When considering stroke prevention and recovery, we often focus on physical factors, including blood pressure, diet, smoking and exercise which are vitally important for physical health. But emerging research is making one thing increasingly clear: mental health matters. A positive mental outlook doesn’t just improve our daily lives, it could be a critical piece in preventing strokes and aiding in recovery if one does occur.
“Stress and anxiety are directly related to physical health,” shared Beth Ulrich who is an Outpatient Licensed Mental Health Professional at the Centra Medical Group Piedmont Psychiatric Center. Stroke and cardiac problems are also often related to mental health issues especially as it pertains to stress related depression and anxiety. Stress is often linked to hypertension and atrial fibrillation which are primary precipitants of stroke.”
New research shows that both positive and negative mental health can significantly influence your stroke risk and recovery. One of the most consistent psychological predictors of stroke is chronic anxiety. According to a prospective study published by the National Library of Medicine, individuals with higher levels of anxiety at the beginning of the study had a significantly increased risk of having a stroke.
Specifically, each standard deviation increase in anxiety symptoms was associated with a 14% increase in stroke risk (hazard ratio 1.14; 95% CI: 1.03–1.25), even after adjusting for other risk factors such as smoking and blood pressure.
Researchers suggest that behavioral pathways such as poor sleep, lack of exercise and substance use, often worsened by anxiety, may be part of the explanation. However, stress responses including chronically elevated cortisol, increased blood pressure and systemic inflammation likely play a central role.
“Mental health diagnoses and life stressors have significant impact on lifestyle choices that contribute significantly to healthy versus unhealthy behaviors,” Ulrich stated. “The ‘cycle’ related to experiencing the difficult symptoms of a mental health diagnosis and seeking poor options for relief, such as smoking, excessive alcohol and drugs, together with social isolation and decreased activity levels, in addition to treatment and medication non-compliance directly place individuals at high risk for multiple and serious health problems, including stroke.
Building stress-reduction techniques into your routine is more than a mental health tool, it’s a preventative health measure. Simple ways you can work to prevent to reduce stress include:
- Practicing daily stress relief (deep breathing, journaling, walks)
- Cultivating emotional vitality (gratitude, goals, connection)
- Getting help for anxiety or depression early
- Staying physically active to boost mood and heart health
- Leaning on your support system
Similarly, after a stroke, many people experience depression or anxiety, which can slow recovery and increase the risk of another stroke, but patients with a positive outlook and emotional support tend to recover faster and more fully. A resilient mindset helps with motivation, therapy participation and long-term healthy habits.
“Stroke often leaves devastating life changes in terms of functional capabilities, cognitive impairment and even personality changes,” explained Ulrich. Discouragement, depression and anger are typically experienced by patients and family members especially as it relates to the pace of recovery and the uncertainty of the level of recovery.”
Patients with strong emotional support networks and a proactive mindset are more likely to adhere to rehab protocols, stay motivated and maintain healthier habits post-stroke.
“A supportive healing environment for a stroke patient should include practical support and good nutrition, exercise, positive activities and supportive and healthy relationships along with good spiritual health,” remarked Ulrich.
Your brain and heart are not separate systems, they’re part of an interconnected whole. Prioritizing your mental health isn't just about feeling good, it’s about protecting your future. Whether you’re working to prevent stroke or navigating recovery, healthy mental health can be one of your strongest allies.
Resources for further reading:
Positive psychological health and stroke risk: The benefits of emotional vitality
Prospective study of anxiety and incident stroke