Lack Of Emotional Response After Brain Injury Or Stroke
Over the last seven years of being the caregiver for my husband after he suffered a hemorrhagic stroke, I have become accustomed to his inability to understand social cues.
If I have a bad day at work or something makes me cry, he has no response. Sometimes, he may even inappropriately laugh.
I understand that is not for his lack of love for caring for me, but rather a result of the subsequent brain injury from his subarachnoid hemorrhage.
However, we recently lost his mother. She passed away on hospice, so it was expected. While I have been crying, sad and just grieving, he continues to go about his day without a care in the world.
To say this has been eye-opening for me would be an understatement. I am feeling so many mixed emotions.
How does he not cry over the death of his own mother?
Does he forget that she passed away?
Will he grieve later?
Should I be addressing this lack of response?
Can I assume if I die, he will have no response?
If you are familiar with our story, you know that Mark does have Pseudobulbar Affect due to his stroke and brain injury. You can find more information about this diagnosis in this article:
While trying to process my own grief about losing my mother-in-law, I have taken a step back and done some reading. While as a healthcare professional, I understand that Mark’s response or lack of response is not something he is able to control, as his wife I want to ensure I’m providing him support in the best way that I can.
When different areas of the brain are affected by a traumatic brain injury or stroke, they can change a person’s ability to process information as well as their ability to express themselves.
This can result in a flat affect or blunted emotions if the limbic system is impacted by the stroke or brain injury.
The limbic system controls our emotional responses. So if this area of the brain is damaged, the emotions that we would expect to see from an individual can become varied, and often the individual can respond in a way that may be considered socially inappropriate.
Initially, I was slightly worried that maybe Mark was not understanding what happened. Maybe he didn’t remember that his mother passed away. Maybe he is holding in his grief and I need to help him work through it.
As the days have gone by, I have noticed that he is asking questions.
How long do they bury someone after they die?
What did my mom die from?
Will I have to worry about developing that?
When did my mom die?
I have answered his questions as he has asked them. Some days, he will ask the same questions multiple times a day.
With that being said, I have decided that his process of grief doesn’t have to look like mine to be healthy. He is obviously aware of and thinking about things related to his mother’s passing.
Recently, I was discussing this with a friend and she said, “Wouldn’t we all be so lucky if we could take life in stride that way?”
After some thought, I feel like that may be a great way for me to look at it.
My mother-in-law loved her family so very much. She especially worried about Mark after his sudden and unexpected brain bleed. I know her well enough to know that she would not want Mark to be sad. I know that more than anything, she wanted nothing but health and happiness for her children and their families.
Working in home hospice for the last 16 years, I know that I have had many lessons on grief and grieving.
As a healthcare provider, I also know that I can overthink things and try to “fix” things that may not be fixable, but rather have to work themselves out.
In the spirit of my mother-in-law, I will continue to support Mark in the best way that I can. I will continue to honor my own journey of grief. I will make sure that her love and light and memory stay in our family for the rest of my days.
If you or someone you love or care for is struggling with grief, there are many resources to help you. You can find help at:
As always, I am a real person and ready and willing to help. You can reach me at: