Personality Changes
After a stroke your loved one may act like a different person. This is because injury to the brain can affect personality.
What Are Personality Changes?
A personality change is a difference in someone’s normal character. The person’s thinking and behavior change. If a change is minor, it may go unnoticed. Major changes can affect relationships with others.
What Do You Need to Know?
Changes in personality are common after stroke. They are also among the hardest to deal with. Not all changes are permanent. Some may disappear over time. Personality changes to watch for include self-centered attitude, emotional lability, apathy and depression. You may also notice behavior problems. For instance, your loved one may get angry or easily frustrated. They may have impulsive behaviors. Your loved one may even get physically aggressive.
Why Is It Important to Get Help?
Personality changes are hard for caregivers to handle. Talk with your healthcare team. They can suggest treatments or ways to deal with personality changes. Think about joining a support group. Talking with other caregivers is often helpful. Learn more about stroke support groups.
What Is Emotional Lability?
Emotional lability is used to describe someone with strong emotions. These emotions are close to the surface and difficult to control. The person becomes upset or cries more easily. Stroke survivors often have intense mood swings. They may be happy and sad in only a few minutes. They may react to everyday events in unexpected ways.
- Be patient. Your loved one cannot help behaving this way. Explain to your loved one that his or her emotions are part of the disease.
- Talk with other family members. Help them understand that stroke survivors have problems controlling their feelings.
- Treat the behavior as a minor problem. Continue what you were doing.
- Change the subject or lead your loved one in a new direction.
What Is a Self-Centered Attitude?
Many survivors become mainly concerned with their own interests. They may lack empathy, or the ability to understand another’s feelings.
- Kindly help your loved one know when they are not being thoughtful.
- Gently remind your loved one to practice polite behavior.
- Praise your loved one for doing thoughtful things for others.
What Is Apathy?
Apathy is a lack of motivation. Apathy is different than being tired or depressed. A person with apathy shows little emotion or feeling. There is often a loss of interest in the activities. Learn more about apathy.
What Is Depression?
After a stroke, a person may have negative feelings. They may think that things will never get better. Depression is a common response to the losses that occur from a stroke. Learn more about depression after stroke.
What Are Behavior Changes?
Stroke survivors often have problems with impulsive behaviors, frustration, anger and aggression. Changes in your loved one’s behavior are hard to deal with. Learn more about dealing with difficult behaviors.
Helpful Tips
- Personality changes are hard to deal with. Remember, this is part of the stroke injury. Try not to take it personally.
- Avoid comparing your loved one to the way they used to be.
- Seek counseling or join a support group. Talking about your anxieties can help.
- Keep up your own schedule to avoid caregiver burn-out.
Remember
Discuss personality changes with your healthcare provider. Ask for an assessment when needed.
Try to accept the changes you see in your loved one. Avoid comparing your loved one to the way they used to be. Some of the changes may be permanent. Others will disappear over time.
Be patient and understanding. Your loved one is facing many changes. Your support is important.
More Resources 
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References: Family Caregiver Alliance (December 2008). Coping with Behavioral Problems after Head Injury. Retrieved April 25, 2009, from: http://www.caregiver.org/caregiver/jsp/*; The Stroke Association (October 2006). Psychological Effects of Stroke. Retrieved April 25, 2009, from: http://www.stroke.org.uk*; American Stroke Association. (2009). Behavioral Changes after Stroke. Retrieved April, 12, 2009, from: http://www.strokeassociation.org*; Trelogan, Stephanie. (2009). Difficult Behaviors after a Stroke. Retrieved Friday, May 8, 2009, from: http://www.caring.com/*; Senelick, RC, Rossi, PW & Dougherty, K. (1999) Living with Stroke: A Guide for Families. (Revised Edition) NTC Contemporary Publishing Company.
These materials were created for the project:
Web-Based Informational Materials for Caregivers of Veterans Post-Stroke
Project Number SDP 06-327 funded by VA HSR&D Quality Enhancement Research Initiative (QUERI)
