Published 10/17/23; Rebecca Hunting Pompon, rhp@udel.edu, with updated edits 5/29/25

 

Living with aphasia can be stressful.

It is frustrating and stressful to struggle to find the right words in the moment. These difficulties also often impact communication with friends and family, basic life activities, and can lead to major life changes. The related stresses may continue even with adjustments to life with aphasia. 

Over time, persisting stress may lead to tiredness, distraction, worry, and sadness. Not surprisingly, chronic stress is closely linked to depression. The symptoms of depression, based on the American Psychiatric Association diagnostic criteria (DSM-V)¹, include:

• Depressed mood – sadness, numbness
• Diminished interest or pleasure in activities
• Change in appetite – eating more or less than usual
• Difficulty with sleep – sleeping more or less than usual 
• Slowed movement (not related to stroke)
• Fatigue, low energy
• Feeling worthless, guilty
• Difficulty with concentration (not resulting from stroke)
• Recurrent thoughts of death

Individuals with depression may experience a combination of these symptoms. Depression symptoms are reported by around 50% of people with post-stroke aphasia²⁻⁴. Other research evidence reports higher than typical rates of anxiety for individuals with aphasia (around 24%⁵).

 

What can you do if you or your loved one with aphasia experience symptoms of depression?

1. Talk with your doctor. If you are experiencing symptoms of depression, your doctor can talk with you about medications and other approaches that may help you feel better. This is especially important if you are experiencing many of the symptoms listed above and/or thoughts about death.
2. Talk with a counselor. Ask your doctor or speech therapist (or a local speech-language-hearing clinic) if they can recommend a counselor. Unfortunately, counseling professionals who know about aphasia are difficult to find in many areas. There are efforts to train counselors on how to work with individuals with aphasia, as well as new aphasia interventions that include mental health and well-being components. We hope these resources will be increasingly available in the coming years.
3. Connect with others. Connection with others is a central part of life. Regular contact with family, friends, faith communities, etc. is important for everyone. Many people with aphasia find that participating in an aphasia or stroke group helps them to cope and thrive with aphasia. These groups connect individuals who share the experience of aphasia and help many people find new friendships and encouragement as they adjust to a new chapter of life. In addition to aphasia and stroke groups in some areas, there are also online aphasia and stroke groups open to join. Please see our Events Calendar to learn more.
4. Do activities you enjoy. Participating in activities that you enjoy can help boost your mood. Some people with aphasia have found new activities and hobbies when old ones are no longer possible. A few example activities are gardening, playing with pets, baking, photography, painting, walks, enjoying the sounds of outdoors, bird watching, one-handed knitting, and listening to music. Add your favorite activities to each day or week; some people find creating and using a daily schedule of tasks and activities can give them a sense of purpose. Activities that move your body are especially good…
5. Move your body. We all know about the health benefits of exercise. Moving your body can help improve your mood and thinking abilities as well. Try to move your body in a way you enjoy every day, such as walking, dancing, or following along with a fitness video. For example, there are many videos available on YouTube for people with limited mobility, balance, or who use a wheelchair – search for “seated exercise” or “seated dance.”
6. Mindfulness / meditation. Spending time focusing on the present moment can help reduce stress and increase a sense of inner peace. Regularly engaging in a mindfulness or meditation practice over time can also help to boost mood. These activities can include maintaining your focus for several minutes on deep and slow breathing, body sensations, sounds or music, muscle relaxation, or a pleasant mental image. Maintaining focus can be challenging, which is why it is called a “mindfulness/meditation practice.” If you find you are distracted when you start, it is okay. Just return your attention to the activity of focus. Like the movement suggestion above, there are many guided mindfulness activities available on YouTube – search for “mindful breathing,” “mindfulness music,” “meditation relaxation,” and many other combinations.
7. Gratitude practice. A gratitude practice can be a helpful addition to your daily activities. Simply put, spending a few moments everyday considering or listing what you are thankful for can help reduce stress and improve symptoms of depression. Additionally, saying or writing what you are grateful for could be incorporated into your own speech/language exercise or a possible speech therapy activity.

There are other ways to help manage the stress of aphasia and improve the symptoms of depression. Importantly, it is often a combination of approaches, activities, and attitudes that together help the individual over time. Every day is an opportunity take small steps in a positive direction.

 

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. (2013).
2. Ashaie, S. A., Hurwitz, R. & Cherney, L. R. Depression and Subthreshold Depression in Stroke-Related Aphasia. Arch. Phys. Med. Rehabil. 100, 1294–1299 (2019).
3. Hunting Pompon, R. et al. Associations among depression, demographic variables, and language impairments in chronic post-stroke aphasia. J. Commun. Disord. 100, (2022).
4. Kauhanen, M.-L. et al. Aphasia, Depression, and Non-Verbal Cognitive Impairment in Ischaemic Stroke. Cerebrovasc. Dis. 10, 455–461 (2000).
5. Campbell Burton, C. A. et al. Frequency of Anxiety after Stroke: A Systematic Review and Meta-Analysis of Observational Studies. Int. J. Stroke 8, 545–559 (2013).