AGGRESSION AFTER STROKE: WHAT TO DO

AGGRESSION AFTER STROKE: WHAT TO DO

We will tell you why aggression occurs after a stroke, how to act for the patient’s relatives during an attack, and what medications are used in treatment.

According to statistics, 30% of patients with acute cerebrovascular accidents have behavioral disorders, psychoemotional disorders, and signs of depression. At first, they manifest themselves in the form of grumbling, discontent, irritability, bad mood.

If nothing is done, post-stroke aggression develops. About 6% of people suffer from it. The condition is dangerous because during the attacks the patient does not control himself. It is worth starting treatment immediately, until he harmed himself or others.

Why aggression occurs after a stroke

A stroke entails a number of physiological consequences for the body: loss of ability to work and the ability to service oneself, impaired coordination of movements, paralysis of the limbs, decreased visual acuity and hearing. To return to the previous quality of life, you need to go through a long rehabilitation period. And in the first months, when the consequences of a brainstroke are felt especially strongly, one must learn to live with it.

In an attempt to come to terms with his new status, a person develops neurosis, depression, emotional instability. In the absence of therapy, these conditions are complicated by aggression.

But the reasons for aggressive behavior in the post-stroke period are not only psycho-emotional in nature. There are also functional disorders:

Stopping the production of serotonin (the hormone of joy) and norepinephrine.
Damage to the areas of the brain responsible for the psychoemotional state: the parahippocampal, frontal and cingulate gyri, as well as the limbic system.
A large focus of ischemia in the brain, affecting areas that are responsible for thinking and behavioral functions.
Having a psychiatric history, when the person already had mental disorders before the stroke.
Ineffective or untimely treatment. The success of the patient’s recovery after a stroke depends on how quickly drug therapy begins.
There are also external factors that can lead to aggression after a stroke. These are alcohol or drug addiction, severe poisoning with toxic substances, prolonged stress, tuberculosis and other serious infections.

Features of the manifestation of aggressive behavior

Symptoms of aggression differ depending on the person’s age, severity of violations, history. Signs of this condition appear already in the first weeks (even in a hospital setting).

Aggression after a stroke begins with:

absent-mindedness;
apathy;
refusal to communicate, walk, eat;
irritability over little things;
increased anxiety;
mood swings.
It seems to a person that his life is over, suicidal thoughts, constant oppression, fears appear. Along with this, emotional instability develops: the patient demonstrates inappropriate behavior, conflict. He treats relatives and medical staff badly.

If there is a mental history, hallucinations and complete loss of control may appear.

What types of stroke are possible for aggression?

There are two types of stroke – ischemic and hemorrhagic. The first one mainly affects motor functions. There may be complete or partial paralysis, problems with breathing and swallowing. The patient loses memory completely or individual episodes of the biography, cannot remember how to use certain objects. Against the background of these disorders, a number of psychoemotional reactions develop, such as: oppression, apathy, fears. And after them – aggression.

The second type of stroke (hemorrhagic) affects the senses to a greater extent: hearing, sight, smell, taste and touch. Receptors become dull, basic reflexes slow down. A person literally learns to live anew. In this regard, his behavior changes dramatically: depression, denial, emotional instability appear.

Aggression after a stroke: what to do for relatives

People around them should remember that the development of aggression is a characteristic symptom of the post-stroke period. And treat this manifestation with understanding. You should not condemn a person, try to reason, use force, or, even worse, show reciprocal aggression.

During this period, the support and attention of loved ones are extremely important to the patient. In addition, it is worth:

Take care of safety. Remove traumatic objects from the patient’s room, close the windows using the handle latches. This must be done gradually, imperceptibly. A person in a state of deep emotional stress can react negatively to changes in the environment.
If children live in the house where the patient is with severe post-stroke aggression, try to minimize their contact with him. And during seizures, try to get the children out of the house.
In case of an attack, behave calmly and collected, be constantly with the patient, do not leave him alone. Panic and retaliatory aggression will aggravate his condition.
If the patient’s condition at the time of an attack of aggression threatens his life, call an ambulance. Tell the operator that a mental health team is needed.
If the attack happened in the evening, do not turn off the light. This can provoke the patient to take inappropriate actions.
Hospitalization can be especially difficult in an attack of aggression. To do this, you will need at least 3 people who will twist the patient and will constantly hold him until he is placed in an ambulance. Talk to him as calmly as possible, do not make sudden movements. The voice should be quiet, soothing.

If a person jumps up, try to seat him. Be careful not to grab your phone or any other object. In this state, the patient can break a thing or throw it at others. Do not be fooled by the seeming weakness of a person after a stroke. During an attack, he is dangerous and strong, as he cannot control himself.

After hospitalization, in a conversation with your doctor, try to remember what caused the attack of aggression. This will help avoid similar situations in the future. Based on the results of the examination, the doctor will prescribe a treatment plan – outpatient or inpatient.

Types of drugs

At the first sign of inappropriate behavior, it is important to see a doctor as soon as possible. He will tell you what to do in case of aggression after a stroke, prescribe medications and write out a therapy regimen. Self-medication in this case is not just unacceptable, it can become a threat to the health and life of the patient.

It is important to select drugs without a depressing effect, safe for the elderly (if the patient is 60+ years old), with a convenient release form.

The doctor pays attention to such factors:

The stage of mental disorder: how long do attacks of aggression last, how they manifest themselves, how long they last.
Type of illness: periodic seizures, latent aggression, inappropriate behavior, situational outbursts, aggression in combination with other mental illnesses.
The presence of pathologies, infectious and chronic processes in the body.
Groups of drugs used in the treatment of aggression after a stroke:

To restore brain tissue and reduce the degree of cognitive impairment, antipsychotics are used.
For the treatment of psychoemotional disorders, antidepressants are used.
Mild emotional arousal is relieved by sedatives.
For severe psychosis, lithium preparations are prescribed.
Suicidal tendencies are treated with serotonin drugs. They inhibit the reuptake of the hormone in the synapses, which has a positive effect on the well-being of people suffering from OCD, autoaggression, and depression.
If convulsions are observed during attacks of aggression, anticonvulsants are prescribed. They increase self-control, reduce overvoltage.
To provide an anti-anxiety effect, drugs of the benzodiazepine group are prescribed.
The sooner aggression is diagnosed, the higher the chance of coping with its manifestations and alleviating the patient’s condition. It is important to pay attention to the slightest nuances of his behavior, tell the doctor about it and follow the instructions exactly.

Remember: with the correct rehabilitation, part of which is the correction of the patient’s psycho-emotional state, he has every chance to return to a full life.

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