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The Truth About Divorce After Traumatic Brain Injury

Comments [26]

Jeff Kreutzer and Jenny Marwitz, Virginia Commonwealth Model Systems of Care

The Truth About Divorce After Traumatic Brain Injury

Have you heard that the divorce rate after brain injury is really high? Have you read that the divorce rate for couples after brain injury is higher than the divorce rate for the general population? If you are a spouse or survivor of brain injury, you may be wondering whether your marriage is at risk.

Media reports suggest that as many as one half of all marriages in the United States will end in divorce. In fact, recent census data indicates that nearly half of all marriages will end in divorce. Believing that the divorce rate after brain injury is higher than the general divorce rate could be very frightening.

Research has given a mixed picture of divorce rates after brain injury. In the 1970s, researchers began to study post-injury divorce rates and found that 40% of couples were either separated or divorced seven years after injury. A review of studies published after 1980 shows alarmingly high post-injury divorce rates ranging from 48% to 78%.

There is little doubt that brain injury can strain marriages. Spouses often take on many of the injured person’s responsibilities, though they may have little experience with their new responsibilities. Unemployment rates after brain injury are relatively high and many insurance companies do not cover the costs of therapy, adding to financial stresses. Brain injury often brings on drastic personality changes which may include irritability, depression, limited awareness of injury-related changes, and argumentativeness. Some spouses have reported, “I’m married, but have no husband” and/or “I’m married to a stranger.”

Knowing the importance of marriage and the need to provide families with valid information, Traumatic Brain Injury Model System (TBIMS) researchers at Virginia Commonwealth University (VCU) looked more closely at research on marriage after brain injury. They found that many of the earlier studies were carried out in Europe where the social and legal system is different than the United States. Furthermore, many of the studies relied on small sample sizes which may not accurately reflect the larger population.

In 2007, Virginia Commonwealth University TBI Model Systems researchers published one of the first comprehensive investigations of marriage after brain injury. The researchers gathered information from 120 people with mild, moderate, and severe injuries who were married at the time of their injury. Survivors three to eight years post-injury, averaging 41 years of age, were asked about their marital status. Results showed that 3 out of 4 (90/120) remained married at the time of follow-up.

As a result of their research, the VCU investigators became concerned that past studies may have produced misleading negative information. In their published research paper, the authors stated, “The present investigation does not [support] the notion that divorce rates for persons with brain injury are higher than those for the general population.”

In 2008, VCU investigators led a multicenter research team which investigated marital stability after brain injury. Information on marital status was collected at 16 NIDRR-funded TBI Model Systems around the country. This study was the largest scale study on marriage after brain injury to date and included 977 persons from different ethnic and cultural backgrounds. The research team found that 85% of survivors remained married for at least two years post injury.

In summary, recent research suggests the rate of divorce after brain injury may, in fact, be much lower than divorce rates for the general population. The news is encouraging. While some spouses report more stresses and marital troubles post-injury, some report connecting with each other in new, positive ways as they face injury-related challenges together.

Marriage is clearly an important part of our culture and a major element of many people’s lives. Still, more research is needed to better understand how injury affects marriages and what can be done to preserve and enrich relationships. First, we need to better understand how the quality of relationships is affected in good and bad ways. Second, we must develop strategies to strengthen marriages so that both partners describe the relationship as positive and fulfilling. There is good reason to be hopeful.


  1. Arango, J., Ketchum, J., Dezfulian, T., Kreutzer, J., O’Neil-Pirozzi, Hammond, F., & Jha, A. (2008). Predictors of marital stability two years following brain injury. Brain Injury, 22(7-8), 565-574.
  2. Kreutzer, J., Marwitz, J., Hsu, N., Williams, J., & Riddick, A. (2007). Marital stability after brain injury: An investigation and analysis. NeuroRehabilitation, 22(1), 53-59.

This article was written by the staff of the Virginia Commonwealth Traumatic Brain Injury Model System. For more information about our programs (www.nrc.pmr.vcu.edu) and conferences (www.tbiconferences.org), please vist our websites or email Jenny Marwitz at  jhmarwit@vcu.edu. Article used with permission. Updated September 2010.

Comments [26]

I am having a very rough time.  His injury was about six months ago.  At first I had hope, but that hope is going away as, over time, I can see that his personality has changed.  He is a stranger to me.  I have no one to talk to who understands.  We dated for 6 years, waiting for my kids to grow up, he finally moved in with me and not one week passed before he had his stroke.  So no, we are NOT married.  He has three adult children, scattered elsewhere in the country. He is not close to them. He has no one else. All friends have abandoned him/us.  I no longer want to be in this relationship, but I feel so stuck. No, it is not a situation that requires a divorce, but he is so dependent on me, and I feel so guilty.  We had all these hopes and dreams, and we never had a chance, really, to be together (living together). So now I live and sleep with a stranger. Can we talk about sex, please? This is one of the hardest things. He is still interested in sex, but I am not! He is not the same guy I have loved and desired during these years.  But I am so afraid of hurting his feelings. How can I tell him that I just don't feel that way about who he is now.  I can't even tell if he realizes that he is not the same person. I work all day, he is home, just sits around watching TV, waiting for me to walk in the door, then he demands incessant attention. I DO give him attention, but honestly this is not the life we lived before or wished to live. We were both independent people with many interests and hobbies, some individual, and a very good match for each other. Now he is totally dependent on me for all human interaction, and I am not cut out for this. I am feeling simultaneously extremely guilty for thoughts of leaving the relationship (we were very committed to each other), and simultaneously grieving the loss of the relationship with the man who was, as though he died, but his body is re-animated by this total stranger. But yes, there are occasional glimpses of the old "him" and that is what keeps me feeling like I cannot leave.  My heart is overflowing with compassion, but like others here have said, if I met him today, we are not compatible and I would not be choosing a relationship with him. Complicating matters is how this situation has driven my young adult children away. They cannot stand to be around him and so I am now suffering the loss of those relationships, too.  I honestly feel I will be leaving soon, but I just have to figure out how. I fear that he will be homeless.  He has distanced himself from his relatives and he has no money other than social security. 

Apr 28th, 2016 8:19am

Hello, suffered a TBI in 2006 and have seizures disorder from TBI.  My husband has stayed by my side and supported me but I have changed over all the years of living with this horrific disability.  He is now depressed and I completely understand why.  He does not deserve my behavior problems, severe depression, and the guilt I carry every day for feeling like a burden to him.  If he does want to leave I will be devastated but I know he will be happier.  

Apr 20th, 2016 10:23pm

It's so sad that I'm mourning for my use to be husband and caring for this stranger. My teenager is depressed because my brain injured husband says the meanest things to her. I'm really having a hard time. My life is so miserable because he's so hateful and grunts at us like an animal. I miss the husband I married so much. He has also lost his empathy. Loosing people in our family in a car accident meant nothing to him. I need love, affection, and support. I don't know what I'm going to do. People do judge and especially Christians. It's not Christian to divorce and the 'in sickness and in health' oath just doesn't apply here. My daughter and I are literally being abused. They aren't living my life 24/7. I'm living one day at a time on faith, hope, and love. I know my God is bigger than this. I pray a lot.

Apr 14th, 2016 11:53pm

I have no hope that he will ever get any better.  I am miserable and suffocating and trapped.  I have continually sacrificed my happiness for his.  I have given up my life and my future happiness to be the companion and caretaker of someone who will continue to drain me until one of us dies.  Don't judge the people that leave. You have no idea what we go through or how desperate we are to just live.

Mar 30th, 2016 4:11pm

I am in the process of a divorce now. I fear the memory of who my husband once was, is what kept me going. I still am very much in love with my husband, but the man I'm married to is not my husband. This man is hard to love. I don't want our marriage to end, but I can't continue in it this way anymore. We have four great kids 7 down to 7 months! Our children need the attention two parents can give, but our problems consumed our time. Now we are no longer we. It is plaintiff vs defendant instead of husband and wife. Doesn't have the same happy connotation, but it's where we have come to be now. My heart hurts for all of you who are or has known someone who had a TBI or is the caregiver/spouse of a TBI survivor. I have seen changes in my husband that I would have said no, he would never do that. I've eaten my words on that one more than a few times. I'm filing for a legal separation. I'm hoping getting him back into therapy and back on his medication will allow him to see he still has love to give and receive. He's stated he didn't feel like a man anymore since not working and taking care of us, but it wasn't just that, he said. It was knowing you had something to do, somewhere you had to get up and go for, the ability to earn a living. All of that was taken away. I would always remind him of what he had left, but he was missing a piece of himself that I could not replace. There can be no violence and abuse within a healthy relationship. That's why I had to leave the marriage. Maybe now he can work on himself and get some help.

Mar 30th, 2016 10:27am

My husband of 6 years (14 together) suffered a cluster of 3 TBIs in 2011, and yet another 1 in 2015. While he is convinced that the TBIs and resulting depression/anxiety are not the reason, he has decided, abruptly it seems, to move out and proceed to end our relationship. I now know in hindsight we failed to support me through his injuries and recovery and also failed to support and nurture our relationship with each other. I remain hopeful that therapy will help open his eyes to a wider range of possible outcomes for us, but for now he is stuck on separation and divorce as the only "logical" option.

Mar 24th, 2016 2:33pm

He's post trearment for brain tumors. I find myself having more conversations with myself in my own head because of the anxiety I have around communicating with him. Im stressed out all the time and it's so much work just to live. In my head I catch myself saying "I hate my life" way too many times in any given day. I recognize how unhealthy his condition is making me and my daughter. We're constantly on eggshells and agreeing with nonsense just to avoid explosive outbursts and long lectures. Argumentative, competitive, childish, unreasonable. I don't know how to deal. The resentment grows. I've become his mother and I've never felt more alone in a relationship. I've been fed up for years now since diagnosis. Its not getting better. How do I learn to deal with this? How can I protect my daughter without just up and leaving him? I'm exhausted. I hate this.

Mar 17th, 2016 10:07pm

Like others, I have to say the anger & narcissism are the worst.  My spouse's accident was two decades ago, 10 years after we'd been together.  I am committed to our marriage vows but it is so hard.  I am always wrong, always mean, always lazy.  I know it's her TBI talking but after all these years that is no consolation.  As others have said, she believes she is fine.  Because I was in a coma for 3 days & had (very minimal) anoxic brain injury after an intentional drug overdose, now I am the one with designated problem.  AKA, her out.  My " brain injury" is worse, her burden heavier.  I don't think spouses/partners, particularly spouses who stay, get the support or credit we deserve.

Mar 9th, 2016 4:58pm

My husband had a mild traumatic brain injury in February 2013, it has been pure hell.  He was unable to care for himself for the 1st three months, then his condition improved but he became very depressed and paranoid.  He has locked himself in the room, states he does not trust me, he accuses me of poisoning him.  He is very impulsive, he will spend hundreds of dollars in a day, he is not going to be able to work again and I can't get him to stop spending.  He has no impulse control anymore.  If he feels threatened in the least he will resort to physical means until he feels safe again.  We have been married 13 years but I left this fall, I didn't go far because I still have to be there to help him, but the emotional and verbal abuse was escalating and he had become violent.  I am so sad that this has happened to us.  The wonderful man I married is gone.  Because he looks fine and presents well no one understands what it was like in our home.  Everyone thinks he is fine.  This has been the hardest thing I have ever been through, and there is not much support.  I feel guilty about leaving him, but he is so angry and aggressive and impulsive I didn't know what else to do.  I wish there were help for families.

Mar 1st, 2016 11:28am

The world of TBI really is so complex both for sufferer and carer. My husband has been left with severe disabilities after a car accident in 2014. I care 24/7 for him at home after a year long hospital stay and have three young children. I ensure he attends all his rehab sessions and try my hardest to ensure he is happy, well cared for and loved...but he shows me normally at least every other evening, that I disgust him and he hates me, he's physically violent and his words are destroying me. I try to shelter my children and explain its not daddy's choice why he acts like this and it's not ok for them to act that way but I'm scared for their future growing up in this environment. Other times he is quiet and just wants to be alone to watch TV and then sometimes he is so loving and caring, he's my old husband and best friend. I tried to get help and spoke to his family but they turned on me and blamed me for provoking him. They told me it was my fault, and tried to say as he's disabled he couldn't physically hurt me, trust me he can and does. I felt so alone so I don't tell anyone now what's happening and I try so hard to keep smiling and stay positive, whilst hiding the new scratches and bruises. I tried to contact our local support group but couldn't get through and when they called back I was with my husband and couldn't talk and they don't call me back anymore after missing each other so many times. I have no local family and my friends are our friends and I don't want to disrespect the memories they have of how he used to be. But he's gone, he's so uncharacteristically selfish, wants to spend money constantly on himself (we just haven't got spare money now) refuses to accept that it's not me that won't let him drive/work/other activities that unfortunately he can't do at the moment, if I upset him in anyway (ie ive helped my son with his homework when my husband had wanted me, I'd not known this and he'd not said anything and we were in the same room) he flipped on me for around five hours, how do you handle this. I don't want to leave him. We've been together for 20 years and those flashes of affection are so welcome but I'm so tired and I know I'm struggling. I know it should be about him and my struggles are of no relevance to his, but he seems so unaware of what he's doing to us as a family it's heart breaking. I'm scared of him

Feb 28th, 2016 5:23pm

My husband and I are now divorced after he suffered TBI in December of 2013. He couldn't face it, blamed everyone and no one was around to help. We had no support and all the love in the world couldn't get us passed his outbursts and extreme behavior. I will forever remember the man I married and loved so deeply. It seems that it doesn't get easier. He made such a mess. Burned my belongings and drug me through so much. No one around him knows how dangerous he has become. I lived with it. With the amount of brain damage and where the damage was he was literally rendered a narcissist. It was like dealing with two different people. He described it as hating the other person inside his brain. There needs to be more support for families. We lived in a rural area. It was scary dealing with it on my own. 

Jan 24th, 2016 2:03am

Its a relief to know there are others who understand what I'm going through. My wife has post concussive syndrome from an injury in early 2015. As she gets better physically, the emotional and mental issues have escalated. She is paranoid but open to keeping her friendships but she doesn't trust me and wants to leave the marriage. After 10 years together, this is quite heartbreaking. Only a miracle will keep us together.

Jan 11th, 2016 7:35pm

I thought reading other people's testimonies would make me feel better about all of my emotions. It just validates what I already knew. This is hard, and it sucks. My husband had an accident in August 2015. TBI ....he hates me. And I am exhausted. My kids watch how he treats me, and try to protect me. They shouldn't have to witness this, but what do I do?

Jan 9th, 2016 12:44pm

My wife had a TBI 20 months ago. She's been horrible to me and her parents pretty much since she came round from here coma. She's ok with everyone else. It's like she can't stand me, I'm left as a single dad of two young children and this person who looks like my wife but is like a stranger to me. Our children avoid her and don't want to spend any time with her as she is pretty hard on them too. It's not her fault but me and the children are the ones that are suffering. My wife blames me and the children as we are the ones who have changed. I'm trapped in a very unhappy marriage that I cannot see is ever going to get better. She has told me she doesn't want to be with us anymore but she can't live on her own as she needs 24/7 care which we cannot afford and the government will only pay a small amount of money to help with. I don't want to see her put in a care home so I'm completely trapped. I can't move on. 

Nov 21st, 2015 4:53pm

It's a very difficult thing to go through. My husbands tbi was 18 years ago & it completely changed him. His personality has definitely changed. Most days I feel like he hates me. He says he doesn't but the way he acts makes me believe differently.

Nov 3rd, 2015 1:43pm

In 2005 age 53 my husband had a stroke. We had been married 11 years. He fully recovered physically but mentally was never the same. He was and always will be the love of my life. I find myself living with 'a man'  I never married. He suffers from Post Traumatic stress syndrome, Anxiety and depression. I loved and supported him thru all of this ( plus cancer ) for 10 and a half years. I am finally leaving him after being verbal and emotionally abused for over 10 years. I kept telling myself he could not help it?! It is not his fault. No the stroke was not his fault but doing nothing at all about his mental state and bad behaviour  and nothing to help our marriage is his fault! We now find ourselves about to be divorced. He is not prepared to help himself and get mental assistance....why because he thinks there is nothing wrong him?! People will say I am abandoning him but I say no i am not! He abandoned 'us'.He had choices and chose not to get help.now it is my turn to make a choice for me. Being 8 years younger I have a lot more time on this earth to find some peace and quiet in my life and be happy. I know I will always love him but I'm in love with the old husband and he is gone!

Oct 27th, 2015 5:27am

Ten years ago, I married my husband after he suffered a stroke the year prior. At the time, the was hope for recovery, not full, but significant. To make a long story, short, There was very little progress to plateau and now decline. I still love him. but caring for him is like caring for a baby, There has never been any intimacy since the stroke therefore my love for him is like loving a brother. I fell my life slipping away from lack of life and living. With the help of friends, I started getting my life back...went back to work and becoming social again. My husband is starting to not remember me unless I'm in his presence. I would never desert him, but life is short and I want to move on with my life. Eventually, he'll end up in a nursing home. and then what am I suppose to do with my life?   

Aug 27th, 2015 11:29am

We made a marriage vow 51 years ago that still stands.We're in it together.

May 8th, 2015 8:08am

After a stroke and several TIA's I was separated and now heading for divorce after 25 years of marriage.  However, it's not because of the burden on my wife.  It's because of my renewed outlook on the fragility and limited nature of our lives.  I view it as a positive thing even though my TBI was, and still is, a devastating injury to myself physically, mentally and emotionally.  So, while some look at our spouses 'abandoning' us, as if we are the problem, how about looking at the injury as awaking us to what matters and giving us the courage to leave?

May 7th, 2015 3:28pm

I must wonder about the study reporting the zero divorce rate after injury after age 60. I am 65 and had serious closed head brain injury from a fall five years ago. That was followed by two hemorrhagic strokes in malformed arteries resulting from the trauma. Together this has produced general and very specific forms of disconnection syndrome that especially affect my left brain control of my right brain emotional responses.

I was very recently examined in a psychiatric hospital unit for several weeks and no psychiatric problems were found. However, while there my wife of 44 years informed me that she would not be at home to greet me when I was discharged. We are now permanently separated as I cannot risk myself again to the extreme level of emotional pain I suffered when she told me she was leaving. There was no physical abuse ever involved and never any form of "wandering" or cheating by either of us. My wife simply has not been able to deal with the severe change of emotional control I have experienced.

The damage to my corpus callosum was extensive so brain hemispheres are partially disconnected and will remain that way. I now live alone in an apartment and the house we did live in is on the market. This is the worst thing that has ever happened to me and I have no way out of it and very little left to live for. I will never kill myself but it will be a relief when that time comes.

Apr 27th, 2015 12:28am

7 years and feel like others.  Why us and life should have been so different.  He tries to pretend he has not changed but can be so different, especially with my family.  I don't think we would be together if it wasn't for the children.

Apr 23rd, 2015 4:23pm

After my husband's accident he is definitely not the person I married. I will wake up to a different person each day never knowing what mood he will be in or what type of person he will be. Most days he is bearable and others I want to run away. What type of person would I be for leaving him when this wasn't his fault? But do I deserve to be miserable for the rest of my life? I have struggled with this for a long time....

Apr 15th, 2015 11:04pm

His tbi injury happened 15 years ago and there's almost not a day that goes by that he does something to remind me he is not the person I fell in love with. I'm often like "who is this guy" and "why did this happen to us?" I am so sad because our lives should have been so different. Had I met him and he was like this I never would have been in a relationship with him. I hate my life with this stranger. Why? Just why?

Apr 2nd, 2015 11:08pm

I find myself making poor decisions in my marriage and work life.  I like to think its unrelated to my injury but I don't know after reading this and other articles.  My injury was about seven and a half years ago which seems to be about the magic number for things to really unravel.  

Feb 21st, 2015 6:14pm

After my injury my wife of 6 yrs , girlfriend of 20 baby mama of 12 left stating I was no longer the guy she married. I have to say I would not have done the same.

Jan 4th, 2015 10:30am

How did you correct for your acknowledged statistical bias in your study sample ("only 15% of subjects were separated or divorced"), when the separated/divorce rate in the general population is higher?

Aug 25th, 2014 4:43am

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