Monthly Archives

July 2019

Depression After Brain Injury

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Written By: Chris B

My stroke occurred in February 2015, unplanned obviously, and very much unwelcomed. Many of my challenges have been summarily defeated/overcome. I have defeated most of my paralysis; I can now use my effected side and jettisoned the cane; speech is very good, but the one ailment that is ever-present for many, regardless of the type of brain injury, is depression.

Part of the unavoidable growth/challenges forced upon many stroke and TBI survivors is the psychological impact of life change as well as overall brain chemistry change due to injury.

Not everyone becomes depressed, but, a sobering half of all people with TBI are effected by depression within the first year after injury. Even more (nearly two-thirds) are effected within seven years after injury. That’s right– it can increase over time.

According to The Model Systems Knowledge Translation Center, in the general population, the rate of depression is much lower, affecting less than one person in 10 over a one-year period.  

More than half of the people with TBI who are depressed also have significant anxiety.

In the big picture, everyone can imagine reminiscing about past life events, not different than an athlete realizing they can’t compete at the same level.

Getting over an ended relationship is never fun – the parallels are similar. As with all of these analogies, visiting the past is better than living in it.

Easier said than done, but, listen to your wellness team, family, church, neighbors, and get help if you or others notice behavior changes or overall withdrawal from society. It’s a very common reaction post brain injury to want to cocoon and remove yourself from interaction, but, staying active and finding friends/purpose/goals can help a lot.

The bottom line, GET HELP, be it, discussion, physician-prescribed medication, counseling, finding a hobby – all have been proven to work and it will be a forward step on your path to a better future.

Fortunately, I’m mobile and can drive, so I was able to increase my social circle by joining a gym and volunteering at a farm museum.

I had the fun effect of crying for no reason (commercials, speeches, church hymns…); medication worked for me without impacting my personality.

Keeping busy is an often-prescribed cure for mood change, which can be difficult as the drive/inertia is often low post brain injury. Group activities and a standard schedule can help with accountability for activities.

BIND is a place where members can find people with similar situations and thoughts from various backgrounds, and the environment can fill the void of lost friendships/coworkers and exposes many to the successes of the recovery journey.

The group activities and responsibilities we undertake help with one’s self-esteem and purpose.

I’d strongly encourage someone who has suffered an acquired brain injury to check out BIND or any local stroke/TBI support group.

Living With Aphasia

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Submitted by: Livia

Aphasia is a condition that steals your communication skills which can include verbal, understanding, and written. This usually happens with a brain injury including stroke, TBI or it can be the result of a progressive disease.  The main treatment for aphasia is speech therapy. In speech therapy, patients learn how to execute language skills.

Symptoms can include: 

  • Incomplete sentences
  • Not being able to comprehend conversations
  • Confusion with words and not making sense

Personally, I have mild aphasia because I had a cerebral aneurysm and it makes life more difficult. I refrain from talking to unfamiliar listeners because I am afraid of what they will think of my voice and judge me. There are approximately 2 million people in the US affected by aphasia.  84% of people have never heard of the term Aphasia. I can understand everything when people talk to me and I do not have a problem with word finding; My speech is just slow and a tad slurry but still intelligible.

How is aphasia treated?

Well, I am glad you asked. Doctors prescribe neurological tests to patients who have survived strokes or traumatic brain injuries. The neurological tests include object identification (i.e. spoon or fork) which determines the severity of the patient’s aphasia. A speech language pathologist can provide therapy to a person with aphasia and help their communication skills. When people hear my voice, they assume I  can not understand what they are saying which is untrue. There  are six different types of aphasia:

Broca’s aphasia: With this aphasia, it is difficult for the person to produce words and lengthy sentences. It is also strenuous to find the appropriate words they want to say as well as the formation of the word is difficult. Typically, they understand speech relatively well and can comprehend reading but writing is challenging. Broca’s aphasia is often referred to as nonfluent aphasia due to choppy and strenuous quality of speech.

Nonfluent aphasia: The patient has sporadic and laborious speech, resembling severe Broca’s aphasia. This patient is, unfortunately, restricted in their speech. Reading and writing is not beyond elementary level.

Global aphasia:   Out of all forms of aphasia this is the most severe; The patient can make few recognizable words and have difficulty understanding speech or not at all. People affected with global aphasia can not read or write. This aphasia is usually observed directly after a head injury and has the potential to improve rapidly. However, with more extensive brain damage, it could  result in a lasting disability.

Fluent aphasia:   In this form of aphasia, the patient has difficulty interpreting conversations but their speech is clear and connected. Yet, do not be fooled if they make no sense. In severe cases, they sound like gang members speaking slang. Fortunately, reading and writing abilities are not impaired.

Anomic aphasia: This occurs when the person struggles with finding the word for the thing they want to talk about. It occurs specifically with nouns and verbs. Their speech is fluent and grammatically correct but it is full of vague words. Difficulty finding words is as evident in writing as it is in speech.

Primary Progressive aphasia:  This is a progressive neurological syndrome that gradually impairs language capabilities. Unlike other forms of aphasia, this is a neurodegenerative disease that is not a result from a brain injury. Primary Progressive gradually deteriorates the part of the brain responsible for language. First symptoms include speech irregularities then eventually memory loss.

I have global aphasia but mine has become significantly better. Researchers are currently investigating the use of medications, alone or in combination, with speech therapy to help people with aphasia. 

Aphasia Awareness

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Written By: Megan

June was Aphasia Awareness Month. Aphasia is a condition that affects the language parts of the brain. One or more of the following language modalities could be affected: speaking, understanding the speech of others, reading, writing, gesturing, and/or using numbers.  Each person’s symptoms vary. 

Here are some quick facts about aphasia:

  • Two million people have aphasia in the USA.
  • 84.5% of people have never heard the term aphasia. 
  • Most people acquire aphasia as the result of a stroke; however, there are many causes including traumatic brain injury, anoxia, etc. 
  • More people have aphasia than many common conditions including Parkinson’s disease or cerebral palsy. 
  • Research has shown that aphasia survivors have a lower quality of life than cancer or Alzheimer’s patients. 

Article source: https://www.aphasia.org/aphasia-resources/aphasia-factsheet/

To get an aphasia survivor’s perspective, I included responses to questions from Cindy, myself, Nathan, and Yvette.

  1. What type of aphasia do you have?

Cindy: I have expressive aphasia.

Megan: Initially, I had global aphasia. Over time, my expressive speech came back with lots of work and therapy. Currently, I have problems on the auditory processing side of language.

Yvette: In the beginning, I had global aphasia. Now, I have anomic aphasia.  

  • How has aphasia affected your life?

Cindy: I have problems speaking, reading, and writing.

Megan: I have problems understanding speech and talking on the phone.

Yvette: In the beginning, I was really messed up. Now, at times, I have problems finding the right word.  

  • How has your aphasia improved over time?

Cindy: My speech got better.

Megan: In the beginning, I couldn’t speak or understand anything. My expressive speech and my ability to understand language came back with lots of therapy and work. My communication skills have improved significantly from the beginning. I’m now a Communications lead at BIND.

Yvette: I went from having global aphasia to anomic aphasia.

  • What do you do to improve your aphasia now?

Cindy: I attend BIND and speech therapy.  

Megan: I attend BIND two days a week. I volunteer at a horse rescue, hospital, and library. At the hospital, I work at the information desk and direct people to doctor’s offices and patient rooms. I get lots of communication practice at the hospital.

Yvette: I attend BIND.

  • What do you wish that other people understood about aphasia?

Cindy: We need to find a way to end stroke.

Megan: Intelligence is not affected by aphasia. 

Yvette: I wish people would help me find the right word.