After a stroke, you may have significant personality changes in addition to the obvious physical effects.
It helps explain why you or your loved one might be acting a little differently.
Acknowledging personality changes can be a huge step in changing unwanted behavior.
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This article gives an overview of some common personality changes after a stroke.
It also discusses the causes, treatments, and how to manage.
Post-stroke depression is usually treatable with a combination approach that includes prescription antidepressant medication and counseling.
Social Avoidance
Its common for stroke survivors to experience social anxiety.
In a 2018 study of stroke andTIA (transient ischemic attack)patients, one-fifth had an anxiety disorder.
Most of those involved avoiding certain situations, including social gatherings.
You may also be more likely to have anxiety if youre experiencing health challenges.
An extreme disability may necessitate moving into anew living environmentto get assistance with daily living.
All of these factors can lead to anxiety and avoiding social situations.
Let your doctor know if anxiety is making it hard to interact socially.
They can help you find the right treatment, which may include medication or counseling.
A counselor can help with different techniques to ease anxiety.
Cognitive behavioral therapy may also help with anxiety.
For social situations, this can involve putting yourself in a situation that helps you face your fears.
Some stroke survivors become forgetful, forgetting names, losing things, or neglecting important tasks.
The loss of cognitive skills can be distressing, and many people make excuses for frequent mistakes.
They may even lie about errors to avoid embarrassment.
It occurs most often with strokes that affect thefrontal lobe, theparietal lobe, or the temporal lobe.
Restoring cognitive skills is a challenge.
But just as physical disability can sometimes improve with physical therapy, therapy may also help cognitive skills.
Researchers are studying these programs to find out how effective they are.
Some memory issues can improve over time.
Taking medication for other issues, like sleeping problems, can sometimes help with memory as well.
you’re able to practice in a quiet environment thats free of distractions.
Emotional Instability
Stroke survivors may find themselves becoming unusually emotional or inappropriately crying or laughing.
Some experience a condition calledpseudobulbar affect, which is characterized by mood changes and uncontrollable expressions of emotion.
Causes of Emotional Instability
A stroke can damage parts of the brain that control emotional responses.
This likely happens along a neural (nerve) pathway in your brain.
The pathway includes the cerebellum, which helps us monitor our expression of emotions.
A stroke may disrupt that pathway and lead to difficulties controlling emotions.
Medications are available to help control this problem.
These include antidepressants as well as Nuedexta (dextromethorphan/quinidine sulfate), the first FDA-approved medication for pseudobulbar affect.
Cognitive therapy and social support can also help you cope.
Apathy can occur after most types of brain injury.
You may have less interest in seeing friends and family and doing things you normally like to do.
Research has shown apathy has a negative effect on your health and quality of life.
Causes of Post-Stroke Apathy
There are several reasons for post-stroke apathy.
Doctors may prescribe antidepressants to help with apathy.
Behavioral therapies may also help those with apathy.
These include planning future goals and problem-solving with enjoyable activities to help increase motivation.
Vascular dementiaoccurs when many small strokes happen over time, leading to a buildup of injuries throughout the brain.
In one study, fluoxetine helped reduce anger scores for stroke survivors.
However, more research is needed to confirm the results.
If you or someone you care for has problems with aggression, seek medical help right away.
Call 911 if you feel that you or someone else is in immediate danger.
Stroke survivors who have anosognosia present a challenging problem for loved ones and caregivers who attempt to offer assistance.
The care they provide is often met with no cooperation.
Sometimes stroke survivors who have anosognosia treat those who are trying to help them with dismissal or rejection.
Causes of Anosognosia
Anosognosia in stroke survivors may be related to several different factors.
Cognitive therapy can help people better understand their condition.
Avoid getting into arguments to convince them about their condition.
Lack of Empathy
After a stroke, a person may sometimes become less empathetic to others.
Empathy means being able to see something from another persons point of view.
Without empathy, someone may say or do things that are hurtful to others.
It can result in self-centered behavior and damaged relationships.
This damage can affect their perceptions of other peoples emotions and facial expressions.
It is not easy to predict whether a lack of empathy will improve after a stroke.
Some stroke survivors can show improvement, while others do not.
If youre a caregiver, try not to take their lack of empathy personally.
Keep in mind that the change in personality is brought on by changes in the brain.
If the person is having trouble reading facial expressions, talk to them about the emotions youre feeling.
Counseling or therapy may also help with improving communication between stroke survivors and caregivers.
Loss of Sense of Humor
A sense of humor requires insight and quick thinking.
Many types of strokes can diminish a stroke survivors sense of humor.
A stroke survivor who was previously funny might not be able to construct jokes.
Loss of Social Inhibitions
Some stroke survivors may behave in ways that are considered socially inappropriate.
They are unlikely to apologize or venture to correct the behavior.
This area allows you to make predictions about what will happen and adjust your behavior when necessary.
When someone has had afrontal lobe stroke, their behaviors probably dont fit their normal personality.
If youre caring for someone with impulsive behavior, try giving them consistent reminders on appropriate behavior.
Jealousy
Some stroke survivors may experience intense, unreasonable jealousy thats out of character for them.
Othello syndrome is characterized by irrational and illogical jealousy, particularly in the context of romantic relationships.
Othello syndrome may be treated with antipsychotic medications, such as Seroquel (quetiapine), along with antidepressants.
Do These Personality Changes Go Away?
It depends on the person and their specific condition.
Some changes may go away on their own.
Others require treatment, including medications or therapy.
Check with your doctor about any personality or change youre experiencing.
They can help you know what to expect and work with you on treatment.
Summary
Personality changes can be common after a stroke.
Some changes may be due to damage in the brain.
Others may be sparked by the stress of dealing with life changes and physical limitations from the stroke.
Some personality changes may get better on their own while others require medication or therapy.
Personality changes after a stroke can be emotionally draining for everyone involved.
It can be reassuring to know that the behavior comes from stroke-induced brain damage.
The unpleasant behavior isnt premeditated or intended to be insulting.
Depending on their condition, some stroke survivors can recognize these personality changes.
That allows them to work on improving them, which can result in more satisfying interpersonal relationships.
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