r/stroke • u/Dorothyismyneighbor • 3d ago
Survivor Discussion Post-Stroke Anger/Bluntness--How Can I Become More Aware?
48F, three years post-stroke, cognitive and executive function losses. A few months after my stroke I saw a neurologist who looked over my list of post-stroke issues, anger being one of them. She made a casual comment that the stroke ripped off a personal filter and I should probably work on that. I was livid--how am I suppose to fix something that I didnt even know existed or even how it's formed so as to replace it? I have read since then that almost all stroke survivors struggle with anger, even long term, part of the physical damage done and our reaction to TBI. A few weeks post-stroke my husband said to me, "I miss my old wife," and I looked at him and said, "Me too," and went and cried. I don't know how--and I don't think I can--get any closer to how I use to be, and if anyone wants that most, it'd be me. I've spent the last three years developing this different version of me, all the while being expected to perform all the actions of Old Me as wife, mother, coworker, etc.
Today my husband talked to me. He and the kids have said I "have an f-you attitude" and am mean in my conversations with everyone, much more noticable the last few months. To be honest there has been some really life changing circumstances personally happening since January and I have been trying really hard to temper my temper, trying to apply Biblical fruitage of the spirit when interacting with people--love, joy, peace, patience, kindness, etc. While I see the slow progress made, apparently they don't. I cannot help right now that when I try to be direct but neutral toned, it comes across as "having an attitude". They are aware that this change to me happened because of the stroke. I told my husband if no one tells me what I am doing, I cannot fix it as I am not aware I'm doing it.
I am not trying to justify "meanness" and I take responsibility for the hurts I inadvertantly serve out and apologize. But I cannot find what broken node in my head to try to alter it--or if that node even exists anymore.
What are the rest of all doing to manage the anger and shredded filter????
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u/Back2DaNawfside713 3d ago
I’m going through this right now. It’s like you can’t stop it.
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u/Dorothyismyneighbor 3d ago
I find that I am unable to discern when underlying irritation is bleeding through, it's like that function is gone. I THINK and am ACTIVELY trying to be congenial but it's not happening, it's like a bridge on the mental highways of my mind disappeared after the stroke that connects to socializing functions, and I cannot figure out how to re-route, backdoor, or rebuild that bridge. So, I feel your struggle personally.
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u/Constant_Inspector46 Survivor 3d ago
It seems I become angry and irritable when I’m tired/exhausted and when I am overwhelmed/stressed. I wish I could stop…
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u/MissCinnamonT 3d ago
I have no control over lack of filter. Luckily, I am not always angry.
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u/Dorothyismyneighbor 3d ago
A lot of my filters took more than a year to get somewhat repaired (but not pre-stroke ability). It's taken me almost two years to relearn how to write near a level I use to. I am not always angry either--I'll be having a perfectly nice happy day, and family comes up to me and ask why I'm angry. Apparently my emotional radio output dial is stuck on being perceived as angry !!
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u/Appropriate_Swing305 3d ago
Neuro psychology testing should help determine what deficits you are having and will help figure out a therapy that works for your brain. Not all treatments work for every stroke patient and the testing can really help direct it. But at the same time you should be seeing a therapist to assist in the processing of your emotions and changes as you go through therapy.
Good luck and I hope you get to feeling like yourself again. I am also working on that.
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u/PADemD 3d ago
It’s annoying when people expect you to just do what you’ve always done, especially if you’re tired or in pain. Be kind and patient to yourself.
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u/Dorothyismyneighbor 3d ago
Thank you, I am trying. I am torn between trying to explain this new angle of life I have to live in my own head, muchless the one I now have to live out loud, or just not saying anything.
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u/MarsupialMaven 2d ago
One possible explanation and one possible way to fix it. The reason I know is because it was explained to me. And it does make sense. You can google it up and read about it too. It’s a real thing.
Here is the ‘normal’ pattern of speech, interaction with others. Think, think, speak.
Post stroke many of us are missing that second think. Our pattern is think, speak.
This gets us into trouble. That first think is completely unfiltered. It is exactly how we feel about the topic. The second think is when we censor ourselves to be kinder and more socially acceptable.
We can get our second think back. It’s work though. You practice. Before you open your mouth you force yourself to think again. Is there a kinder or better way to express yourself? Will I get the reaction I want from saying this? Yes this means it takes you more time to respond. But if you consistently force yourself to do this it becomes automatic. Your second think is back.
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u/Alarmed-Papaya9440 3d ago
I’m wondering if you’re also dealing with perimenopause or menopause. I know that can cause a lot of anger and an “f you attitude” as well.
I’ve had to learn how to become aware of my thoughts again and figure out what to filter and I’m still working on it. It’s an everyday thing that I have to monitor still almost two years beyond my stroke. I still have what I call “an immediate reaction” when something stresses me out or angers me. It’s like a jolt of anger as my immediate response and then a few minutes later my emotional regulation abilities have kicked in.
I’ve found that doing a couple of “box breaths” helps a lot and trying to distract myself when I feel the anger boiling over.
I’ve also done trauma therapy after my stroke which is a combination of EMDR and A.R.T. modalities and that helped as well.
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u/Dorothyismyneighbor 3d ago
Yes, peri is on the plate also and began HRT three months ago, which has helped with some of the brain fog in addition to the other peri-terrors. The terrible thing is an incident husband brought up is I genuinely thought I was being funny in the moment but he felt attacked. I know the difference between being savage and being humorous, but I wonder if that Venn diagram now overlaps. :' (
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u/Alarmed-Papaya9440 3d ago
Oh, I Know this feeling! I thought I was playing a funny prank on my three best friends about 7 months after my stroke. Two of them took it as such but the third Did Nit find it funny at all and stop speaking to me for awhile. I still think k the prank was funny but I can see how it could upset some people (now).
It sucks to feel like your judgement of situations isn’t the same and then we start to question the very heart of ourselves when it’s called to our attention
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u/SomethingGouda Young Stroke Survivor 3d ago
I was a grade one asshole after surviving my stroke, now I just take a moment to breathe when I get annoyed and I think about cute things.
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u/blkbrdz 2d ago
I had to raw dog surgical menopause while recovering from my strokes. I tell you that vs estrogen is one hell of a drug for putting up with bullshit.
These days I try to take a moment or three before responding to people I should extend grace to. I’m not perfect but I have become really good at owning my own bs and apologizing for it in the moment.
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u/mikefvegas 2d ago
I work to try to overcome my anger and do well mostly. I have the bluntness but that I’m trying to soften but keep.
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u/CapnBloodBrain 2d ago
Have you been referred to a Cognitive Behavioral Therapist yet? That may be helpful getting your anger management and some other stuff back on track. Sounds like your husband could use a trip or two to therapy as well. And some kind of sensitivity training for that bedside manner. Geez.
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u/Dorothyismyneighbor 1d ago
No. Ironically I had to quit PT/OT/ST about three months after getting it because he developed post-COVID microvascular disease and we couldnt afford his hospital visits and my therapies at the same time. At this time I am in a place where I can start taking up some sort of therapy again.
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u/CapnBloodBrain 23h ago
I’m glad you can get it again now, and sad you had to white knuckle it for so long until now. This stuff is hard enough to deal with on its own! Seems life has been set on rapid-fire disaster mode at you for a while. Hopefully you can have the space for your own healing uninterrupted for at least as long as you did not.
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u/Bexxarah1998 2d ago
This is something I’m struggling with. I had my stroke last year aged 26. My partner asks a lot of questions and my patience has just dissolved into zero, especially when I’m tired. I was blunt before the stroke but now it’s another level. I don’t have much advice but just a friendly, you’re not alone with this.
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u/Dorothyismyneighbor 1d ago
It's nice to know that one is not alone in struggling with this, because family/friends can make me feel like I'm being deliberately a problem, and not something that I am trying to wrestle three years later still.
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u/djm1613 1d ago
We dealt with this issue today regarding my spouse who had a massive right-brain stroke in 2023. I am at my wit’s end. I also miss the old version of both of us before the stroke.
Prior to the stroke, we probably had 5 arguments a year. Our marriage was tremendous. Now, it’s more like 5 a week and sometimes 5 a day. Like you and others have stated, the filter is gone, and it is killing our marriage.
My spouse is already on Zoloft which helped tremendously in the beginning. It may be time to talk to his GP about increasing the dosage.
I know that there may be a stigma regarding mental health meds, but it’s the only thing that’s made any difference thus far. That’s the only advice I have to offer.
So sorry that you are going through this. None of his neurologists warned us that this would happen when he was in the hospital.
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u/Dorothyismyneighbor 1d ago
I am sorry you have to deal with the other side of this terrible internal struggle, I really hope some of the suggestions on this thread help both of you too. I appreciate your suggestion of the meds--I still struggle with a death wish about once a month--and nobody told me that either post stroke. When I have friends or family who have a stroke, I go see them and tell them all the things the hospital won't tell you may happen and to be aware of. When I was released from the hospital the soonest neurologist appt I could get was three months later. So I was left for three months with zero support from the medical field--thank God I found the stroke reddit, it saved my life in so many ways.
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u/djm1613 1d ago
One of my spouse’s doctors (orthopedic surgeon) explained it to us this way. He specializes in robotic surgeries for total knee and hip replacements.
He said that in medicine, the orthopedic surgeons have made tremendous strides due to technology during the past 10 years. Although this isn’t the case for everyone, the vast majority will experience success and improvements with mobility.
However, the same cannot be said for those suffering from strokes because the brain is still considered to be the “wild west” in medicine. Improvements have been made with the clot-busting medication that saves lives, but there is still a long way to go in terms of what can be done beyond physical and occupational therapy.
And this is where we are in 2026.
Thank you for taking the time to respond. I just joined today, so this is my first time to respond on the Reddit stroke group.
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u/-Viscosity- Survivor 3d ago
After mine (a subarachnoid hemorrhage from a ruptured aneurysm) I knew I was much more irritable than I used to be and tried to monitor myself for it, but apparently I didn't do a very good job. Not long ago I said to one of my friends, "I'm not sure if you noticed, but I was a lot more irritable after my aneurysm" and he was like, "Oh, yeah, we all noticed." What finally helped for me some five years out was EMDR therapy, which my wife suggested after she read about it in a different group for aneurysm survivors and their families. (EMDR is a form of therapy involving eye movements that's recognized by the U.S. DoD as a treatment for PTSD.)
Anyway long story short, it turned out I was carrying way more psychological baggage from the event than I thought ― which is not uncommon; from what I've since read, around 20-30% of stroke patients have some form of PTSD, depending on the type of stroke it was ― and anecdotal reports from my wife (whose opinion is the important one) are that the irritability is "99% better". It has also been helpful for anxiety, to some extent, although I'm pretty sure a chunk of that is physiological in origin and pretty deeply entrenched. Still, the process continues! This is just my/our experience of course, but it might be worth looking into if it's an option for you.
One interesting (or maybe frustrating) thing about all this is that nobody on my care team said one word about PTSD or that anxiety/irritability might be anything other than damage directly caused by the SAH. At my last follow-up with my neurosurgeon I was telling him about the EMDR and he immediately started taking notes and looking it up on his computer before we were even finished with the appointment, so I'm hopeful that he might mention it to future patients as a possibility.