Emotional Disorders

Emotional Disorders After Stroke

A stroke is traumatic, both on the survivor and his or her family. If you or someone you love has survived a stroke, know that you may face a variety of emotional problems, which need to be managed to ensure the best recovery. Problems may include uncontrollable emotions, depression and anxiety.

Uncontrollable emotions

During stroke recovery, survivors may find themselves laughing or crying at inappropriate times. This may be a result of pseudobulbar affect (PBA), which is a common medical condition following stroke. This inability to control emotional responses may be confusing and frustrating for you, and may add to your feelings of social isolation, fear and shame. In some cases, these episodes may even be mood-inappropriate.

For example, you might laugh uncontrollably, even if you are angry. Sometimes referred to as involuntary emotional expression disorder, PBA can be characterized by an exaggerated and uncontrolled display of emotion.

Signs and symptoms

Some people who have experienced PBA symptoms report them coming on almost like a seizure, with an outburst of emotion lasting anywhere from seconds to several minutes. And PBA may happen several times a day, sometimes severely.

Causes of PBA

PBA is commonly associated with stroke, and while the precise triggers are not completely understood, it is thought to be caused by a disruption in the brain’s neural network that generates and regulates emotional output and motor control. Anywhere from one-quarter to one-half of stroke survivors report experiencing PBA, with prevalence rates higher in patients who are older or who have had prior strokes.

Some stroke survivors with depression experience a deeper depression if they have PBA.


Grief in the wake of a stroke is a common, and even healthy, reaction for a stroke survivor. However, when it turns into depression, it is important for you to get treatment. In some cases, depression can be caused by actual damage to the brain from your stroke.

Some symptoms of depression following stroke may include:

  • Feelings of emptiness
  • Chronic fatigue
  • Sleep disorders
  • Inability to concentrate or make decisions
  • Feelings of helplessness
  • Sudden irritability
  • Suicidal thoughts


Stroke survivors frequently report feelings of anxiety. When not controlled, it can adversely affect recovery, rehabilitation, your relationships and your quality of life. Signs of severe anxiety may include:

  • Continuous worry, fear, irritability and restlessness
  • Feelings of panic and shortness of breath
  • Rapid heartbeat
  • Shaking
  • Nausea
  • Poor concentration
  • Muscle tension

If you or someone you love is living with emotional disorders following a stroke, know that the leading-edge care, rehabilitation and support you need is close by at Northwestern Medicine. We're home to highly trained physicians*, psychologists, nurses and therapists specializing in stroke, along with the latest technology, and advanced research and clinical trials. Learn more about emotional disorders.

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In the spirit of keeping you well-informed, some of the physician(s) and/or individual(s) identified are neither agents nor employees of Northwestern Memorial HealthCare or any of its affiliate organizations. They have selected our facilities as places where they want to treat and care for their private patients.