What happened to our marriage/relationship after the stroke?
After the crisis and my husband stabilized, the reality of our life change became very evident to not only me but my husband as well. What was once routine no longer was. Our roles in our marriage suddenly changed and I was now responsible for holding our lives together. This is a very lonely place but now 5 years in, I can share that it does get better, but it will never go back to your pre-stroke marriage or relationship with your loved ones. I am frequently asked to share our challenges and how we overcame them. When addressing my marriage, I needed to be vulnerable, honest and determined that we would find our way. Like most, your loved one is either not able to participate in the marriage or is not willing to.
I am not a marriage or relationship counselor, but I have heard your cries at wanting your loved one back. I got it, I was there and it is a day-to-day commitment. The changes that I and others have experienced have a similar theme, but everyone has a little different story. This month, let’s focus on what the changes look like and possible why’s and what has worked for my husband and I. Just a quick disclaimer, no marriage or relationship is perfect, and your past relationship always seems better in hindsight.
The changes that you may experience are not only physical but emotional, behavioral and cognitive. Many are due to the source of the stroke or the anger and depression related to this sudden life change. But no matter what the source, your feelings are real and need to be acknowledged so that you can move forward.
The two concerns I hear most often are: Will we ever have an intimate relationship again? And we are both so angry and fearful that I don’t know if we can get past this?
Let’s start with intimacy. Sexual intimacy in your marriage may change. Stroke can affect the sex lives of couples. Insecurity, doubt, and fear can affect the most open and loving couples; leading to questions like: Is sex safe? Am I still considered attractive? Am I able to be a caregiver and a lover simultaneously?
Sexual side effects of a stroke vary depending on where the stroke occurs. Frontal lobe stroke survivors may exhibit less socially appropriate behavior and reduced inhibition. Temporal lobe strokes are associated with a decline in sexual arousal. Despite being rare, stroke can cause an increase in sex drive, lead to hypersexuality, and result in inappropriate sexual behavior.
Getting back to a normal routine means getting back to a healthy sex life. The importance of love, being loved, and the physical and mental benefits of sex are undeniable. Sexual intimacy following a stroke can pose difficulties and anxieties for couples. See a healthcare professional if you are experiencing any problems.
What can help both of you…
Fatigue can affect desire and energy. Note the times when your loved one is well-rested. This could be first thing in the morning or after a nap. Find the best time for the two of you.
Medications can affect sexual desire. Medications such as high blood pressure or depression meds can reduce sexual desire. Plan sexual activity prior to that day’s dose. This may help with impotence.
Above all, remember, sex is not a performance. You don’t have to succeed or fail, and it doesn’t always happen perfectly every time. There are other ways to express your feelings and be close to another person. Returning to your usual sex life can be very scary. Take your time. Find what works for the two of you. Relax and focus on building intimacy and then add intercourse when you are both ready.
Finding new ways to be intimate is challenging. We follow old habits of our past love life. I needed to let go of the past and be open to a new phase of life. Touch is an issue for us; the sensory overload is just too much. We have opened a new way of sharing our love. We now share more of our feelings, use humor to combat the frustration and loneliness, and share thoughts and words regarding how we each feel about each other. Do we fight? Do we at times still love each other but don’t like each other? You bet, but we have found a way to be with each other at the end of the day.
I needed to understand his perception created his reality and then find the best way to handle our emotional needs. Discussions about issues would cause anger or just a blank stare, claiming I was being overprotective. It’s a common occurrence, yet no one teaches you how to deal with it. Though always together, our comprehension of things was completely unlike each other’s. Sadness and loneliness resulted from the misunderstanding. To give you an idea; when asked how this has affected our marriage? He said, “It’s the best it’s ever been!”
We are both so angry and fearful that I don’t know if we can get past this?
While not universal, anger or aggression occurs in 11–35% of stroke survivors acutely and 19–32% within the first-year post-stroke. Strokes are life-changing, bringing a wave of different emotions to your loved one. This emotion, anger, can come in phases. Brain damage can cause problems with information processing and comprehension. They may get angry because of impulsiveness or an inability to empathize.
Despite individual differences among survivors, anger frequently stems from task frustration, communication problems, and a feeling of helplessness. Other triggers include fatigue, anxiety, overstimulation, and the behavior of others. What can be done to improve the stroke survivors and caregivers wellbeing…
Determine the cause of the anger. When identified, work to lessen or eliminate. In the long run, people can engage with a healthcare provider to gain strategies for adjusting their reactions to triggers. Completely avoiding triggers is difficult, even with a reduction in them, because life is unpredictable. The caregiver must team up with a health professional to gain anger de-escalation skills. Dial 911 immediately if you are in physical danger.
Give yourself a breather. Exhaustion and frustration can heighten feelings of anger. Deep breaths and a moment of reflection can help prevent things from getting worse. Helpful coping strategies include deep breathing, relaxing music, meditation and prayer, physical activity, visual breaks, and emotional expression through journaling or art.
A family’s reaction to anger is critical. Experiencing someone else’s anger is draining and painful. Addressing the issue right away will benefit you both. Effective diffusion approaches.
Empathy. The survivor’s anger stems from their situation, not from you. To help survivors feel heard, focus on empathetic listening and responses, avoiding arguments. Despite the difficulty, responding calmly and deliberately can help diffuse anger, preventing escalation.
Validate both of your feelings. Their limitations or insensitive comments often triggered anger. Communicating with your loved one that their words, frustrations, or anger is understandable but is hurtful. Then ask how can we get past this?
Loved ones and survivors can lessen anger by working together to minimize controllable triggers; for example, avoiding crowded places, encouraging rest to reduce fatigue, and celebrating recovery progress. Stroke survivors and their loved ones may struggle with anger after a stroke; however, recovery is achievable.