Stress. We’ve all experienced it at some point in our lives, but it’s a bit hard to define. You know it when you feel it.

Small child looking down at a very large set of stairs to climb.

There’s typically some sort of external or internal trigger that starts the stress response. For stroke survivors, it can be the stroke itself. External triggers are things like a fight with or divorce from a significant other, moving, losing a job, or deadlines. Internal triggers might be difficulty making decisions or having a perfectionist mindset.

When we experience a stress trigger, our body goes into a state of “fight or flight,” similar to anxiety. The body releases cortisol and adrenaline (stress hormones), and we experience physical symptoms, as a result, to prepare for either “fight or flight.” These symptoms can include:

  • Muscles tension
  • Headaches
  • Fatigue
  • Shortness of breath
  • Increased heart rate
  • Increased blood pressure and glucose

Is It Stress or Anxiety?

Honestly, the two overlap quite a bit. Stress is generally a short-lived response to an external trigger. Anxiety is a build-up of excessive worrying that does not go away. Often the focus of anxiety is about events, social interactions, obligations, or health issues.

Both issues can lead to similar problems with sleep, attention, and concentration, eating a poor diet, and feelings of frustration and anger. Regardless of whether it’s stress or anxiety, it’s necessary to find ways to better manage the way we react.

Reducing Stroke Risk With Stress Management

We will all experience stress. Unfortunately, there’s no getting around it. It’s the way our bodies have evolved to deal with threats.

The problem with stress isn’t the short bursts we get in response to a particular trigger. It’s when our body maintains a constant stress response over time. This chronic stress is where damage to our bodies can cause real issues, like strokes.

When we are chronically stressed, our bodies release cortisol (one of the stress hormones) which can stay elevated in our bloodstream. Cortisol is not inherently bad. In fact, it’s in a group called glucocorticoids which are hormones responsible for our immune response to reduce inflammation in the body. It also aids in maintaining normal blood glucose levels.

However, when cortisol remains chronically elevated, we run into problems. It not only increases our blood pressure and heart rate, but it can also raise our blood glucose level to an unhealthy range. Unhelpfully, it causes us to crave high fat and sugary foods. These foods actually reduce the feelings of stress but cause other problems related to a poor diet.

While stress itself is not the cause of strokes, the effects it has on the body over time can contribute to increased risk.

Managing stress is not only an important way to improve our quality of life, but it can also reduce the risk of future strokes.

Unhealthy vs. Healthy Coping Strategies

There are many things we can do to better cope with stress. Although finding healthy ways to cope with stress can be difficult. Sometimes we gravitate towards things that we know might not be good for us. Most of the time these things make us feel better in the moment but have negative consequences in the long term.

Let’s look at some examples of unhealthy and healthy coping strategies:


  • Distraction
  • Drinking alcohol
  • Smoking
  • Procrastinating
  • Overeating
  • Staying up late
  • Negative self-talk
  • Avoiding social interactions


  • Exercising
  • Getting enough sleep
  • Eating a healthy diet
  • Practicing relaxation strategies
  • Seeking professional help
  • Taking a warm bath
  • Learning to identify and manage stressors
  • Creating a stress management plan

Think about what you tend to do when you are stressed. Do you lean more toward unhealthy or healthy coping strategies?

Create a Stress Management Plan

One of the best things you can do for yourself is to create a stress management plan. There is a phenomenon called “decision fatigue” which means that you only have brain space to make so many decisions in a day. The more decisions you make, the more fatigued you can get. You may make less than optimal decisions later in the day just because you’re too tired to think about it.

After a stroke, you’re likely already dealing with neuro-fatigue. It’s helpful to take the guesswork out of how to respond to stressors. There are three steps to creating a stress management plan.

Identify your stress triggers and symptoms.

Improve your self-awareness by recognizing what situations stress you out and how you react to them. Determine if you’re more prone to stress out when faced with external or internal stressors. Think about the way these stress triggers cause you to feel, both physically and psychologically.

Create a plan on what to do before, during, and after a stressor.

Having a plan in place when faced with stress triggers will significantly cut down on your decision fatigue. Use the worksheet and examples I’ve provided to figure out what things you can do to combat stress before, during, and after it occurs.

List out potential doses of stress relief for each level.

Plan out doses of stress relief. If you’ve had a super stressful day, you might need a high dose of stress relief. Stretching or deep breathing (low dose) might not cut it. Instead, plan an at-home spa day to really relax.

Stress happens to all of us. By putting systems in place to help you manage it, you’re likely to improve your quality of life and reduce your risk of having a first or secondary stroke!

Get Started

To help get you started with your stress management plan, here are three free worksheets:

  1. Identify Triggers (pdf)
  2. Recognize Symptoms (pdf)
  3. Create a Stress Management Plan (pdf)

Let me know how they work for you!