The Truth About Divorce After Traumatic Brain Injury

Jeffrey Kreutzer, PhD, 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.

Here are more findings:

  • 17% of survivors were divorced and 8% were separated, an overall
  • marital breakdown rate of 25%
  • male and female survivors had similar marital breakdown rates the more serious the injury, the greater likelihood of divorce; for example, on average, people who were divorced had been unconscious three times as long as people who were still married
  • age mattered; people who were older at the time of injury were much more likely to stay
  • married; no participant 60 years old or older was separated or divorced
  • length of marriage was important; people who had been married for longer periods of time before the injury were more likely to stay married after the injury; none of the couples married 30 years or more before the injury got separated or divorced.

Other important study results:

  • only 15% of subjects were separated or divorced
  • age was a very important predictor of marital stability with older persons less likely to divorce
  • male survivors were more likely to have an unstable marriage (i.e. to be separated or divorced) than female survivors
  • cause of injury was an important factor; persons who were injured as a result of violence were less likely to be married at follow-up
  • for minority group members, persons with more severe injuries were more likely to remain married
Posted on BrainLine January 30, 2009. Reviewed July 27, 2018.


  • 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.
  • 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. Article used with permission. Updated September 2010.

Comments (120)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I cried so hard when I read your post, This has been happening to me sense Feb 15th 2018, and your right I have searched for help , but find the law for disability not me. That how I word it "Living in Hell"

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

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. 

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.

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?

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. 

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.

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 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!

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?   

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

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?

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.

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.

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....

I feel exactly the same way- 11 years post stroke and I am at my breaking point, now has white matter disease, only more miserable as he loses more memory, and function. What kind of person leaves after 40 years of marriage. I feel I should just ride it out.

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?

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.  

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.

I had a brain injury in 2008, I was in hospital and physiotherapy for 6 months,I wasn't married but as my girlfriend of 2 years was there for me I decided to marry her that will come back to backfire on me. I was a party man and was out all the time plus I followed my football team all over the country. After the accident I had to learn how to walk and talk again as I was paralysed down one side of the body.
The girl , knew what she was getting into as we didn't get married until 2012, but still brought my injury up all the time and would say DO YOU SEE WHAT I NEED TO PUT UP WITH, when I would forget something with my memory loss. I had a lot of money and when my savings got low she said I want out, I cant put up with you anymore and finished it at the end of 2018. I changed as a person and wasn't confident and let her walkover the top of me, and since we have split I have my confidence back and my old personality is coming back. At the end of the day its a bad thing at the time but in the long run its so much better.

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?