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Most of us have heard a story just like this one, and millions more are actually living it.

A committed couple is enjoying a good life together when an accident, a sports injury or a stroke comes along and changes everything.

From one moment to the next, their world is turned upside down as the injured partner struggles to get better. Months, even years of medical appointments, tests and physical therapy pass in a painful blur, consuming a huge share of their time and energy.

As the visible wounds begin to heal, both partners believe that things will soon “get back to normal.” But in fact, nothing is the same as it was before.

• The injured one is having trouble sleeping. And concentrating. And following a conversation.
• S/he is tired all the time and can’t keep up with everyday activities. Memory and attention problems are creating conflicts.
• Bright lights and noisy environments – even a favorite restaurant – might feel like torture.

“I’m just not myself,” the injured partner says. And the loved one listening may silently think, “That’s right. You’re not the person I fell in love with.”

These are just some of the signs that a mild brain injury has taken over this couple’s life. But don’t let the word “mild” fool you. The effects of brain injury on loving, committed couples are ANYTHING but light.

We think of brain damage as something caused by a catastrophic event like a car crash or a fall from a great height. But in reality, there are many ways that brain injuries happen.

You can tumble off your bike and hit your head, not even losing consciousness, and hurt your brain. You can take a spill walking the dog or going down the stairs or playing tennis. The blow to your head doesn’t have to be particularly hard – and you don’t have to be in a coma for the effects to show up.

There are 2 typical sources of brain injury, and it helps to understand more about them.

Acquired brain injuries are those that happen as the result of a stroke, an aneurysm, or a period of time when the brain is deprived of oxygen. Other causes include drug use or exposure to certain chemicals.

Traumatic brain injuries come from accidents, falls, sports injuries and explosions such as the ones a soldier might survive in a war zone. But again, the word “traumatic” can be misleading. The whack on the head doesn’t have to be all that significant to create major problems.

So-called blast injuries are most commonly seen in military personnel. The complex pressure waves that throw their bodies back from the explosion can do significant damage. Emergency medical personnel or firefighters may also suffer from injuries of this kind.

If you are dealing with the effects of brain injury on your primary relationship, you are far from alone. In the U.S., a traumatic brain injury happens every 21 seconds, affecting more than 3.5 million people every year.

No wonder millions of couples are desperately searching for help. If you’re one of them, you have already seen the devastating effects that brain injury is having on your loved one – and you.

You feel like a stranger in your own body – or in your parntership. This is the most common complaint I hear from the couples I see in my therapeutic practice. The injured person feels alienated from him/herself, and the “healthy” partner hardly recognizes his or her loved one.

Communicating is hard. Coming up with the right words can feel impossible. The injured one may rattle on without getting to the point, or sink into silence, or have that glazed-over look, leaving the other one completely in the dark.

Energy levels are low. Brain-injured people suffer from chronic and profound fatigue. Partly, this is due to poor sleep – but even after 8 or more hours of rest, the brain is working so much harder just to process the same information that energy is sapped quickly, much like a cellphone battery that is dying fast.

Sex has gone out the window. Brain injuries affect hormone levels, which in turn can affect desire. The sense of anguish and embarrassment about everything that’s happened can also hack away at a couple’s intimate life. Many say they haven’t even thought of asking each other for sex – yet they’re starved for the closeness it once gave them.

Roles and responsibilities suddenly change. The injured partner may not be able to handle the simplest of chores. S/he may not follow through on things, or may handle tasks in a shoddy way. This can affect the ability to work and, in turn, create serious financial stress. The inability to initiate, plan, organize and pay attention – all supported by the brain’s executive functioning — are profoundly disrupted, leaving the healthy partner struggling to compensate.

Resentment and anger build up. Both of you may feel the injured one “should be better by now,” even though you know that healing takes time. This can create a climate of blame and shame that colors every interaction and leads to open conflict.

Loneliness and isolation may set in. Your loved one may be too tired, angry or ashamed to socialize. Worse yet, you may feel lonely in each other’s presence – a tremendous source of pain that is hard to discuss. Family and friends don’t always understand, and they may agree you should be healed by now, an attitude that only makes matters worse.

With all these difficult changes, one or both of you may feel depressed and hopeless. But take heart. There are things you can do to turn things around.

As a brain injury expert with more than 30 years of experience working with married and committed couples, I’m here to reassure you that brain injury doesn’t have to destroy your relationship. You’ve already lost a lot — but you don’t have to lose each other.

Many couples come to me believing that breaking up, or settling for an unsatisfying relationship, are their only options. But I show them that there are ways to create a strong, loving union as they adjust to the “new normal” and move forward with their lives.

If you’re terrified that your relationship is in trouble, here are 3 crucial pieces of advice I would offer you.

Remember that healing takes time. Regardless of how the brain injury happened, it’s crucial to know that recovery is always slow. The injured person may look just fine, but that’s only what we see on the outside. We know that it can take years for the brain to heal, which means that patience must be an essential part of your approach to life now.

Remember that you’re NOT alone. While it may not feel true right now, you do still have each other. And now that you know more about the effects of brain injury, you can turn toward each other for sustenance and understanding. The right therapist will be able to provide you with rock-solid support as you navigate the healing process together.

A trained couples therapist should be part of your care team. However, I would suggest you look for one who is educated in the effects of brain injury. Your therapist will help you see the effects of the injury on your relationship and create a loving, safe environment where you can say how you truly feel. This is one of many first steps on the hopeful road to a new life for both of you.

While my private practice is currently full, if you’d like to work more directly with me – whether you are the survivor, partner (or both), or family member – you can do so the following ways:

1. Discover How to Manage Your Emotions and Overwhelm After a Traumatic Brain Injury
2. Get on the Waiting List for my “Ask Lori” Private Community for TBI Survivors and Partners.

I look forward to being in touch soon.

Lori Weisman, MA, LMHC, began her health care career as a speech pathologist, learning firsthand from her clients about the painful challenges of living with a brain injury. A talented and caring psychotherapist, Lori has worked with thousands of married and committed couples who are rebuilding their lives in the wake of brain injuries. She is a frequent lecturer and consultant in her field and maintains a thriving practice near Seattle, Washington.