health.
- Journaling. Keeping a journal where you write down your thoughts, feelings, concerns—along with your hopes for the future—helps you gain control of your emotions and improve your mental health. If you can’t write because of your stroke, perhaps you can keep an audio journal, where you speak and record your innermost thoughts and concerns, letting them out of your body and mind and releasing them into the Universe. It’s important not to keep these things bottled up inside of us.
- Meditation. Meditation has been used for centuries to help create a feeling of relaxation, inner peace, and present moment awareness, which can significantly reduce stress. If you’re unfamiliar with meditation, it’s simple to get started. Find a quiet, comforting place where you won’t be disturbed. Then, focus on your breath. Take 10 deep breaths, from your belly, and let each one out as slowly as you can. Try to clear your mind of anything else. I find “guided” meditations are the easiest way to get started because you’re talked through what to think about and focus on. You can use an app, like Headspace or Calm, or even find free guided meditation videos on YouTube that can be extremely helpful. And don’t worry if you’re not a great meditator in the beginning, it’s called a “meditation practice” because becoming good takes practice.
- Exercise/Movement. Exercise boosts your mood, improves sleep patterns, and can help manage depression and anxiety by releasing “feel good” chemicals into your brain. You don’t necessarily have to work up a sweat or kill yourself in the gym. Instead, even a brisk walk will help you. My doctor recommended I get at least 30 minutes of exercise a day when I was at my lowest point. That was more than I could muster in those early days. But I started with five minutes of walking on my treadmill, then, slowly, worked up to 15-20 minutes a day, and eventually, up to 30 minutes. I was amazed at how good it made me feel.
- Get outside/Get grounded. Fresh air can raise oxygen levels in your brain, increasing serotonin levels to boost your mood. Our bodies and brains are wired to be connected to Mother Earth. That’s why we feel better when we go hiking, or to the beach, or just hang out in our backyard, listening to the birds sing. The grass, flowers, and trees release mood-boosting aromas that nourish our bodies, minds, and souls. I even recommend hugging a tree. It feels really good. Think of the storms the tree has survived. If you give it your negative energy, it will reciprocate by giving you some of its enduring strength.
- Listen to uplifting music. Music can help lower stress levels, blood pressure, and heart rate. It can also help you feel your feelings and boost your mood. But it’s important to choose uplifting music—whatever that sounds like for you. Some people prefer gospel music over pop music, or classical over country music. Listening to sad songs when you’re depressed will only bring you further down. Find something that brings you joy and increases your frequency. I like to start my day by listening to uplifting music.
- Eat healthy and stay hydrated. A diet of nutrient-rich foods sets you up for fewer mood swings and improves your ability to focus, increasing your attention span. It’s also critical to drink enough water. Without water, your brain can’t get enough of the amino acid tryptophan needed to create serotonin—the “feel good” chemical—that regulates mood. Also, your brain needs water to function properly, combatting symptoms of depression and anxiety. Recommendations vary about how much water we should drink every day, but my goal is to get 64 ounces every day, or eight, eight-ounce glasses of water.
- Get plenty of sleep. Quality sleep is closely related to mental health. It helps maintain cognitive skills, such as attention, learning, and memory. Since so many (nearly 75%) of people with depression show symptoms of insomnia, it’s critical to focus on ways to improve your sleep. If you’re having trouble sleeping, there are things you can do to help, such as limiting “screen time” an hour before bed. You can also listen to soft music or a sleep meditation, or use aromatherapy to set the mood for sleep. For me personally, it took prescription sleep medications to help me get over my insomnia post-stroke. Once again, it’s important to talk to your doctor about medication if you think you need it. Most people won’t.
- Keep your hands busy. This one surprised me the most. It’s all in the hand-brain connection. Something about keeping your hands busy helps your mind pause and become more centered, making it possible to take the next step forward. Find something you love to do with your hands, even if it’s only for five or 10 minutes a day. You’ll likely notice you’re calmer and more relaxed when you do.
- Get into a routine. The anxious mind needs routine. Routine reduces stress by making the situation appear more controllable and predictable. Start by getting out of bed at a decent hour! Staying in bed is a great way to feed your depression. Open the blinds in the morning and let the sunlight in. Play uplifting music as your alarm clock, to start your day off on an upbeat note. Schedule activities throughout the day to stay busy. My morning routine consists of drinking a glass of water first thing, then meditating for 10 minutes or more, then journaling and practicing gratitude. You don’t have to schedule out every minute of every day. However, do try to adhere to a consistent routine, and don’t forget to schedule time for things that bring you joy.
- Talk it out. Talking about your problems, concerns, and feelings, can release pent-up negative energy in the body and mind. It can reduce stress, strengthen your immune system, and reduce physical and emotional distress. Talking with someone you trust is key, and it probably shouldn’t be someone who you live with or are close to. You need an objective listener who won’t try to “fix” things for you, but will listen with the intent to understand. This could be a licensed therapist or a neighbor, or a member of the clergy—wherever you feel safe to disclose your feelings and emotions, where you won’t be judged.
With these ten mental health “hacks” (shortcuts), you’ll have a sturdy foundation for your mental health. You don’t have to try all 10 at once. Start with one or two and work your way up. Test a combination of the hacks and see which ones work best for you.
Good luck and I wish you all the happiness and fulfillment in the world. I promise, there is light at the end of the emotional tunnel after a stroke, just don’t give up on yourself or buy the lies depression and anxiety are telling you.
For more about my story, please check out my book: “Invisible Scars: Stroke Survival, Recovery, and the Unexpected Mental Health Fallout.”
By author, speaker, and life coach Angie Read