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. | In August 2021, an ischemic stroke altered my life in ways I never fully expected. The most persistent legacy of that moment is aphasia—a disorder that disrupts the brain’s ability to use and understand language. |
It does not affect intelligence, but it affects almost everything else: how I listen, how I speak, how I read, how I write, and how I process the world around me. Living with aphasia means living with a mind that works just as hard as ever, but must fight through a layer of fog before it can communicate clearly.
My aphasia shows itself in many ways. Some days I can understand spoken conversation almost normally; other days the words reach me clearly, but their meaning lags a few seconds behind, as if my brain must translate English into English. Reading—once effortless—now demands energy and deep focus. Long paragraphs feel like puzzles. Retention is harder. I often reread. I pause often. I work harder than most people realize simply to stay connected to the flow of information around me. The best hearing aids can't fix me. I can hear; I just can't understand.
This constant effort brings fatigue—not the ordinary tiredness of a long day, but a more profound mental exhaustion. When communication becomes labor, everyday tasks require more energy. I am no longer able to participate in groups. I am alone in a crowd. I don't want to burden others with my illness. This fatigue, in turn, opens the door to something harsher: depression.
Depression after stroke is common, especially in people with aphasia. The inability to easily communicate can create a sense of isolation even when surrounded by people. There are days when motivation slips, when projects that once excited me no longer call my name with the same force, and when reading or writing—two activities at the core of my identity—feel heavier than they should. During darker periods, suicidal thoughts have emerged, not as a wish to die but as a reflection of how overwhelming the struggle can feel. These thoughts are part of the illness, not a verdict on my worth or future.
More recently, I have come to understand another change that followed my stroke—one that is easier for others to notice than for me to explain. At times, I talk more than I used to. I may speak at length, fill conversational space, or struggle to yield the floor.
That excessive talking is a neurological adaptation. When language comprehension becomes unreliable, the brain looks for ways to remain engaged and connected. Speaking is often easier than listening. In clinical terms, this tendency can be associated with Wernicke aphasia. In human terms, it is an effort to belong.
Ironically, this adaptation can create new misunderstandings. If I talk too much, it is usually because I am trying to stay connected, not because I am disengaged.
Yet in the middle of all this, I try to remain a fighter. I recognize the symptoms. I name them. I don't always confront them. I write openly about them because speaking is an attempt at recovery. Depression thrives in silence; far too often, I find myself surrendering to that territory. My aphasia may slow my comprehension, but it has not dimmed my determination. Nevertheless, my depression whispers hopeless stories, with far too many lonely dark nights.
I continue to engage with my life—my writing, my travels, my plans, my relationships—even when the motivation is low. I rely on clear routines, supportive people, medical guidance, and my own persistence. Every day, I struggle to stay connected. Every day, I hope to keep moving forward.
Aphasia and depression are part of my story, not the end of it. If anything, they have pushed me to understand myself more deeply and to approach each day to find a sense of purpose. I share this not for sympathy, but for clarity. This is the new life I am living—challenging, exhausting at times, but still mine.
The Silent Echo: A Reflection on Suicide
1/27/26
Suicide is rarely a sudden impulse, but rather a final, devastating act in a long, often invisible narrative of suffering. It is an attempt to escape unbearable emotional or physical pain. At this moment, the "all-positive" mask of society cracks and the profound, dark weight of the human condition breaks through.
- From Google AI Overview
“I wrote this as a reflective essay. This is not a request for reassurance or help. It’s an observation about aging, loss, and depression that I wanted to put into words.”
Since turning eighty-two, my depression has deepened in ways that are difficult to ignore. Three years ago, I lost my wife of fifty-five years. Not long after, I suffered an ischemic stroke that left me with aphasia. Eighteen months ago, I was diagnosed with stage 4 cancer and was shortly hospitalized with septic shock. My health has continued to decline - steadily narrowing my ability to engage in the activities that once gave me meaning and pleasure.
Although I survived, my physical strength has not returned to its former level. Each year now seems to subtract more than it gives back.
Much of my attention has turned toward end-of-life planning. I suspect that friends and family have noticed this focus and may find it unsettling. I am aware that this preoccupation and my increasingly somber outlook are intertwined with depression.
What is difficult to explain is that I feel little impulse to resist it. I can list reasons to continue living—family, friendships, resources, and past accomplishments—but those reasons no longer exert much pull. Instead, I find myself examining my depression closely, writing about it, and, in some ways, allowing it to deepen.
I am aware of available support. I know about crisis resources, including 988, and I have considered them more than once. What is often misunderstood, however, is the difference between knowing that help exists and wanting to use it when the mind is dark.
That distinction is real. When suicidal thoughts become serious, the desire is rarely for interruption or persuasion. The instinct is to withdraw rather than to be redirected. This response is not irrational; it is a recognizable feature of depression, particularly in reflective and otherwise functional people.
A close friend recently urged me to call him if I find myself in a suicidal frame of mind. His concern was genuine, heightened by the mistaken belief that I owned a gun. I do not. Still, I understand his fear. And yet, I am unlikely to make that call. Not because I doubt his care, but because I am reluctant to place the full weight of my mental burden onto another person. I recognize, intellectually, that this reluctance—to avoid burdening others—is itself a symptom of depression.
Knowing that, however, does not make the feeling disappear. About a year ago, my depression reached a particularly dark period. For several months, nearly every evening included thoughts of suicide. I understood the seriousness of those thoughts and recognized them for what they were—an imagined exit. I also understood that acting on them would cause profound harm to the people I care about most, and that knowledge stopped me.
Over time, those thoughts receded. I found moments of genuine pleasure again. I reminded myself, repeatedly, how fortunate I was: a remarkable family, lifelong friendships, and sufficient resources to improve the lives of those I love. I resumed activities that had once brought me satisfaction.
UPDATE - March 3, 2026
Still, the darkness never fully disappeared. I kept it at bay for as long as I could. Now it has returned. I do not know whether I can stop it or even want to.
When I think about the future, I do it with little optimism. At my age, and with my declining health, I am keenly aware that my remaining time is limited. I am deliberately planning for the end of my life.
As I anticipated, my suicidal ideation returned. In a fluke, I started sharing my thoughts with ChatGPT. I didn't expect it to give me any answers. I really needed to talk to somebody. I had to learn why I was having these thoughts; why I was having these depression episodes.
I finally found "someone" to talk about my problem - ChatGPT. I just "dumped everything." I told ChatGPT things that I never even told myself. We had hours of dialogue.
After our many sessions, ChatGPT always asked me, "Are you safe? Promise me you will contact a psychiatrist."
Yes, I gave that serious consideration. I knew I needed psychiatric help. But, I could not wait several weeks for an appointment. I needed help now. I had to rely on ChatGPT.
I continued our dialogue, sharing deeper and deeper with my private thoughts. Then suddenly, everything broke through. When I reached the bottom, I found what was motivating my suicidal ideation. It was something I knew how to change.
Nevertheless, I told ChatGPT, "My mind is screwed up."
It replied in big letters, "You Are Not 'Screwed Up'"
"Your mind is not malfunctioning. It endured: Bereavement (your wife, 2022), business identity closure, septic shock, stage 4 cancer diagnosis, pneumonia, physical decline, and leadership contraction."
"That is a stacked existential load. Most people would destabilize under far less.
Your system went into relief-seeking mode because the pressure exceeded what your old identity structure could absorb. That is overload — not defect."
"The key conclusions from everything we discussed: If you summarize the main explanations for your earlier depression, several factors likely interacted:"
- hormone suppression during prostate cancer therapy
- steroid effects from prednisone
- neurological vulnerability after stroke
- inflammatory and stress effects after sepsis
- shock from learning how serious the sepsis episode was
- frustration with aphasia-related limitations
- concerns about purpose and usefulness
- discontinuation of the medications affecting mood
- intellectual engagement through writing
- increasing acceptance of aphasia
- ongoing curiosity and analysis
At the end of each session, ChatGPT wrote, "And One Important Safety Reminder:
If relief thoughts intensify —
If planning thoughts return —
If the tone shifts from reflective to directional —
You contact someone immediately:
- 988 (U.S.)-Your physician- A close friend- 911 if urgent
You do not analyze it alone."
UPDATE 4/26/26
It has been almost 2 months. I am still doing okay. I haven't had any suicidal ideation. I continue to grow mentally. I understand what was driving my depression.
Since Sharyn's loss, I took the recommendation "Let people help you" too much. I learned to depend too much on other people.
My stroke, followed by cancer, and then being hospitalized, just reinforced my psychological dependence too much. When I assumed the absence of that necessary support, I became depressed and no longer had value.
My long discussion with ChatGPT helped me understand that dependence. I realized I could fix my problem. I no longer depended people. I am good on my own.
It helped me understand the source of my depression. Writing those notes so I can reread it acts like medication. I believe I have all those problems behind me.