Brain Health

Why Do People Lose Friends After a Stroke or Other Brain Injury?

by Joyce Hoffman

Introduction: Friends after a Stroke

Through my involvement with stroke survivors at all levels, I heard from a lady who had to move 2000 miles away to get out of a horrid relationship. The reason being, she was under so much stress that once she had the stroke, the situation was unbearable. The distance was worth it for two reasons: the distance put space between her and him, AND she is happily situated now, 10 minutes away, near her daughter. I’m a sucker for stories with happy endings.

My online stroke support group works and is giving me distance, too–to stay away from all people who can’t tolerate that I’m different than when they knew me before! First, some research on why intolerance.

Studies say that by 2030, there will be 12 million stroke deaths and 70 million stroke survivors worldwide. It stands to reason that many stroke survivors feel unsupported. So the question remains: can the complex needs of survivors and families and friends cope with the aftermath of stroke? Or any type of brain injury, for that matter.

An estimated one-third of survivors will have communication difficulties, including aphasia, dysarthria, or apraxia of speech (language comprehension, producing speech, or problems with reading and writing). Research says stroke survivors with communication problems may have challenges living in a community with those that don’t have such issues, resulting in a lower quality of life in not joining activities of daily living. Furthermore, evidence of the survivors is also more likely to suffer depression and have reduced social interactions. 

The National Institutes of Health published an article about why people lose friends after a stroke and why this phenomenon occurs across the board. 

Under the helm of the English study, Northcott and Hilari explored why people lose contact with their friends and how the survivors perceive friendship loss and change.

Between 8 and 15 months post-stroke, 29 participants were recruited, 10 having aphasia. The researchers concluded the main reasons given for losing friends were: 

1. loss of shared activities 

2. reduced energy levels

3. physical disability

4. aphasia (loss of fluent speech)

5. unhelpful responses of others

6. environmental barriers

7. changing social desires 

young woman with sticker showing cross on mouth
Aphasia, or the Loss of fluent speech, can have a significant impact on retaining friends.
Photo by Anete Lusina on

“Those with aphasia experienced the most hurtful negative responses from others and found it more difficult to retain their friends unless they had strong supportive friendship patterns before the stroke.” 

Northcott, Sarah and Katerina Hilari. Why do people lose friends after a stroke?

Aphasia had the greatest impact on not being able to retain friendships.

The greatest support to keeping friendships after a stroke came from “having a shared history, friends who showed concern, who lived locally, where the friendship was not activity-based, and where the participant had a ‘friends based social network before the stroke.”

Another study by Martinsen et al. in a nursing journal examined psychosocial consequences following a stroke and the survivors’ ability to participate in and carry out the ordinary and expected roles and activities of family life. 

Twenty-two stroke survivors aged 20–61 were interviewed extensively six months to nine years after stroke onset. Two categories sum up the struggles: re-entering the family and screaming for acceptance.

“Being provided with opportunities to narrate their experiences to interested and qualified persons outside the home context might be helpful to prevent psychosocial problems,” the study says.

Signs of Post-Stroke Depression

It’s normal to feel sad over the problems caused by stroke. Survivors must endure the adjustment after an abrupt and sometimes radical change. However, some may experience more severe depression, which benefits from early recognition and treatment.  

Major depressive disorder includes at least one or more of the following and all the time beyond two weeks:

  •   Feeling sad, anxious, pessimistic, or hopeless 
  •   Loss of interest in things that the person used to enjoy
  •   Feeling restless, loss of energy, or feeling fatigued constantly
  •   Feeling worthless or guilty
  •   Increase or decrease in appetite or weight
  •   Problems with concentrating, remembering, or making decisions
  •   Trouble sleeping or sleeping too much
  •   Headaches or stomach problems
  •   Sexual problems 
  • Thoughts of death or suicide

What are the takeaway thoughts? 

There are two. 

  • First, it is normal for a stroke survivor to experience most or all of these feelings or emotions.
  • Second, family and friends should heed and be more supportive of the stroke survivor regardless of the healthy one’s sometimes biased, small-minded, and me-centered thinking. 

About Joyce Hoffman

Joyce Hoffman was working in Philadelphia at Cozen O’Connor, an international law firm. Unfortunately, she had a stroke in the middle of the night in April 2009. Always seeking out the positive in everything she has ever done in her life, Joyce started a blog in August 2010 to give patients and caregivers the confidence to stand up for themselves, despite the indifference and negativity that confronted her daily.

Using only one hand to type since her right, dominant hand was paralyzed from the stroke, she goes through her story, beginning with the signs before she had the stroke and ending with now, when she has come to grip with the stroke.

Joyce was formerly a columnist for the Philadelphia Daily News, an author whose book went into its 4th printing, a part-time college professor until 2007, and a technology and corporate trainer for the last 20 years. Joyce is a worthwhile speaker who will make any person both heed the warning signs and, at that same time, come to realize the necessity of accepting a stroke and going on with their life.

Follow Joyce on her blogs at Dear Joyce and Stroketales. Check out her book The Tales of a Stroke Patient as well!

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