After My Brain Injury, Why Is Speaking Harder on Some Days than Others?

After My Brain Injury, Why Is Speaking Harder on Some Days than Others?

I am 53 and had a TBI more than 14 months ago. Some days I just cannot speak words or make sentences. I still work most days and run regularly to keep in shape … and to keep happy. Recent tests showed that the area of my brain near my left ear is still not normal and I have some hearing problems on that side, too. I don’t take medication of any kind. Are there other strategies I don’t know about that I could use to improve my issues with aphasia?


Aphasia affects your ability to understand as well as to produce language to express yourself and is usually caused by damage to the left side of your brain. A hearing loss adds to the challenge of having aphasia from your TBI, because you have to work harder to hear what is being said in addition to understanding the words. It is wonderful that you are busy and active, but you may need to take a closer look at what causes the differences in your communication from day to day.

  1. Look at your overall health. Are you consistently eating and sleeping well, or do you feel more tired or stressed on some days? Your communication ability is likely to mirror how you are feeling physically and mentally.
  2. On a bad day, try to ease up in what you expect of yourself. Get more rest on those days, and try not to put yourself in difficult communication situations.
  3. Get your hearing checked by a certified audiologist to see if you would benefit from some kind of amplification.
  4. Make sure you minimize other sources of noise (TV, music, crowds) so you can hear and concentrate to your best ability.

And remember that one of the hallmarks of having had a brain injury is inconsistency. You will have good days and bad days but hopefully you will see a pattern of improvement over time.


Posted on BrainLine May 6, 2011.

Comments (32)

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.

We must not get aphasia mixed up with old age as we get older our speech is not as effective or hearing is not as Keen even our sense of smell and Chase my dog

The description sounded like broca's area aphasia. But i read this for the good day vs bad day confirmation. I think mine is prefrontal damage and Wernicke's aphasia (if not other parts-someone beat me until i went limp i am guessing)- can't follow people talking to me. Make up phrases. I have to stay hydrated and take vitamins the day before exams. Otherwise i cant understand what the questions mean sometimes.

Hello just wanna ask a question my name is Norman I had a brain injury in 2005 I had a bleed on the brain in hospital for eight months but now I get memory loss I tried to come out with things and it comes out totally wrong I tried to think of something to say but it won't just come I can't think of it

I had a concussion in early 2019. Since then I’ve had issues with stuttering/slurring words. Mixing words up. Saying things that don’t make sense. I wouldn’t even notice I was doing it. Now I can catch my mistakes and correct them after I’ve said the wrong word and sometimes I’m just lazy and leave the wrong word out there. It gets worse on bad days when I have been overstimulated. But being able to tell when I said a wrong word or mispronounced a word was a step in the right direction. It means I Am healing.

I had accident on motorcycle but somehow i got saved by many injuries but suffrred a hairline fracture near spinal cord, almost dislocated shoulder and minor scratches.. but after accident i do not remember a thing like for atlst 10 days.. i do have a little bit of visual memory regarding those 10 days.. in these 10 day i do not remember what i said to people like I’ve been to neil armstrong marriage, changing stories about accident like i fell from roof or mountain, even i ride my bicycle without any fear or protection after which i was in so much pain that I realised I’ve been to accident and i should not have ride the bicycle... and many more that people heard from me which i could not even remember or say if I’m aware bcs these are all non sense... and after accident i feel so chnged from inside mentally that i could not explain.. my perception about things has chnged.. can anyone pls tell me what was it ?

It sounds like you had some brain damage occur in the accident that the doctors didn't do their diligence to look for before sending you home. Sometimes with a head injury you may not even remember having it.

My son didn't get a head CT scan when he split his head open which caused TONS of issues afterwards due to late treatment, all because he had lost half (yes half) of his blood and was in a semi-conscious stupor when the trauma doctor asked him what happened (the concussion was actually a result of falling, after the initial scalp injury that caused the blood loss). He didn't even remember hitting his head until days later - on the same side that already had mild brain damage from birth.

So rather than a few issues that were well-controlled with medication, he developed many new issues, and the neurological condition he had before the accident came roaring back so the meds could no longer hold it. The neuro was an idiot though who didn't want to do anything unless it was his idea, even when another doctor said to have it done. There were so many tests and such that we were told to get which he refused to order because he just chalked it up to psychological issues or it all being in his head.

So today we have difficulty understanding speech off and on, trouble reading long or complex sentences, "blank-outs" that I strongly suspect to be absence seizures, emotional swings, visual and auditory hallucinations, distorted vision, hearing that cuts in and out, and much more. It started exactly on the day of the injury. Thing is, all those symptoms can come from a large region of the brain where the occipital, parietal, and temporal cortexes all come together.

I'm not a doctor but common sense (I say that to spite the neuro who wouldn't order the tests) says that when you start having abnormal symptoms immediately following a head injury, chances are what you're looking at is some degree of brain damage.

I have a speaking problem when I speak I am laod and my word are mix each other and I speak difficult but when I speak normally my word are correct... This happened after my car accident... What is the reason behind?.. My understanding is normal and written is Aslo. Normal only issue in speaking?.... Before accident I speak normally and every think is perfect when I try to speak before accident in my accent I have a problem now what can I do

Hey, my brother had a horrible accident almost 7 months ago. He suffered from a brain injury, although he is improving, he is still unable to speak. His body is healing and we are working hard to stand, but his speech we have made no improvements. He can pick the right words off of note cards, as well as make sound. He copies me when I make certain letter sounds but there is an long OOOO sound at the end of every sound. He is able to laugh, screams out, but no words. He will give us a thumbs up or down when ask a question so we are certain he understands us. I would love any advice on how to help him. He is in a nursing home right now even though hes only 29 b/c we are having trouble with his insurance to cover therapy, so the only word it sounds like he says everyday is Home. He is able to write some words that are clear and other words do not make sense, and he doesn't write all the time. Is there anything we can do to help him? I miss talking to him and I know caring for him would be a lot easier to ensure we doing exactly what he needs if he could communicate with you. Any help would be great! Thank you so much!

Turn music on and tell him to sing with you. We are going through the same thing with my cousin. MUSIC HAS HELPED HIM A LOT AND HE'S JUST NOW STARTING TO SAY WORDS. He has his whole left frontal lobe gone from gunshot. He's just now starting to say words. Keep praying

I have had a Traumatic Brain Injury for 20 years.
My speech was affected along with Memory and Every Emotion i have is Now multiplied. Anger and Depression Being the Worst.
Music Therapy helped me Alot with my speech.
Good Luck to y'all

I worked as a nurse for many years. Use his favorite music and get him singing. His tongue and mouth may have to relearn to form the proper positions for the sounds. Getting enough fluids, keeping away from neuroprovoking foods (see Amy Yasko's pdf on them) and continuing to see he gets low inflammatory foods and stays away from synthetics as much as possible (move that nursing home dresser made of particle board away from the area he sleeps in, at least on the other side of the room), no scented products, no heavily processed personal products and cleaners, exposure to sunlight instead of artifical light after sunset (the brain needs a ratio that's higher in sunlight to moderate the neuroexcitratory compounds artifical light makes), no foam products. For therapy can you get him someone who will come in for a cranial sacral treatment? Then see if you can get him out to LENS neurofeedback therapy and try the vagal protocol. Often the vestibular system gets thrown off when these things happen. LENS can be a shortcut as can zinc twice a day, 45 or 50 mg. I also have a demyleination process that was turned on by stress and damage to the left frontal cortex as well as a history of brain insult and injury. At one point when I got language back, I formed my first word again. The f bomb. The more frustrated I got the more it would fly out of my mouth. I had taken monastic vows a few years prior and it was horrid for me. Luckily the universe had a sense of humor and I largely recovered thanks to hard work and a few therapies I could do when I had the money.

My nephew (15 yo) was cross checked in hockey a week ago. they used the baseline scan and he did have a concussion. several nights in the hospital. They sent him home. He has lost all speech, and is having a difficult time even writing. Is this aphasia? They live in Alaska - can't believe they sent him home. His mom has had 3-4 concussions and treated them nonchalantly - she now has brain damage. How is aphasia diagnosed? Treated? What's the long term prognosis?

I had a terrible fall nearly 6 years ago and broke my nose. I had symptoms of concussion but it was never diagnosed. My ability to communicate verbally has been gradually getting worse. Some days I’m fine and some days I’m not. However, I have no trouble when I’m typing or writing. People close to me know and have patience with me on bad days, but I dread speaking to new people sometimes because I sound like a blithering idiot. It this something I could have diagnosed with an MRI? It’s very frustrating.

This answer from "The Expert" is the most "simply" comprehensive "matter of fact" response I've heard in a long time!! Totally "Spot On!" The only thing I'd add as a consideration is acupuncture/pressure as & adjunct. "STRESS" in my "non scientific evidenced based" opinion is the "Mother Lode" of most other problems. It can be experienced in a myriad of ways. The easiest way 2 identify something/one as a "stressor" is your physical response. I cut off cable..Some people & am very selective about who or what I entertain. I made this decision before the 1st of the year & it has been a blessing!! Lastly, when those inevitable days come when my "Get up & go has gotten up & gone" I don't lament nor beat myself up about it any more. I've come 2 see those days as "friends". A good friend saying "Not 2day". There'll be another day 2 attack your "perpetual" To Do List.

I have expressive aphasia and have struggled for years to understand why my condition made me hyper vulnerable to exploitation and abuse. I feel as if nothing I say is ever heard and at times have agonized for months attempting to find the words or a phrase to get a point across. My speech disorder seems to irritate my girlfriend and colleagues this has led to the destruction of both personal and professional life it can be amazing how cruel even those who claim to love you can become .

I feel you.
I too have a speech impediment and it sucks!
I'm overly verbal and only when I get angry or upset someone understands.
I try and convey my thoughts through speech and I get stuck.
I believe in speaking though as it helps me be more fluid and in tune with interpersonal relationships and communicating.
It's always been me against the world.
No more victim mentality.
Although the people on my journey has always paid me with high respect, regard or says I'm amazing through my infliction as I prove to myself to push myself to be my highest good it's always never been enough for me.

I have this problem , I suffer with brocca aphasia , I've been called horrible names , people don't give me chance to speak seems like they taking over my life

My TBI was in 2008, I still have the issues as well. For me eliminating all other noises surrounding helps only sometimes. Even when I am one on one with a person alone in a room I have these same issues. I think overtime my anxiety about it reduced by speaking slower and taking more time to think ahead about points on certain topics in order to feel prepared for certain conversations, like topics for work.

I had a bleed on my brain near 2yrs ago now and i also have white matter disease some days i find i can't remember my words so i take longer to search for the word i am looking to say,on a bad day i have what i call like rice in a bottle shaking in my head which makes my head feel really heavy especially on the right side of my brain i am 44 with 2kids and scared to death of what  is coming next.

I was told that this was migraine aura for me even after I had a brain aneurysm coiled. Very good info.

hey its been 19 months since mine and im still struggling!! if i struggle i get comments like 'dont worry we all do that' or 'thats normal for most people'!! what they dont understand is that your/mine brain is actually struggling to find words and put them in sentences!! be brave. as i always think - im still alive!!

My most severe TBI occurred in 1971... to this day I experience problems understanding what I hear & read. I also experience problems expressing my thoughts verbally. Public speaking is a freaking nightmare! Anyway, I've given up on "getting better", I focus instead on doing a better job of dealing with the issues I face every day.

In a brain injury i was in coma for 5 days. After 21 days i got relief from hospital. Within 30 days i felt good. But i have a speech problem. Up to day hours of 4 or 5 pm its ok. But after that my tongue dont work properly. If i am busy it may ok for whole day. If i am in tension or in pressure it may start from morning. Pls guide me what i have to do.

I had a member come to my adaptive yoga class yesterday with Aphagia, he could only hear me when I was looking directly at him. I augmented my speech with hand gestures - I'm wondering if doing so was helpful to the member. He indicated he really did not hear much of what I was saying - but he was following the rest of the class in doing the postures. I'd like to be able to help him develop more, but can we do it in a group setting?  I'd love some input.  Thanks! -=PS=-

While it is nice to know that there are others with these issues; I just want to get better and be over this. My Tbi was in May of 2010 and all the smart folks are just saying: "hang in there". So I'll continue, but I know there are going to be bad days like yesterday where I really messed up my family. It's great they are all stickng by me but I've got to wonder "for how long?"

Seriously look into HBOT treatments. I’ve had them. It works to help heal the brain. is my physician’s website.

My TBI was in 1986, and it was only a few years ago that I regained my articulate speech, so keep optimistic because you never know how long it will take! Also until a few years ago, I found that I was reading less because life was getting busy. Aphasia-like symptoms resulted, which I think actually were likely as much or more to unfamiliarity instead of the TBI itself, so ... keep reading complicated texts because while the root cause might be Aphasia related, sometimes we can compensate)!
I had a Severe TBI on Feb. 5, 2000.Many times the words just won't come to me, I know what I want to say but can't express it. Drives me nuts, & most of the time just forget what I'm getting at altogether. Used to be slurred speech for a long time, still slurred from time to time or really fast & when I try to slow down to be clear just picks right back up again, people can't understand me half the time. Can't focus for long, frustrated very easily. For a while I felt like things were getting better but, now just seems to have gotten worse. Idk, I could go on, but ... I can't remember right now. Smh...
I too have had these issues with hearing loss, sometimes I just can't find the right word or I jumble a word up. I hate to say I'm glad to hear that this is not unusual, but it helps to know that others have or had the same problems. I just keep telling myself tomorrow is a new day when I have bad days.
My TBI was in 2001 and aphasia is a more recent problem for me. I use my hands more when I can't find the words, and sometimes I get so mad I say a cuss word which I never did before. I was also left completely deaf on my right side. Are there any programs to help with this?
I had a TBI on Sept 10, 1995 and still have difficulties. I sometimes leave out whole words when I type or write. My speach is slurred at times and I sometimes have difficulty coming up with the proper word to use. My short term memory is better than right after accident, but not anywhere I'd like to be. Being a perfectionist also causes somke depression at times. :(
I occasionally have a problem with this; I can write well, but words don't come out orally and conversations get cut short and I lose track. This has been diagnosed as dysphagia. It can be frustrating and maddening when trying to get across an important point.