“STATISTICS ON APHASIA:

• Estimated Cases: More than 2 million people in the United States are living with aphasia, making it more common than conditions like Parkinson’s disease and cerebral palsy
• Annual Incidence: Approximately 180,000 individuals acquire aphasia each year, most often as a result of a stroke.
• Public Awareness: Only 40% of people in the U.S. are aware of aphasia and can correctly identify it as a language disorder that impairs communication abilities.
• Post-Stroke Effects: Stroke survivors with aphasia experience a higher incidence of post-stroke depression compared to those without aphasia, highlighting the emotional and psychological challenges associated with the condition.”

National Aphasia Association (How common is aphasia? – National Aphasia Association)

“Aphasia is a language disorder that affects a person’s ability to communicate—but not their intelligence. It can occur suddenly, often after stroke or brain injury, or develop gradually, as in the case of Primary Progressive Aphasia (PPA).

While every journey with aphasia is unique, early support and ongoing connection can make a powerful difference. This site is your starting point for trusted information, practical tools, and a vibrant community of support.

Explore the many ways people with aphasia—and those who care about them—navigate communication, expression, and life.

What is aphasia?

Aphasia is a disorder that results from damage to portions of the brain that are responsible for language. For most people, these areas are on the left side of the brain. Aphasia usually occurs suddenly, often following a stroke or head injury, but it may also develop slowly, as the result of a brain tumor or a progressive neurological disease. The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia may co-occur with speech disorders, such as dysarthria or apraxia of speech, which also result from brain damage.

Who can acquire aphasia?

Most people who have aphasia are middle-aged or older, but anyone can acquire it, including young children. About 1 million people in the United States currently have aphasia, and nearly 180,000 Americans acquire it each year, according to the National Aphasia Association.

What causes aphasia?

Aphasia is caused by damage to one or more of the language areas of the brain. Most often, the cause of the brain injury is a stroke. A stroke occurs when a blood clot or a leaking or burst vessel cuts off blood flow to part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients. Other causes of brain injury are severe blows to the head, brain tumors, gunshot wounds, brain infections, and progressive neurological disorders, such as Alzheimer’s disease.

What types of aphasia are there?

There are two broad categories of aphasia: 1-fluent and 2-nonfluent, but know there are several types within these groups.  So the 2 main groups of aphasia are as follows:

1- Fluent aphasia

There is damage to the posterior temporal lobe of the brain.

This may result in Wernicke’s aphasia (see figure above), the most common type of fluent aphasia. People with Wernicke’s aphasia may speak in long, complete sentences that have no meaning, adding unnecessary words and even creating made-up words.

For example, someone with Wernicke’s aphasia may say, “You know that smoodle pinkered and that I want to get him round and take care of him like you want before.”

As a result, it is often difficult to follow what the person is trying to say. People with Wernicke’s aphasia are often unaware of their spoken mistakes. Another hallmark of this type of aphasia is difficulty understanding speech.

2- Nonfluent aphasia

The most common type of nonfluent aphasia is Broca’s aphasia (see figure above).

People with Broca’s aphasia have damage that primarily affects the frontal lobe of the brain.  Damage to a discrete part of the brain in the left frontal lobe (Broca’s area) of the language-dominant hemisphere has been shown to significantly affect the use of spontaneous speech and motor speech control. Words may be uttered very slowly and poorly articulated.

They often have right-sided weakness or paralysis of the arm and leg because the frontal lobe is also important for motor movements. People with Broca’s aphasia may understand speech and know what they want to say, but they frequently speak in short phrases that are produced with great effort. They often omit small words, such as “is,” “and” and “the.”

For example, a person with Broca’s aphasia may say, “Walk dog,” meaning, “I will take the dog for a walk,” or “book book two table,” for “There are two books on the table.” People with Broca’s aphasia typically understand the speech of others fairly well. Because of this, they are often aware of their difficulties and can become easily frustrated.

OTHER TYPES OF APHASIA:

– Global aphasia, results from damage to extensive portions of the language areas of the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ability to speak or comprehend language.  Damage to the language processing centers in the left hemisphere of your brain, including Wernicke’s and Broca’s areas, can cause global aphasia. These two areas are critical for the production and understanding of language.

This is the most severe form of aphasia. It usually involves the following features.

• Loss of fluency. People with global aphasia struggle with the physical act of speaking. People with the most severe forms of this might only make small or isolated sounds, or they might not make any sounds at all (mutism). They also may repeat words or simple phrases over and over (this is a problem with fluency, as they’ll still have trouble repeating back words or phrases you say to them).
• Problems with understanding. People with this struggle to understand what others are saying. They might understand very simple sentences, but the more complex the sentence or phrase, the harder it is to understand.
• Struggle with repetition. Global aphasia affects repetition, meaning a person with it might struggle to repeat back words or phrases you say to them.
• Other symptoms: This kind of aphasia happens with conditions that cause severe brain damage, such as major strokes or head injuries. The damage is usually severe and affects multiple parts of the brain, causing other serious symptoms like one-sided paralysis, blindness and more.

Other forms of aphasia

• Transcortical motor aphasia: This is similar to Broca’s aphasia but usually not as severe. A key difference is that people with this don’t have a problem repeating back phrases or sentences you say to them.
• Transcortical sensory aphasia: This type is similar to Wernicke’s aphasia but usually not as severe. Like with transcortical motor aphasia above, people with this type don’t have a problem repeating back what you say. This type of aphasia is common with degenerative brain conditions like Alzheimer’s disease.
• Conduction aphasia: This type of aphasia affects fluency but not understanding. People with this struggle to pronounce words, especially when trying to repeat something you say to them.
• Mixed transcortical aphasia: This aphasia is like global aphasia, except that people with this can still repeat what people say to them.
• Anomic aphasia: People with this kind of aphasia struggle to find words, especially names of objects or words that describe actions. To get around this problem, they often use several words to explain what they mean or non-specific words like “thing” instead.

“The brain is a complex organ that controls thought, memory, emotion, touch, motor skills, vision, breathing, temperature, hunger and every process that regulates our body. Together, the brain and spinal cord that extends from it make up the central nervous system, or CNS.

Weighing about 3 pounds in the average adult, the brain is about 60% fat. The remaining 40% is a combination of water, protein, carbohydrates and salts. The brain itself is a not a muscle. It contains blood vessels and nerves, including neurons and glial cells.

Gray and white matter are two different regions of the central nervous system. In the brain, gray matter refers to the darker, outer portion, while white matter describes the lighter, inner section underneath. In the spinal cord, this order is reversed: The white matter is on the outside, and the gray matter sits within.”

John Hopkins Medicine (Brain Anatomy and How the Brain Works | Johns Hopkins Medicine)

IIlustration body part,human brain left and right functions

The brain is like a committee of experts. All the parts of the brain work together, but each part has its own special properties. The brain can be divided into three basic units: 1 the forebrain, 2 the midbrain, and 3 the hindbrain.

1-THE CEREBRUM (The Forebrain) AND ITS FUNCTIONS:  Knowing what part of the cerebrum, if the brain injury is their, can explain the reasons for the symptoms the individual is having.

1-The forebrain is the largest and most highly developed part of the human brain: it consists primarily of the cerebrum and the structures hidden beneath it, which is the inner brain.

THE REGIONS (The 4 LOBES) THAT MAKE UP THE CEREBRUM:

The cerebrum, the large, outer part of the brain, controls reading, thinking, learning, speech, emotions and planned muscle movements like walking. It also controls vision, hearing and other senses. The cerebrum is divided two cerebral hemispheres (halves): left and right. The right half controls the left side of the body. The left half controls the right side of the body.

Each hemisphere has four sections, called lobes: frontal, parietal, temporal and occipital.  A lobe simply means a part of an organ (earlobe for example).  Each lobe controls specific functions. For example, the frontal lobe controls personality, decision-making and reasoning, while the temporal lobe controls, memory, speech, and sense of smell.

–The frontal lobe is the largest lobe of the brain.  The frontal lobe are the last parts of the brain develop as a person ages and the part of the human brain that is most different from other mammals and primates.  The last part to mature is the prefrontal lobe. This happens during adolescence. Many things affect brain development including genetics, individual and environmental factors.  We learn to become adults in our frontal lobes.   You choose between good and bad actions; override and suppress socially unacceptable responses; and determine similarities and differences between objects or situations. The frontal lobe is considered to be the moral center of the brain because it is responsible for advanced decision making processes. It also plays an important role in retaining emotional memories derived from the limbic system, and modifying those emotions to fit socially accepted norms.  The frontal lobes are considered our emotional control center and home to our personality. There is no other part of the brain where lesions can cause such a wide variety of symptoms (Kolb & Wishaw, 1990). The frontal lobes are involved in motor function, problem solving, spontaneity, memory, language, initiation, judgment, impulse control, and social and sexual behavior. Frontal lobe damage effects one or more of these areas depending on the severity of the damage.  The frontal lobes are extremely vulnerable to injury due to their location at the front of the cranium, proximity to the sphenoid wing and their large size. MRI studies have shown that the frontal area is the most common region of injury following mild to moderate traumatic brain injury.

–The parietal lobes can be divided into two functional regions. One involves sensation and perception and the other is concerned with integrating sensory input, primarily with the visual system. The first function integrates sensory information to form a single perception (cognition).  The parietal lobes have an important role in integrating our senses. In most people the left side parietal lobe is thought of as dominant because of the way it structures information to allow us to read & write, make calculations, perceive objects normally and produce language. Damage to the dominant parietal lobe can lead to Gerstmann’s syndrome (e.g. can’t tell left from right, can’t point to named fingers), apraxia and sensory impairment (e.g. touch, pain). Damage to the non-dominant lobe, usually the right side of the brain, will result in different problems. This non-dominant lobe receives information from the occipital lobe and helps provide us with a ‘picture’ of the world around us. Damage may result in an inability to recognize faces, surroundings or objects (visual agnosia). So, someone may recognize your voice, but not your appearance (you sound like my daughter, but you’re not her). Damage to the parietal lobe depends on severity and location of the area. Because this lobe also has a role in helping us locate objects in our personal space, any damage can lead to problems in skilled movements (constructional apraxia) leading to difficulties in drawing or picking objects up.

–The temporal lobes they are in the section of the brain located on the sides of the head behind the temples and cheekbones.   It’s responsible for processing auditory information from the ears (hearing).   The temporal lobes play an important role in organizing sensory input, auditory perception, language and speech production, as well as short term memory association and formation. The Temporal Lobe mainly revolves around hearing and selective listening. It receives sensory information such as sounds and speech from the ears. It is also the key to being able to comprehend, or understand meaningful speech. In fact, we would not be able to understand someone talking to us, if it wasn’t for the temporal lobe. This lobe is special because it makes sense of the all the different sounds and pitches (different types of sound) being transmitted from the sensory receptors of the ears. Temporal Lobes Kolb & Wishaw (1990) have identified eight principle symptoms of temporal lobe damage: 1) disturbance of auditory sensation and perception, 2) disturbance of selective attention of auditory and visual input, 3) disorders of visual perception, 4) impaired organization and categorization of verbal material, 5) disturbance of language comprehension, 6) impaired long-term memory, 7) altered personality and affective behavior, 8) altered sexual behavior. These can be due to tumors on the right or left side of the temporal lobe, due to seizures in the temporal lobe and if seizures regularly happen to this individual in the temporal region, which causes lack of oxygen to that area of that area of the brain it will effect one or more of the functions of that lobe which we discussed earlier, listed above.

-The last region or lobe that makes up the cerebrum is the occipital lobe. The occipital lobe is important to being able to correctly understand what our eyes are seeing. These lobes have to be very fast to process the rapid information that our eyes are sending. This is similar to how the temporal lobe makes sense of auditory information, the occipital lobe makes sense of visual information so that we are able to understand it. If our occipital lobe was impaired or injured we would not be able to correctly process visual signals, thus visual confusion would result.

2-Midbrain – The uppermost part of the brainstem is the midbrain, which controls some reflex actions and is part of the circuit involved in the control of eye movements and other voluntary movements.

3-The hindbrain includes the upper part of the spinal cord, the brain stem, and a wrinkled ball of tissue called the cerebellum. The hindbrain controls the body’s vital functions such as respiration and heart rate. The cerebellum coordinates movement and is involved in learned rote movements. Rote means “mechanical or habitual repetition of something to be learned.”. Rote learning is flashcards, times tables, any kind of memorization-based learning. Rote movement applies to activities we do in a mechanical, repetitive way. Running, for example.  When you play the piano or hit a tennis ball you are activating the cerebellum= balance/coordination.

Knowing how the brain functions to understand this month’s awareness Aphasia (which we will discuss tomorrow).

“Regarding PTSD there are changes in arousal and reactivity

These affect how alert or reactive your body feels. You may:

• Act in risky or self-destructive ways (like substance use or reckless behavior)
• Feel irritable or have angry outbursts
• Have trouble concentrating or sleeping
• Startle easily

PTSD doesn’t have a quick cure, but it can be managed. Some days may feel harder, especially during stress or reminders. Progress often isn’t a straight line, and ups and downs are common.

This condition doesn’t define who you are, but it may change your routines, relationships and energy for a while.”

Cleveland Clinic ( Post-Traumatic Stress Disorder (PTSD): What It Is & Symptoms )

Many risk factors revolve around the nature of the traumatic event itself.

Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Women’s changing role in our military

A growing number of women are serving in the US military. In 2008, 11 of every 100 Veterans (or 11%) from the Afghanistan and Iraq military operations were women. These numbers are expected to keep rising. In fact, women are the fastest growing group of Veterans.

What stressers do women face in the military?

Here are some stressful things that women might have gone through while deployed:

-Combat Missions.

–Military Sexual Trauma (MST). A number of women (and men) who have served in the military experience MST. MST includes any sexual activity where you are involved against your will, such as insulting sexual comments, unwanted sexual advances, or even sexual assault.  Know this as well, how common it is?  An estimated 1 in 3 female veterans and 1 in 100 male veterans in the VA healthcare system report experiencing MST. It is important to note that by percentage women are at greater risk, but nearly 40% of veterans who disclose MST to VA are men.  A good question is how many just don’t report it period?

-Feeling Alone. In tough military missions, feeling that you are part of a group is important.

-Worrying About Family. It can be very hard for women with young children or elderly parents to be deployed for long periods of time. Service members are often given little notice. They may have to be away from home for a year or longer. Some women feel like they are “putting their lives on hold.”

Because of these stressors, many women who return from deployment have trouble moving back into civilian life. While in time most will adjust, a small number will go on to have more serious problems like PTSD.

How many women Veterans have PTSD?

Among women Veterans of the conflicts in Iraq and Afghanistan, almost 20 of every 100 (or 20%) have been diagnosed with PTSD. We also know the rates of PTSD in women Vietnam Veterans. An important study found that about 27 of every 100 female Vietnam Veterans (or 27%) suffered from PTSD sometime during their postwar lives. To compare, in men who served in Vietnam, about 31 of every 100 (or 31%) developed PTSD in their lifetime.

What helps? Research shows that high levels of social support after the war were important for those women Veterans.

What can you do to find help for women or men with PTSD?

If you are having a hard time dealing with your wartime memories, there are a number of things that you can do to help yourself. There are also ways you can seek help from others.

• Do things to feel strong and safe in other parts of your life, like exercising, eating well, and volunteering.
• Talk to a friend who has been through the war or other hard times. A good friend who understands and cares is often the best medicine.
• Join a support group. It can help to be a part of a group. Some groups focus on war memories. Others focus on the here and now. Still others focus on learning ways to relax.
• Talk to a professional. It may be helpful to talk to someone who is trained and experienced in dealing with aging and PTSD. There are proven, effective treatments for PTSD. Your doctor can refer you to a therapist. You can also find information on PTSD treatment within VA at: VA PTSD Treatment Programs.
• Tell your family and friends about LOSS and PTSD. It can be very helpful to talk to others as you try to place your long-ago wartime experiences into perspective. It may also be helpful for others to know what may be the source of your anger, nerves, sleep, or memory problems. Then they can provide more support.

Don’t be afraid to ask for help. Most of all, try not to feel bad or embarrassed to ask for help. Asking for help when you need it is a sign of wisdom and strength.

Don’t let PTSD get in the way of your life, hurt your relationships, or cause problems at work or school.

TYPES OF TREATMENT FOR BOTH MST including sexually harassed or assaulted and all other types of PTSD:

MST or PTSD treatment can help.  Learn what treatment is likely to help you make choices about what’s best for you.

If you suspect that you or a loved one has post-traumatic stress disorder (PTSD), it’s important to seek help right away. The sooner PTSD is confronted, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past.

• Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
• Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
• EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

• Treatments for Veterans based on U.S. Dept of Veteran Affairs states the following;  “Evidence-based therapies are among the most effective treatments for PTSD. They can include the following — which are in many cases available at a local VA medical center.

  • Cognitive Processing Therapy (CPT) helps Veterans to identify how traumatic experiences have affected their thinking, to evaluate those thoughts, and to change them. Through CPT, Veterans may develop more healthy and balanced beliefs about themselves others, and the world.
  • Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
  • Prolonged Exposure (PE) helps Veterans to gradually approach and address traumatic memories, feelings, and situations. By confronting these challenges directly, Veterans may see PTSD symptoms begin to decrease.
  • Cognitive Behavioral Conjoint Therapy (CBCT) helps couples understand the effect of PTSD on relationships and can improve interpersonal communications. Veterans may also experience a change in thoughts and beliefs related to their PTSD and relationship challenges.
  • Eye Movement Desensitization and Reprocessing (EMDR) helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).”.

When looking for a therapist for post-traumatic stress disorder (PTSD), seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can start by asking your doctor if he or she can provide a referral to therapists with experience treating trauma. You may also want to ask other trauma survivors for recommendations, or call a local mental health clinic, psychiatric hospital, or counseling center.

” Key facts:

• An estimated 3.9% of the world population has had post-traumatic stress disorder (PTSD) at some stage in their lives.
• Most people exposed to potentially traumatic events do not develop PTSD.
• Feeling supported by family, friends or other people following the potentially traumatic event can reduce the risk of developing PTSD.
• More women are affected by PTSD than men.
• There are effective treatments for PTSD.“

World Health Organization WHO ( Post-traumatic stress disorder )

Can children have PTSD?

Children can have PTSD too. They may have symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:

• Children under 6 may get upset if their parents are not close by, have trouble sleeping, or act out the trauma through play.
• Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
• Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.

People in general with PTSD may also have other problems,   These may include:

• Feelings of hopelessness, shame, or despair
• Depression or anxiety
• Drinking or drug problems
• Physical symptoms or chronic pain
• Employment problems
• Relationship problems, including divorce

What helps? Research shows that high levels of social support after the war or event the person has gone through were important for those women  and men Veterans including those not veterans.

What can you do to find help?

If you are having a hard time dealing with your wartime memories, there are a number of things that you can do to help yourself. There are also ways you can seek help from others.

• Do things to feel strong and safe in other parts of your life, like exercising, eating well, and volunteering.
• Talk to a friend who has been through the war or other hard times. A good friend who understands and cares is often the best medicine.
• Join a support group. It can help to be a part of a group. Some groups focus on war memories. Others focus on the here and now. Still others focus on learning ways to relax.
• Talk to a professional. It may be helpful to talk to someone who is trained and experienced in dealing with aging and PTSD. There are proven, effective treatments for PTSD. Your doctor can refer you to a therapist. You can also find information on PTSD treatment within VA at: VA PTSD Treatment Programs.
• Tell your family and friends about LOSS and PTSD. It can be very helpful to talk to others as you try to place your long-ago wartime experiences into perspective. It may also be helpful for others to know what may be the source of your anger, nerves, sleep, or memory problems. Then they can provide more support.

Don’t be afraid to ask for help. Most of all, try not to feel bad or embarrassed to ask for help. Asking for help when you need it is a sign of wisdom and strength.

Don’t let PTSD get in the way of your life, hurt your relationships, or cause problems at work or school.

PTSD treatment can help.

Learn what treatment is like to help you make choices about what’s best for you.

If you suspect that you or a loved one has post-traumatic stress disorder (PTSD), it’s important to seek help right away. The sooner PTSD is confronted, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past.

TYPES OF TREATMENT:

• Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
• Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
• Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
• EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

When looking for a therapist for post-traumatic stress disorder (PTSD), seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can start by asking your doctor if he or she can provide a referral to therapists with experience treating trauma. You may also want to ask other trauma survivors for recommendations, or call a local mental health clinic, psychiatric hospital, or counseling center.