Sadness and Depression in Aphasia

Sadness and Depression in Aphasia

“It was like a bomb went off in our lives” - Laura, wife of client with very severe aphasia

When families reach out to us about treatment options, they may describe their loved one as ‘sad’, “depressed”, or “discouraged” after their stroke. As the family of someone with aphasia, this can be very hard to watch. You want to take away all the pain, the sadness, and the frustration your loved one is having right now. You want to eliminate all the bad feelings and help cheer them up. You want your life to go back to normal.

It’s important to note that there is little difference between sadness and clinical depression. Strokes that have occurred in the frontal part of the brain can lead to depression. This part of the brain contains the receptors and pathways for certain neurochemicals that control mood. When the stroke affects those areas, it takes time for the brain to rebalance these neurotransmitters. Doctors may routinely prescribe antidepressants after a stroke to help manage clinical depression. Depression looms over all aspects of your activities.

Sadness, on the other hand, is a normal human condition. You’re sad because you miss your old life and are grieving. You’re grieving what you’ve lost - your jobs, your relationships, your independence and more. Your thoughts may largely focus on how you do want your old life back. As we all know, you can’t go back in time and change any of this. Sadness can be a natural part of the coping process.

As the caregiver watching your loved one grieve, while you yourself are grieving, you just want it all to go away. YOU want it to be back the way it was. In an effort to make this go away, you want to find something to alleviate this discomfort. So you focus on trying to make your loved with aphasia happy. You feel it’s your responsibility to balance out your loved one’s reactions. But someone else’s happiness is not your sole responsibility.

If you keep thinking about it deeply, you may realize that you’re trying to alleviate your own discomfort and deal with your lack of control over this situation. While you can control some external events - like doing intensive therapy or finding a new doctor - you’re helpless to change any of this directly. It can’t be undone. There’s no magic wand.

The good news is that accepting that you can’t control any of this will free you to separate yourself from the emotional drain. You can’t help someone by climbing into the pit with them. Ultimately, you come to realize that your loved one must be responsible for his/her own coping and change. Trying to manage your emotions as well as someone else’s is a large burden to carry. People are rarely happy all day every day.

What can you actively do to help?
  • Acknowledge that they are sad ("I know this is really hard for you") and give them some space alone if needed.
  • Get counseling for yourself. You need an outside perspective and support.
  • Understand that emotional healing from loss takes time. It can come in waves.
  • Know that you will get through this. It won't be fun and it may not be easy, but you will come to a "new normal".
  • Try to engage in activities that help keep you busy. Your loved one may reject these activities at first, but offer them. Remember that you can't force someone to do something they aren't ready to do. You can only control yourself and your reactions.
  • All things change. Sadness is temporary. If you feel your loved one's mental health needs to be addressed, speak to your doctor or counselor for their recommendations.
  • Lastly, remember that there are others out there in the same boat, connect with them in support groups like Aphasia Recovery Connection or local groups for aphasia support.

    About Dr. Bartels

    Dr. Bartels earned a Ph.D. specializing in aphasia. She started The Aphasia Center to help families with aphasia access individual treatment. Read more about her work here.

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