The world learned on Wednesday that Hollywood legend Bruce Willis, 67, will retire due to his diagnosis of aphasia, a potentially devastating condition that causes a person to lose their communication skills.
Willis’ family say the condition will force the Die Hard star to step away “from the career that meant so much to him”.
About one million Americans suffer from the disease, reports the National Institutes of Health, and about 180,000 people are diagnosed with it each year.
It can manifest in many ways and often results from head trauma, stroke, tumor, or other brain damage.
Aphasia can also be devastating, with experts saying it causes depression in more than a third of cases, can lead to personality changes and can even drive friends and family away from the affected person.
Other famous examples of aphasia include former Arizona congresswoman Gabby Giffords and Game of Thrones star Emilia Clarke.
“Imagine being dumped in a country whose language you don’t speak – can’t understand, read, write or speak. It would impact all of your interactions – that’s what it’s like to have aphasia,’ Darlene Williamson, president of the Aphasia Association, told DailyMail.com.
While it’s impossible to say for Willis specifically how much the condition has affected him and his behavior, Williamson reports that it can often be devastating for patients.
“The consequences of living with a language disorder can alter a person’s behavior and outlook on life,” Williamson said.
“About 35% of people with aphasia suffer from depression.”
The cause of the disease, which is often some sort of traumatic brain injury or stroke, can lead to massive personality changes.
‘[Aphasia is] difficulty with language that comes from some sort of brain injury. The most common source is stroke…but it can come from any other type of damage,’ Dr Brenda Rapp, a cognitive scientist at Johns Hopkins University, told DailyMail.com.
Certain infections that affect the language centers of the brain can also cause the formation of aphasia, as well as cognitive decline and deterioration associated with dementia.
The condition can make it very difficult for an actor like Willis to pursue his career, as just talking about the lines can become a challenge.
“It would be tough for sure,” Williamson said of trying to continue playing while suffering from the disease.
“Aphasia affects language comprehension, speaking, as well as reading and writing. There are different levels of severity, which would be another deciding factor. It may not be impossible, but playing would require additional accommodations.
Dr Rapp said that despite the communication failures caused by the disease, people who suffer from it still have the same thoughts and are internally the same person. Although the experience can be alienating, loved ones should remember that the person has not changed. Pictured: Willis with family and friends after a ‘roast’ event in 2018
There are four common types of aphasia which make up the vast majority of cases: fluent – often referred to as Wernicke; non-fluid – known as Broca; anomic; and Primary Progressive Aphasia.
Rapp explained that there are different forms of the condition as each represents a different type of breakdown in the communication process.
Whether it is the ability to translate thoughts into appropriate words, the ability to physically say words, or the ability to interpret and understand the speech of others, every part of communication is a complex process, and even mild brain damage can cause problems.
Although the condition causes communication failures, Rapp notes that the person themselves is still the same.
Their thoughts, beliefs and feelings towards their loved ones remain, although it can be frustrating and alienating for the aphasic patient and those around them to deal with this condition.
Willis’ family did not reveal what type he was dealing with, the severity of a case he had, or what root cause was found for the condition.
According to Stroke Association, a UK-based group, those with Wernicke’s aphasia have the ability to string together long phrases of words, but will often say things in a way that doesn’t make sense, or even use invented words.
They will also suffer from reading and writing impairments and may find it difficult to understand clear verbal communication to them.
An example used by Rapp is that a person may misunderstand the phrase “John kicked the dog”.
Dr. Brenda Rapp, a cognitive scientist at Johns Hopkins University, explains that aphasia is often caused by a stroke and can manifest in different ways.
While the average person would clearly understand who kicked whom in this scenario, someone dealing with this type of condition may have trouble determining whether John or the dog was the person kicking.
Broca’s aphasia often causes a person to forget words or put together an appropriate chain of words, even when their brain can fully understand what they mean.
A person with this type of condition will often use simple, short sentences to get the point across, as they are sometimes unable to say what they want correctly.
The Stroke Association says these sentences will often be around four words or less.
A person with Broca’s aphasia will also have difficulty writing, but their reading ability is not affected.
A person with anomic aphasia may have trouble finding specific verbs and nouns they need to get their point across and will speak very vaguely.
It can also translate into their writing, where they simply won’t be able to generate the correct words needed to say what they would like to say.
Primary Progressive Aphasia Aphasia damages a person’s ability to communicate in almost every way.
A person suffering from this version of the condition will have difficulty speaking, reading, and writing.
Their ability to process and understand someone who speaks to them is also damaged.
Doctors can often detect aphasia via an MRI or CT scan, and will be able to pinpoint the exact part of the brain causing the problem.
There is no way to fix or cure the condition entirely, but patients will often undergo speech therapy to help rebuild their language skills.
“There is not much progress [with medication for the condition]… the treatment for aphasia is speech therapy,” Rapp said.
She noted that in some cases, a person may undergo electrical stimulation therapy alongside speech therapy in order to “get the most out” of the experience.
Williamson said that “strong family support is an essential part of living successfully with aphasia.”
It’s not always permanent, however, and its duration and severity often depend on the severity of the brain damage.
Stroke victims in particular who suffer from aphasia can regain their speech, and often in just a few weeks.