Loss of function after a stroke may be temporary or limited; some people recover most of the functions they have lost and continue to live independent lives. However, some people who have strokes need assistance with daily tasks (such as bathing or dressing). Others may become permanently dependent on family members, friends, or healthcare providers for all their daily care. Many people who do not immediately or fully recover from a stroke work with professional therapists who help them adapt to their limitations and function as independently as possible.
A physical therapist can help the person recover physical strength and mobility and prevent immobility by providing treatments such as exercise, massage, and manipulation. A physical therapist also can help the person learn to use equipment such as a walker or a cane properly. An occupational therapist can help the person regain muscle control and coordination and learn to compensate for his or her limitations. A speech therapist can work with the person to recover as much of his or her speech as possible and can teach the person (and his or her family) other methods of effective communication. A speech therapist also can help the person deal with breathing and swallowing problems.
After a stroke, many people experience feelings of depression (see page 345). They may feel frustrated or isolated, especially if they have not been able to return to their usual routine or if they are having problems communicating with others. Symptoms of depression include sleeplessness, indifference, and withdrawal. For most of these people, the depression is temporary. It may be helpful for the person to join a support group to share experiences and information with others who are in a similar situation. Talking with a psychiatrist or another mental health professional may help the person cope with and overcome his or her depression. To treat prolonged depression, a doctor may prescribe antidepressant medications such as tricyclic antidepressants, serotonin reuptake inhibitors, monoamine oxidase inhibitors, or bupropion.
Some people who have had a stroke may experience inconsistent and unpredictable mood changes. For example, they may laugh or cry inappropriately or may become irritable without apparent cause. In such cases it is important for family members and friends to understand that the person cannot control this behavior and that he or she will benefit from their patience and ongoing support.
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