Mental Wellbeing

Mental and emotional wellbeing are a key part of our general health. Any major life event or change – including illness and health problems – can have an impact on mental wellbeing.

Struggling with your mental wellbeing does not necessarily mean you are mentally ill, or that anything is wrong with you. It is normal and healthy to have emotions like anger, sadness, or anxiety – which does not stop them from often being unpleasant and hard to manage.

Some conditions (such as stroke) and physical symptoms (such as fatigue or breathlessness) may also directly affect on your emotional state. For example, when you are fatigued, you may find you are more prone to low mood and emotional “numbness”; on the other hand, severe breathlessness or heart palpitations can trigger anxiety.

Remember that there is no wrong way to feel. What is important is that you are able to cope with your feelings and to come to terms with them. If you do not feel able to manage your feelings, or if your mental state is affecting your day-to-day life, it may be helpful to talk to someone. This might be a doctor, nurse, or counsellor; on the other hand, it might be a friend or family member.

The pages in this section are a very brief overview of a very complex issue. If you are struggling with mood, emotions, or mental wellbeing, it is best to seek more specialist information.

Low mood and depression

The experience of a medical condition can impact your mood a lot. So can the stress of being close to, or responsible for, someone else who is experiencing medical problems. Often, this comes with the realisation that there are things you can no longer do, or big changes in your life which affect the things that comfort you, or that you have new responsibilities and stresses.

Low mood or depression don’t just mean being sad. They can also feel like:

• Emotional numbness – you may find that you rarely feel strong emotions at all, or that positive emotions like happiness or excitement pass much more quickly
• Fatigue or lack of energy
• A lack of motivation, or difficulty imagining the future
• Feeling like nothing matters
• Sleeping a lot, or, on the other hand, unusually bad sleep
• Difficulty connecting with people or being in social situations

A low mood is not necessarily a mental health problem. It can be a healthy, reasonable reaction to an uncomfortable situation. However, it can also affect your ability to manage your life, and it can be very unpleasant.

If you feel that your low moods are making it hard to cope, or if your low mood has lasted for several months, you can always speak to a doctor, nurse, or mental health provider for support.

Raising your mood

There are some things you can try to help raise your mood:

• Talk to someone: Often, working through your feelings and discussing what is causing your low mood can help to make you feel better. This conversation doesn’t have to be with a specialist – chatting to a friend, family member, or trusted colleague can make a big difference.
• Mindfulness: Trying to be conscious of your feelings, especially trying to be aware of things that make you happy or grateful, can help your emotional state a lot. It can also help you to recognise issues which may be causing your low mood, and begin to address them.
• Routine: Building a daily routine can help you to stay active and engaged in life, and give you structure which helps to support your emotions.
• Being social: Even if you don’t talk about your feelings or your health, just being around other people can help. Humans are social animals, and spending time with others is important to our mood.
• Exercise: If you are able to exercise, this can improve your mood a lot, especially if you can go outside. Exercise releases endorphins, chemicals in the brain which trigger happiness and excitement. Even a small amount of exercise can help your mood.
• Diet: Sugar, alcohol and caffeine can all cause energy crashes, which lower your mood in the long run, even if they may make you feel better for a little while.

It may be tempting to turn to chemical support. Alcohol, cannabis, or other drugs can seem like an escape from low moods and bad feelings. However, while this may make you feel better in the short term, the “come-down” often leads to even lower mood once the effect wears off. Over time, you can also become dependent on these substances to feel good, which is expensive and may affect your health in other ways.

If you feel that you need alcohol or drugs to deal with your low mood, it may be a sign that you should seek help. Doctors, nurses, and mental health professionals may be able to suggest healthier ways to raise your mood.

Stress and anxiety

Stress is a very normal and healthy response to health crises, either your own or those of the people around you. We react to unstable, unpredictable, and frightening situations with stress and anxiety, which are part of how we are able to find a way out of the situation. However, sometimes this can become excessive and can make recovery harder.

Stress can cause:

• “Catastrophising”, where you constantly think about the worst possible outcome of a situation, even if it’s very unlikely
• “Dissociation”, where you feel disconnected from your body and the world around you
• Hyperactivity and loss of focus
• Loss of appetite, or overeating
• Difficulty trusting people
• Heart palpitations or a fast heart rate
• Difficulty sleeping
• Panic attacks, where you struggle to breathe and may feel dizzy and/or sick

Stress can have major effects on your physical health. It can cause headaches, nausea, breathlessness, heart issues, and gut issues. Stress can also damage your immune system, making you more likely to get infections and illnesses. You may heal more slowly.

Stress and anxiety can also make aspects of day-to-day life frightening and difficult to deal with. For example, it may become difficult to go outside, to try new things, or to speak to people.

Managing your stress

Some techniques that can help in managing your stress include:

Mindfulness: Being aware of your feelings and your environment, which can help you to anchor yourself to the moment. This can also include techniques to understand the situation you are in, and what can be done to help.

Talking to people: Often, working through your feelings and discussing what is causing your low mood can help to make you feel better. This doesn’t have to be a specialist – chatting to a friend, family member, or trusted colleague can make a big difference.

Breathing exercises: Focusing on your breathing can help to balance out some of the physical impacts of stress, and to calm you.
Ask questions: Understanding your situation and what to expect can reduce anxiety a lot.

Planning ahead: By focusing on how you will tackle the things that cause you stress, and understanding what you want to accomplish, you can start to feel more in control and to get your situation into perspective.

Routine: Building a daily routine can help you to stay active and engaged in life, and give you structure which helps to support your emotions. It can also help with sleep and general health.

Diet: Caffeine, sugar, and alcohol can all make stress and anxiety worse. A healthy, balanced diet can help support your body to recover from stress.

Grief

Grief is a common response to stroke, heart attack, and other medical conditions.

This is not only the case when somebody has died. People often experience a sense of grief and bereavement because life has changed so suddenly. You may feel that you have lost the person that you knew before they were hospitalised. If you were the person who suffered a health crisis, you may feel that you have lost the life you knew, or that relationships you had before have changed or been lost.

This is all a normal reaction to dramatic change.

Grief and bereavement can show up in a lot of different ways. You may experience depression, anxiety, anger, frustration, denial, or a sense of being overwhelmed. It can be difficult to express these feelings to the people around you, especially if your grief is not for a person, but for something less clear and well-understood.

Managing anger and frustration

Many people dealing with health problems find themselves angry and/or frustrated with the changes they experience in their lives. The changes you face can feel unfair, and you may find that you struggle to make your experiences understood. This can be especially true if you are struggling to communicate.

It can also be very frustrating to deal with health services when you have long-term health problems. Some health professionals may be dismissive or talk past you, and even if they are not, they may not fully understand your experiences. Many health professionals use jargon and specialist language which can be difficult to understand. All of this can be very aggravating.

It is completely normal and healthy to feel angry at times, especially in stressful situations. What is important is that you manage this anger and frustration in a productive way, which doesn’t cause harm to yourself or the people around you.

If you feel that your anger is out of control, or that you are uncomfortable with how angry you are, some things that can help include:

• Journaling or writing down the things that are making you angry or frustrated
• Using art or crafts to express your feelings
• Breathing exercises
• Mindfulness
• Exercise or activity to burn off energy and distract yourself from your anger while you process
• Visualising a thing or place that makes you happy

Emotional dysregulation

Damage to your nervous system, which is common in people who have experienced a stroke, can lead to emotional dysregulation – a difficulty in controlling your emotions. You may also express emotions that aren’t appropriate to the situation.

Over time, you can learn tools to help manage your emotions. If you feel that your emotions are out of control, consider speaking to a doctor, nurse, or counsellor about ways to manage your feelings.