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You might have heard of celebrities like Wendy Williams and Bruce Willis having a mysterious condition called aphasia. But what exactly is it, and how do people get it?
Aphasia can be extremely frustrating to deal with due to the way it makes communication difficult. But there is hope — and knowing how to support someone who has aphasia is key to helping them find their voice again.
What causes aphasia, and how does it affect the brain?
According to the National Aphasia Association, there are at least 2 million adults in the U.S. dealing with aphasia at any given time. A stroke is one of the most common causes of aphasia, but anything that injures or damages the brain — like a head injury, tumor or infection — can also cause it. Sometimes, aphasia develops gradually as a symptom of dementia. Other times, aphasia is a temporary symptom of a seizure or a transient ischemic attack, aka a mini-stroke.
“Aphasia in most people is caused by dysfunction of their dominant brain hemisphere (usually the left brain), because there are a couple of different centers in the left side of the brain that control the ability to produce or comprehend language,” explains Dr. Breana L. Taylor, a UW Medicine vascular neurologist who treats patients at the Comprehensive Stroke Center at Harborview Medical Center.
Depending on which area of the left brain is affected, someone may have more trouble with one aspect of language than others, such as reading, writing, understanding speech or using language.
What are the different types of aphasia?
Because of the diversity among experiences of aphasia, doctors have come up with different ways of categorizing specific symptoms. Global aphasia, for example, describes someone who has difficulty with all aspects of language. There are eight other types of aphasia, but the two most common are Broca aphasia (aka non-fluent aphasia) and Wernicke aphasia (aka fluent aphasia).
Broca aphasia makes it hard to say words
Broca aphasia occurs when something affects the left part of the frontal lobe of the brain, where speech is formed. This area of the brain is called Broca’s area; French physician Paul Broca demonstrated that damage to this area caused aphasia.
“People with Broca aphasia have difficulty with the production of speech,” Taylor says. “They know what they want to say, but they can’t get it out.”
This is, understandably, a very frustrating experience, so people with this type of aphasia may get upset when they try to communicate. They may also have a hard time reading and writing.
Wernicke aphasia makes speech nonsensical to listeners
Wernicke aphasia is the result of damage to part of the temporal lobe called Wernicke’s area, which plays a role in language, memory, object and facial recognition and emotion processing. Wernicke’s area is named after Karl Wernicke, a 19th-century physician, who identified the area involved in this kind of aphasia.
“Someone with Wernicke aphasia will say lots of things, but those things don’t necessarily make logical sense,” Taylor explains. “To them, what they’re saying makes complete sense, so they might get more frustrated with the person who’s listening to them who doesn’t understand them.”
The language people with Wernicke aphasia produce is sometimes called a “word salad” because the words sound randomly thrown together.
What are other symptoms of aphasia?
Sometimes, aphasia symptoms may be subtler, like a person not being able to name objects they see or use every day, or mixing up sounds that are similar when they talk.
Some people may not use filler words like “and” or “the” and other people may be able to follow written commands but not verbal ones or may be able to understand what someone says but not repeat their words.
The point is, aphasia is truly unique in each person who has it because of the numerous ways the brain can be injured or damaged.
Can aphasia be treated? Can someone with aphasia recover?
Whether or not aphasia will resolve depends on why someone has it. Many people can regain some language ability after a stroke or brain injury, for example, but that is much less likely to happen with a progressive degenerative condition like dementia.
The most effective treatment is working with a speech-language pathologist, who can help someone learn how to speak, read and write again or, if that isn’t possible, help them learn new ways of communicating.
This could look like relying more on a form of language they understand, like written language, if speaking is difficult. It could also look like using flash cards with images on them or learning types of non-verbal communication.
“There’s a really cool form of therapy that speech-language pathologists do called melodic intonation therapy, which involves using music to stimulate communication,” says Taylor. “We’ve had a number of patients here at Harborview who can’t speak but can follow the melody of the song or they can move their mouth in the appropriate shapes. Sometimes walking through the neurology ward, you hear singing.”
How to help a loved one with aphasia
Singing aside, there’s no question that aphasia can be a challenge to deal with, both for the person who has it and the people around them, especially family, caretakers and close friends.
There are some things you can do to strengthen your communication with each other while reinforcing the autonomy and dignity of the person with aphasia.
Don’t dismiss their communication attempts
If someone is trying but struggling to communicate with you, try to be patient with them. Don’t interrupt, correct them constantly, or pretend like you understand what they’re saying if you don’t.
Instead, it’s OK to tell them you didn’t understand something or guess what they’re trying to say and ask if it’s correct.
“Give people realistic goals and realistic opportunities to do what they’re able to do, and don’t assume that because someone is aphasic, they don’t have things they’d like to say,” says Taylor.
If someone asks you to speak for them or to help others understand what they’re saying, that’s fine as long as it’s their request.
Adjust how you communicate
Pay attention to someone’s specific difficulties and make it as easy as possible for them to communicate with you. This might mean giving them things to write with instead of expecting them to speak, asking questions that require only ‘yes’ or ‘no’ answers, or using flashcards with emotive words that the person can use to explain how they’re feeling.
When the person is communicating, listen intently and with your full attention, as that will give you a better chance of understanding what they’re trying to convey.
Avoid adding pressure
If someone is going to speech therapy sessions and is trying to recover, don’t rush the process or put added pressure on them to get better.
“You want to avoid chastising them or trying to speed their recovery along; it’s going to take the time that it takes,” Taylor says.
Use their native language
If someone with aphasia speaks two or multiple languages, you may notice that they’re better able to communicate using their native language.
This can be true even if someone is fluent in more than one language; whichever language they first learned may be easier to understand. Encourage them to speak in the most comfortable language, even if this requires making some adjustments, like learning how to communicate with them in that language or asking for an interpreter to work with them at their medical appointments.
Encourage them to seek support
While family and friends can help support a loved one with aphasia, it’s also important for someone with aphasia to interact with people who understand firsthand what the experience is like.
Connecting with peers can help people with aphasia feel less alone and help validate the challenges they’re going through. Many hospitals and clinics have support groups for people who have experienced a stroke or brain injury or are dealing with dementia. Finding support groups can be helpful for family members and caretakers, too.
Ultimately, preventing isolation for the person with aphasia is important.
“There is a tendency for people to ‘other’ people who have neurologic diseases or illnesses, but they are still humans with emotions and feelings,” Taylor says. “They deserve to be incorporated into the community and society, be treated with the same respect we give everyone else and be allowed to have a voice even if they communicate differently.”
