ANDMila Clarke she spoke again a few days ago in a podcasts of his aneurysms. The 39-year-old actress, in fact, underwent emergency surgery for the first time in 2011, when the aneurysm triggered a brain stroke, and then again in 2013. And she said she had «had an emotional breakdown». Because «I felt like a survivor», but only for having managed to «cheat death». And at that point «I started to think that she would come to get me. I was convinced I had to die.” In short, the feeling of having survived but at the same time of being predestined. A form of post-traumatic stress disorder which, in recent years, medicine has often described among patients in the recovery phase after suffering a ruptured aneurysm or stroke.
Cerebral aneurysm and psychological trauma: why it happens
Cerebral aneurysm, especially when it ruptures causing a subarachnoid hemorrhage, is a sudden eventviolent and often perceived as unstoppable. Even in cases where medical intervention is decisive and physical recovery is good, the brain does not “archive” the event automatically. In a review published on PubMed which analyzes psychological disorders after cerebrovascular events, is highlighted as anxiety, depression and post-traumatic symptoms are frequent even in patients with good neurological recovery. It is therefore not a marginal reaction, but a recognized clinical outcome.
When the body heals but the mind remains alarmed
Post-traumatic stress disorder, in fact, it does not only concern “classic” traumas such as those experienced by soldiers in combat or by survivors of natural disasters. Even an acute medical event can trigger it, especially when it is sudden and perceived as immediate threat to life. One of the most interesting studies on the subject, published onAmerican Heart Association Journalsshows that approx a quarter of stroke survivors develops symptoms consistent with post-traumatic stress disorder in the months following the event.
And stroke and brain hemorrhages from ruptured aneurysms they share similar psychological dynamics: sudden loss of control, intensive hospitalization, fear of imminent death. In the case of aneurysm, these symptoms often manifest themselves in a very concrete way: intrusive thoughts related to hospitalization, difficulty sleeping, hypervigilance towards any physical signal and above all a constant fear that “it could happen again”.
The fear of recurrence
One of the most typical components in survivors is the persistent fear of a new breakup. Even when the aneurysm has been treated surgically or with endovascular techniques, many patients they continue to perceive their body as unstable. There Brain Aneurysm Foundation explicitly describes how anxiety, depression and fear of recurrence are a frequent part of the psychological recovery process after aneurysm, even in patients without residual neurological deficits. Because it is not the real probability of a new event that has an impact, but the subjective perception of risk, which often remains high even when medical checks are reassuring.
One of the most difficult aspects to process is the perception of having come close to death suddenly and uncontrollably. This element is also central in Emilia Clarke’s storywhich describes the feeling of a death “avoided by chance”, but not really overcome on an emotional level.
How to overcome it
These disorders are treatable, but require a direct approach. According to the American Stroke AssociationThat dedicates a page to the emotional effects that a stroke or a ruptured aneurysm can have on patients, “A good psychologist or psychiatrist can help.” Because «treating depression and anxiety not only improves the survivor’s mood, but It also promotes physical recoverycognitive and intellectual”. But, he underlines, “also social support”.
The most effective approaches include cognitive-behavioral therapywhich works on the reprocessing of intrusive thoughts and catastrophic beliefs related to health, and EMDR, used in many centers for the treatment of trauma, including medical trauma. In more complex cases it can be useful pharmacological support to reduce anxiety and insomnia, always integrated with psychotherapy.
