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Psychiatric Problems in Stroke Patients

Psychiatric Problems in Stroke Patients. Dr. Himalee Abeya. Common Post Stroke Problems. In Patient: Psychological problems Psychiatric illnesses In Carers: Difficulty in coping with change. Psychological Impact of a stroke. Recovering from stroke mentally exhausting

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Psychiatric Problems in Stroke Patients

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  1. Psychiatric Problems in Stroke Patients Dr. Himalee Abeya

  2. Common Post Stroke Problems In Patient: • Psychological problems • Psychiatric illnesses In Carers: • Difficulty in coping with change

  3. Psychological Impact of a stroke Recovering from stroke mentally exhausting • Emotional changes • Cognitive changes • Behaviour changes • Relationship changes Need to adjust

  4. Common Psychological problems Adjusting to change – GRIEF • Shock • Denial • Reaction • Acceptance

  5. Common Psychological problems EMOTIONAL: • Helplessness • Frustration /anger • Sadness • Worry

  6. Common Psychological problems COGNITIVE: • Memory loss • Aphasia + communication problems

  7. Common Psychological problems BEHAVIOUR: • Confused and cautious • Poor judgment + irritable • Apathetic

  8. How to communicate with a stroke patient • Keep conversation at an adult level • Use a normal tone of voice • Speak at a comfortable pace • Avoid distractions • Talk one-on-one

  9. Post stroke psychiatric illnesses • Depression • Anxiety • Emotional lability (hard to control) • Dementia • Psychotic illness

  10. Post stroke depression • Depression common DEPRESSIVE ILLNESS: • Sadness and crying • Lethargy • Loss of interest • Sleep loss and Low appetite • Suicidality + • Low concentration For > 2 weeks

  11. Post stroke depression- Mx • Identify early and treat • Rx reduced illness & reduced mortality • Early measures: • stimulate interest • encourage leisure activities • participate in spiritual activities • Individual counseling / group therapy • Drugs – SSRIs best

  12. Emotional lability • Sudden laughing or crying for no reason • Short time • Difficulty controlling emotional responses • No happiness or sadness involved RESULT: Patient feels embarrassed, frustrated and angry.

  13. Emotional lability ADVICE TO PATIENTS: • Be open about it • Distract yourself • Note posture you take when crying - change • Breathe in and out slowly • Relax your forehead, shoulders (these tense when crying) TREATMENT: drugs possible

  14. Vascular dementia • Forgetfulness • Disordered thinking Specially when intense • Language problems • Change in behaviour • Cognitive testing done

  15. Vascular dementia - Mx • Safe environment • Orient • Improve memory • Stimulate • Keep occupied – schedule • See to hearing/ vision • Drug treatment

  16. Caregiver problems • Huge burden • May get depressed/ anxious • Need help & support • Schedule day • Keep fit • Take time off

  17. Thank You

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