S.W.56 yo female had a massive stoke on 11/12/23, she had a long road of recovery.Received and is currently receiving PT and OT.The stroke left her left arm and leg paralyzed.She is currently in a wheelchair but is able to walk with the help of a supportive brace and a walker.

She has ups and downs in her level of energy, some days after she has done more physical activity she notices that she needs to rest the next day.Her sleep is fair.sometimes she feels rested the next day and sometimes she doesn't .Her overall energy is tamasic.

Her mood is baseline low somedays she goes more towards depression on other days she feels more positive.She has a history of depression in the past and a history of trauma.She is not able to speak about.She has a difficult time to share her feelings.She is currently taking and antidepressant and tolerating it.

She was raised catholic but does not go to church and does not talk much about her religious believes or needs

She has a sharp intellect but has trouble expressing herself.She has very low self esteem and a low sense of self.

The yogic view of stroke according to the kleshas

Avidya (ignorance and forgetfulness) we forget that our true nature is spirit
Asmita (overindentification with the self):we over identify with the pain, pain can tell us what to do and what not to do, can dominate sand has a life of its own.
Raga (attachment) when pain persists we can become attached to the suffering and keep in the cycle of suffering.
Desha (aversion)averted to to the pain and want to suppress it, pushing thought limitations , forgetting our true nature.
Abhinivesha ( fear/fear of death) clinging to life which perpetuates the cycle of pain
Intergal yoga magazine:
Patanjali’s Words: The Five Kleshas (Causes of Suffering)

I am designing my treatment plan with the help of the integral yoga manual
adaptive gentle and chair yoga teachers manual since my client is in a wheelchair
in general stress and too much activity can trigger fatigue after stroke, it is very important to not go over personal limits so carefully monitor the amount of activity and stress that might even be caused by a well meaning yoga session.
the client already has a history of trauma and depression, after a stroke it is common to experience an increase in depression.Yoga can offer improved of mood after stroke.

Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review
Asimina Lazaridou 1,2, Phaethon Philbrook 1,2, Aria A Tzika 1,2,*

Additional ideas on how to treat this client

• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.