The Part of Stroke Recovery I Wasn't Prepared For: Grief

Nobody tells you that recovery can make grief louder.

In the beginning, you are often too busy surviving to understand everything you have lost.

Everyone celebrates what returns.

The first steps.

The stronger arm.

The clearer words.

The first journey outside alone.

The first time you do something you had quietly wondered whether you would ever do again.

Those moments deserve celebrating.

But there is another side of recovery we don’t talk about enough.

Sometimes getting better gives you enough distance from survival to finally understand what you lost.

In the Beginning, There May Be No Room to Grieve

The early days after stroke can be overwhelming.

Doctors.

Scans.

Medication.

Rehabilitation.

Questions.

Fear.

People asking how you are.

People telling you how lucky you are.

And underneath all of it, you are trying to understand how you went from the life you knew to this one.

There may simply be no room for grief yet.

You focus on the next thing.

Getting through today.

Getting out of hospital.

Standing.

Walking.

Using your hand.

Getting home.

Becoming independent again.

You tell yourself you’ll deal with everything else later.

Then later arrives.

Sometimes Everyone Else Moves On Before You Do

There can be a strange point in recovery when the people around you begin to believe the emergency is over.

You are home.

You look better.

You are doing more.

Maybe you are working again.

Maybe you are driving.

People relax.

They stop asking as often.

Life begins moving normally around you again.

But your normal may still feel completely different.

When you were visibly struggling, people understood that something enormous had happened.

When you start looking well, the invisible parts become harder to explain.

The fatigue.

The concentration problems.

The loss of confidence.

Sometimes recovery makes your struggles less visible without making them disappear.

You Can Miss Someone Who Is Still Here

There is another kind of grief after stroke that can be difficult to explain.

You can miss yourself.

The person who didn’t have to think about energy.

The person who could make plans without calculating the cost afterwards.

The person who trusted their body.

The person who didn’t analyse every headache, strange sensation or moment of dizziness.

The person who didn’t know what it felt like to have a stroke.

You are still here.

And yet parts of the life you inhabited so easily may no longer feel familiar.

There is no funeral for that version of yourself.

No flowers.

No cards.

No recognised period of mourning.

You survived.

And sometimes survival makes you feel as though you have no right to grieve.

But survival and grief are not opposites.

Gratitude Does Not Cancel Grief

This can be one of the hardest contradictions to carry.

You know how differently things could have ended.

So when sadness appears, another thought can follow immediately:

I should be grateful.

And perhaps you are.

Deeply grateful.

But gratitude does not require pretending nothing was lost.

You can be grateful that you survived and angry that it happened.

You can be proud of how far you’ve come and still wish you never had to make the journey.

I am grateful to be alive.

I still wish this had never happened.

Both can be true.

Then Comes the Harder Question

At some point, the question stops being:

How much will I recover?

And becomes:

Who am I if I never become exactly who I was?

Because stroke can change more than movement or speech.

It can change confidence.

Relationships.

Work.

Energy.

Priorities.

Plans.

The way you think about time.

For a long time, you may desperately want to become the person you were before.

Then slowly, the question changes.

Not:

How do I become exactly who I was?

But:

Who am I now?

Eventually, “Before” Becomes Quieter

One of the quieter changes in long-term recovery can happen when you stop measuring every day against the life you had before.

Not because you have forgotten.

Not because everything returned.

But because the life you are living now begins to feel like your life.

And slowly, before becomes less of a measuring stick.

It is still there.

It just becomes quieter.

For months, sometimes years, life can feel divided into two places:

before

and

after

And eventually, you begin to realise there is also a now.

You can spend so long fighting to get your old life back that you barely notice another life forming alongside it.

Not the life you expected.

Not necessarily the life you would have chosen.

But one that can still become yours.

Did your grief come immediately after stroke, or later — when everyone else thought you were getting better?

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@AlisiaGayle , this is succinctly put and a very true reflection on how some of us feel/ felt in many stages of our journeys. I still struggle to articulate this to others so may well steal or borrow some of this wisdom.

I got stuck in a world of assumption from everyone else I was fine, never off my feet really then you were lucky sir - your going to be fine again.

Done my rehab got function back, checked over fit to drive again, back to work then fell down and back in hospital again this time wiser and given more wisdom. Then the cycle begins again but this time no real rehab now talking therapy encouraged to talk about feelings of loss and grieving - also back at work again and everyone thinks hey your great but was never sure it was that simple. Even to the point people forgot my stroke happened but a wee reminder came and knocked me down again this time I decided not to be Rocky Balboa and get up just as quick to be knocked back down again, taking a more measured approach and know now that sometime people just can’t get this stroke life/ recovery.

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This is so brilliant..,it describes me perfectly…I realised it was a form of grief having gone through it when I lost my partner…I know I have to endure it but it doesn’t make it any easier…I am slowly becoming accustomed to my new life…I still cry and despair and sometimes think I don’t want to be here anymore….but I am mobile and functional, the gratitude and resilience has to be there eh….and I do have a wicked wicked sense of humour…so good days can follow bad, just keep on keeping on….i think experiencing a stroke is such a trauma, PTSD can last a long long time, I try not to be sad xx

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@jbob Thank you so much for this. Please borrow whatever words help, if they make it easier to explain something that is so difficult to put into language, then they’ve done their job.

What you said about everyone assuming you were fine because you were back on your feet, driving and working really stood out to me. That outside picture of “you’re doing great” can be so different from what recovery actually feels like on the inside.

And I really understood your Rocky Balboa comparison. Sometimes getting straight back up can look like strength, but after enough setbacks, a more measured approach can actually be the wiser one.

I think one of the hardest parts of stroke recovery is exactly what you said at the end ; sometimes people simply cannot fully understand this life unless they’ve lived it.

I’m really glad the piece resonated with you, and thank you for sharing so much of your own journey.

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Thank you too @AlisiaGayle sometimes it would have been easier if they gave you a good old fashioned cheat sheet. But they didn’t so it’s all trial and error.

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Thank you for sharing this. I think you’ve described the contradiction so well, you can be grateful for what you have regained and still grieve deeply for what changed. Those feelings can exist together.

I’m really glad you have those good days, your wicked sense of humour, and that sense that you are slowly becoming accustomed to your new life. But I also don’t want to skim past what you said about sometimes feeling that you don’t want to be here anymore. Please don’t feel you have to simply endure those moments alone. If those thoughts become strong or frightening, please reach out to someone you trust or to professional support.

Stroke can be an enormous trauma, and looking functional from the outside doesn’t tell anyone what is happening inside.

Keep that wicked sense of humour. Sometimes getting through recovery really is one good day after a very bad one. Thank you for being so open about yours. xx

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Thank you for replying. Dont worry I have two dogs who counsel me regularly and I would never leave them. I was trained in mindfulness, cognitive behavioural therapy and listening sills in my career working with high risk offenders so apply this to myself when I can….i know thoughts of despair will ALWAYS pass…i think like you say it’s very important to accept and recognise really bad thinking and seek assistance, this forum is a great resource for support x

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My goodness @AlisiaGayle this is an incredibly powerful piece thank you for articulating so eloquently how I feel.

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So glad it resonated,:heart:. One of the reasons I write these pieces is because so much of stroke recovery is felt very deeply but can be incredibly hard to explain to other people. If this helped put some of that into words for you, then I’m really glad I shared it.

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That’s spot on Susie “accept and recognise really bad thinking and seek assistance, this forum is a great resource for support.”

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@AlisiaGayle Thank you for sharing this beautifully written piece.

I’m sure it will resonate with lots of the contributors on here, it certainly did with me. I’m 9 years post stroke following a hemorrhagic stroke which paralysed my left side and some days I still struggle to accept my situation.

The part that jumped out to me was "I am grateful to be alive but I very much wish this had never happened " and as some else said I sometimes wish that I hadn’t survived but one look at my amazing family brings me back to reality :heart:.

Thanks again for sharing your amazing writing, it’s what makes this community such a great to be.

Regards

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Thank you so much for this. Nine years is such a long time to carry the consequences of a stroke, and I really understand why that line stayed with you.

I think one of the hardest things to admit is that gratitude and grief can exist together. You can love your family deeply, be thankful you survived, and still have moments when you wish this had never happened ,or even moments when survival itself feels unbearably heavy. This part is very common especially when things get tough.

I’m glad your family gives you that anchor when those thoughts come.

Thank you for being part of these conversations. xx

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Thanks for writing this. I had a haemorrhagic stroke 18 months ago and have paralysis down my right hand side. Do you mind me asking how you are now? I am finding the uncertainty of what my final “outcome” will look like, I.e. will I regain the use of my right arm and leg , will I be able to walk without the use of a stick or an AFO to correct my foot drop one of the most difficult things to deal with. I totally understand the feeling of grief and loss for my old life. I have recently done a mindfulness course which has been useful but it has also been suggested that some form of grief therapy may also be beneficial.

Any suggestions/thoughts gratefully received.

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Thank you, Mark. I really understand the uncertainty you’re describing because I remember wondering exactly the same thing; how much would come back, what would be permanent, and what my life would eventually look like.

I’m now 4 years post-stroke and have recovered far beyond what I imagined in the early days. I had foot drop too and wore an AFO for a period of time. I’ve regained a huge amount of function. My recovery continued well beyond the point where I initially thought it might have stopped.

That said, I still have some residual effects and I don’t consider recovery to mean becoming exactly the person I was before. For me, it has also meant adapting, rebuilding confidence and learning what this version of my life can be.

At 18 months, I would be very reluctant to think of where you are now as your “final outcome”. Nobody can promise what function you will regain, because every stroke is different, but my own recovery taught me not to decide too early what my eventual limits would be.

On the grief side, I think acknowledging it helped me. I could be incredibly grateful to have survived and still grieve what I had lost.

And welcome to the community, Mark. I noticed this is your first post. I’m really glad my piece gave you somewhere to start talking about it.

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Thank you @AlisiaGayle for your very wise words, whih have coaxed many other wise words from other contributors.

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Thank you so much for posting this. We can relate to so much. My husband had a haemorrhagic stroke 21 months ago. He had another bleed a couple of months ago. He is now mainly in a wheelchair with a useless right arm/hand and leg, memory problems, speech problems and depression. This has totally changed our lives and the leisurely, carefree retirement we hoped to enjoy together is not happening. It is now a matter of doing exercises, seeing drs, nurses, paying private for physio, long list for speech therapy, trying to think of things he can do with only one hand. It is just awful to be honest although I never admit that to him because he struggles enough to accept what has happened. We don’t ask for much but if he could just use two hands or walk a few steps unaided it would help so much.

I appreciate all kinds of strokes are devastating but everyone we meet can now get around quite well and/or take up hobbies because they can use both hands. We visited a Dr recently (for his depression) who told my husband he was very lucky to be alive but he doesn’t feel he is. He often says he wishes he had just gone all those months ago.

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It’s a really astute and eloquent observation that will resonate with many here. I have a slightly different perspective as I had no grief. I never recognised an old me or new me, nor lamented what may have been lost. When I was told that I had had a stroke, I replied back to the doctor, that’s just b****y typical.

I feel the same as I was but just with a condition due to the four strokes that battered my brain over three months. I’ve always had a curious relationship with my brain and I think I recognised it had been damaged but I am still who I was before stroke, I haven’t lost anything, in fact, I feel I have gained something for better or worse.

For me, thinking that I have changed since stroke is a bit like reaching fifty, and through entropy, telling myself I have lost who I was when I was twenty. I haven’t, I’m still that person as far as I know. :laughing: A bit slower, a bit more peppery on top, a few more wrinkles, but ultimately the same silly sod who entered this life back in 1976.

However, I understand and empathise with those who need to grieve or go through the stages of grieving. I guess my life pathway has been so non-linear that I haven’t a chunk of linear time to look back on in one lump sum. It’s always been higgledy piggledy with me and after stroke it was just another fine mess or as Dorothy Parker once quipped, fresh hell.

It’s an odd thing, but I have a friend who, after stroke, spends every day trying to get back to who he was. I understand the frustration, but I can’t relate. Stroke can be so crippling and so sudden, it is different from aging because aging takes time, one gets used to the changes. I liked aging, I liked the slowness and the limitations, always felt uncomfortable with the rush and urgency of youth. I’m not one of these people who say youth is wasted on the young, I think that is a terribly resentful and defeatist way of compartmentalising age.

I do feel spasms of envy from time to time, if I see someone darting about from place to place or seemingly handling decisions with carefree abandon, this materialises out of frustration that I can’t behave that way, but then I remind myself, why would I want to?

I can’t discount the pain and effort it takes me to move through the day and face the challenges I ought to meet, but it is the same person I have always known and loved/hated that is doing that, not a new me.

Identity is a weird one, made up of DNA, nurture and nature &c, it’s even weirder since the invention of the camera, let alone the mirror. We see ourselves, I think that is odd to start with. I’m rambling a bit here, but I have only one mirror in the house, mainly for the benefit of my partner. I never look at my reflection unless by accident or if I have shared a photo of myself. My rambling point is, how I see myself post stroke is not a reflection of who I am, it is just who I am.

And if I think of time, who I am in ten years from now may be perceived as different from who I am now. I may have developed other conditions, illness, probably more wrinkles and silver streaks, but I’ll still be thinking I haven’t lost a penny.

Anyway, that is my two pence worth, know it is a slightly different angle. You have tapped into an interesting philosophical subject about the self, something I enjoy getting my teeth into, other than a tasty pie.

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@Rups Thank you for this. I really like the distinction you make between losing function and losing yourself. You clearly acknowledge the pain, limitations and frustration that stroke has brought, but you don’t interpret those changes as evidence that your identity disappeared. For you, stroke seems to be another major change within the same continuous life, rather than a dividing line between an old and new self.

I think that is exactly what makes this subject so interesting. Some people experience stroke as a rupture and need to grieve who they were, while others experience a strong continuity of identity despite enormous changes in what they can do. Neither experience is less real.

It begs the question: after stroke, did you lose only functions, did you lose part/all of yourself as well, or was it a bit of both?

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@Mark1974 Hi and a big welcome to our community. I hope you will find this a useful place to be.

I’m 9 years post stroke following a hemorrhagic stroke which paralysed my left side, I walk with a stick and the help of an AFO or my FES machine. I potter around at home unaided but use a stick outdoors. Unfortunately I have never recovered the use of my left arm or hand despite regularly using different types of equipment to improve things. I will never give up trying to improve my left side.

Despite my disabilities I have a better life than I ever thought I would, we socialise regularly with friends and family and have travelled abroad numerous times which I was sure I would never be able to do again. Yes life is different but you can still have a good life.

I wish you well with your recovery, it’s still early days and there’s always improvements to be made.

Regards Sue

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Rupert - As always, this is a very interesting read for me on so many levels. I love the way you make the associations and distinctions. I have to bookmark this so I can come back to it because I feel each time I read it, I will see something new/different as there are so many takeaways from it which I easily miss on the first or any single reads. It’s almost like a reference book which you go back to :slight_smile: I feel I must read it at different times of the days to see what hits me.

Spike Milligan esque :slight_smile:

Just love this.

Thank you.

:pray:

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