Changes in personality are common after stroke. Personality changes may be the most difficult changes to understand and get used to. After a stroke, existing personality traits can become exaggerated. In contrast, sometimes people behave in ways that aren’t like them at all. Changes in personality can have a profound impact on stroke survivors and their relationships.

Sudden mood swings or uncontrollable emotions are common after stroke. People may cry or laugh with little or no real cause. This is called emotional lability or the pseudobulbar effect.

Personality changes can also include apathy, irritability and aggression. Disinhibition can see people say or do things that are considered socially inappropriate. Disinhibition can be very difficult for the people close to the survivor, although it can have its funny side at times. Impulsivity is acting without thinking and can lead people to do things that are unsafe or inappropriate.

Sometimes difficult behaviour is aimed only at the people closest to the survivor. This is quite consistent with people’s behaviour generally. Most of us show the more difficult parts of ourselves only to the people we are closest to, safe in the knowledge that they will probably forgive us.

Some stroke survivors seem unable to recognise or understand that their behaviour or personality has changed, and feel that there is nothing wrong with them so they have no reason to change. Planning strategies to help the stroke survivor become aware of their actions and their effect can help.

Everybody needs to find their own way of coping with these changes and this will take time. There can be grief about the survivor no longer being the same person they were before. Just like in life, personality after stroke will continue to change over time. Immediate changes in personality are not always permanent.

Speak with your doctor or health professional. Treatment such as psychological interventions or behavioural management strategies can help. It can also be helpful to talk to trusted family members and friends, so that they understand what is happening and can provide support.

Personality changes

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headspace: National Youth Mental Health Foundation

Your Guide to Managing Behaviour after ABI - BrainLink