Complications of aphasia 

The challenges of living with aphasia can sometimes cause further problems.

Catastrophic reactions

Many people with aphasia experience episodes of what is sometimes called a catastrophic reaction. This is where a person suddenly experiences overwhelming feelings of frustration, anger, depression or a general feeling that they cannot cope with their immediate situation.

Signs of a catastrophic reaction include:

  • anxiety
  • aggression
  • crying or laughing uncontrollably
  • screaming
  • stubbornness

A catastrophic reaction is often triggered when a person with aphasia becomes acutely aware of their communication difficulties. Therefore, it commonly occurs at the start of a course of speech and language therapy.

If someone in your care experiences a catastrophic reaction, you should remain as calm as possible and try to reassure them these feelings will pass and everything will be alright.


Because losing the ability to communicate can be a devastating experience, depression is a common complication of aphasia.

In addition, many conditions associated with aphasia, such as stroke or Alzheimer’s disease, may change the chemistry of a person’s brain, making them more vulnerable to depression.

Research suggests as many as eight out of 10 people with aphasia will experience at least one episode of depression.

Due to obvious communication problems, it may be difficult for someone with aphasia to let others know they are feeling depressed. Possible signs that a person with aphasia may be feeling depressed include:

  • lack of energy
  • little interest or enthusiasm in speech and language therapy
  • lack of appetite
  • weight loss
  • withdrawing from social contact with others
  • insomnia

If you are concerned someone you know with aphasia may be depressed, if possible, encourage them to communicate how they feel and whether they think they may benefit from treatment for depression. You should also make your concerns known to a member of their care team.

The types of anti-depressant known as selective serotonin reuptake inhibitors (SSRIs) have proved to be moderately effective in treating depression in people with aphasia.

Page last reviewed: 13/11/2012

Next review due: 13/11/2014