Do strokes cause personality changes? (11 ways)

This blog post aims to answer the question, “Do strokes cause personality changes?” and explore the various aspects of a stroke and personality and their relationship to help understand the answer. 

Do strokes cause personality changes?

Yes, strokes can cause personality changes. A stroke alters the survivors’ as well as everyone else’s lives. Survivors not only go through bodily changes, but they also go through personality changes that range from indifference to disregard. Some survivors appear to be unconcerned about anything. 

Strokes can cause personality changes in the following 11 ways –

• Depression.
• Social Avoidance.
• Loss of Cognitive Skills.
• Emotional Instability.
• Lack of Motivation (Post-Stroke Apathy).
• Aggression.
• Lack of Stroke Awareness (Anosognosia).
• Lack of Empathy.
• Loss of Sense of Humor.
• Loss of Social Inhibitions.
• Jealousy. 

What are these 11 ways in which strokes can cause personality changes?

Depression.

Depression is a frequent personality change that occurs after a stroke, with up to 33% of stroke survivors experiencing depression. Although precise figures are difficult to determine, data shows that those who have had a stroke are more likely to report depression than those who have not.

Causes –

Physical restrictions: You may feel disempowered or handicapped as a result of the limits imposed by a stroke, such as weakness, visual loss, and coordination issues.

Health concerns: Following a stroke, you may be concerned about your health or anxious about your own death. Post-stroke depression might be exacerbated by thoughts of powerlessness or hopelessness.

Brain changes: Stroke-induced injury to the brain can cause changes in how it operates, resulting in altered biological activity and sadness.

Treatment delays: Many people are hesitant to seek help for depression. Some stroke survivors are worried about what others may think of them. Other survivors may be sceptical about the treatment’s efficacy.

Social Avoidance.

Stroke patients frequently feel social anxiety. One-fifth of stroke and TIA (transient ischemic attack) patients had an anxiety issue, according to a 2018 study. The majority of persons engaged try to stay away from particular settings, such as social events.

Causes –

Changes in your brain from the stroke may induce anxiety, including social avoidance. If you’re having health problems, you’re more prone to experience anxiety.

Some stroke survivors have significant difficulties that make driving, leaving the house, and even getting out of bed difficult. A severe handicap may entail relocating to a different living situation in order to receive support with 

everyday activities.

All of these things might make you feel anxious and make you avoid social 

interactions. This can exacerbate loneliness, creating a vicious cycle that is difficult to break without a well-thought-out strategy.

Loss of Cognitive Skills.

Language, problem-solving, reading, and simple arithmetic operations are all affected by cognitive changes. Some stroke survivors lose their memory, forgetting names, misplacing items, or failing to complete key activities.

Confusion or difficulty understanding topics that a stroke survivor could previously grasp can also be caused by cognitive problems. Cognitive decline may be upsetting, and many people make explanations for making frequent errors. To avoid shame, they may even lie about mistakes.

Causes –

After a stroke in practically any part of the brain, cognitive functions might be lost. Strokes affecting the frontal lobe, parietal lobe, or temporal lobe are the most common causes.

Emotional Instability.

Stroke survivors may become abnormally emotional, sobbing or laughing in unsuitable places. Some people suffer from pseudobulbar affect, which is characterised by mood swings and unrestrained emotional displays.

Causes –

Parts of the brain that govern emotional reactions can be damaged after a stroke. This is most likely due to a neural (nervous) circuit in your brain. 

The cerebellum is part of this system, and it helps us keep track of our emotional expression. A stroke might damage this route, making it harder to manage emotions.

Lack of Motivation (Post-Stroke Apathy).

A stroke can cause apathy, which is characterised by a lack of drive. After almost any form of brain damage, apathy can develop. You may have less desire to see friends and family and participate in activities that you typically like. Apathy has been demonstrated to have a detrimental impact on your health and quality of life studies.

Causes –

Many tasks might appear excessively difficult and unsolvable after a stroke due to a reduction in cognitive ability. 

Post-stroke sadness, having less responsibility after the stroke, and the idea that “nobody will notice” what you do can all contribute to it. Apathy can also be caused by changes in the brain’s structure and function as a result of the stroke.

Aggression.

Some stroke survivors become irrationally resentful and enraged, behaving in cruel or physically abusive ways.

Causes –

Aggression, like other behavioural and psychological changes linked to stroke, is frequently a result of both emotional reactions to the stroke and stroke-induced brain impairment.

Stroke survivors who have had a big stroke or who have a stroke pattern that causes vascular dementia are more likely to be aggressive.

Vascular dementia develops when a series of minor strokes occur over time, accumulating lesions throughout the brain. It’s marked by a loss of memory and cognitive abilities, as well as disorientation, difficulty finding objects, difficulty following directions, and behavioural changes.

Lack of Stroke Awareness (Anosognosia).

Anosognosia is a mental illness in which patients refuse to accept their diagnosis. Anosognosia is a term used to describe overconfidence and a lack of understanding that anything is amiss following a stroke. 

An individual with anosognosia may be astonished to learn that medical help is available at all. Stroke survivors with anosognosia pose a difficult dilemma for loved ones and caregivers trying to help them. 

They are frequently greeted with resistance to the services they deliver. Stroke survivors with anosognosia sometimes disregard or reject individuals who are attempting to assist them.

Causes –

Anosognosia in stroke patients can be caused by a variety of circumstances. Anosognosia has been connected to impairment to the right hemisphere of the brain in several studies. Other risk factors include advanced age, prior strokes, and mental health issues.

Lack of Empathy.

Following a stroke, a patient may become less empathic toward others. Empathy refers to the ability to perceive things from another person’s perspective. The stroke patient may say or do things that are damaging to others if he or she lacks empathy.

Friends and loved ones are generally saddened by a lack of empathy after a stroke, but the stroke survivor usually goes unrecognised. It can lead to egotistical conduct and strained relationships.

Causes –

After a stroke, brain damage on the right side of the brain is the most common cause of a lack of empathy. Their impressions of other people’s emotions and facial expressions may be harmed as a result of this injury.

Loss of Sense of Humor.

Humour necessitates intelligence and rapid thought. Humour is frequently founded on the awareness that when disparate thoughts that do not belong together are combined, they become humorous and hilarious.

A stroke survivor’s sense of humour might be affected by a variety of factors. A stroke victim who was once amusing may lose the ability to tell jokes. Someone who used to be able to detect and laugh at jokes could no longer be able to.

Causes –

The right frontal lobe of your brain is where you get your sense of comedy. People with injury to the right frontal lobe have problems comprehending jokes and cartoons, according to research from the University of Toronto. 

They grinned and laughed less, and they couldn’t figure out what punch lines to use.

Loss of Social Inhibitions.

Some stroke survivors may act in ways that are seen as socially unacceptable. Taking food from a stranger’s plate, criticising someone aloud, and even undressing or peeing in public are all examples of inappropriate behaviour.

Stroke survivors who engage in socially undesirable conduct frequently lack the capacity to recognise that their activities are inappropriate. They’re not likely to apologise or try to make amends.

It can be difficult for caregivers and family members who are responsible for a stroke survivor’s safety and care.

Causes –

The most prevalent cause of this socially unacceptable conduct is a frontal lobe stroke. This section allows you to make predictions about what will happen and, if required, make behavioural modifications.

Jealousy. 

Some stroke patients may suffer out-of-character levels of acute, unjustified jealousy. Othello syndrome, named after a character in a Shakespearean play, is caused by a rare form of stroke.

Irrational and unjustified jealousy, especially in the context of love relationships, characterises Othello syndrome.

Causes –

Stroke survivors with a right cerebral cortex lesion may develop Othello syndrome. This region of the brain was impacted in case studies in patients who had grown irrationally jealous and accused their partners of adultery.

After a stroke, personality changes are frequent. Physical changes in the brain may be to blame for some of the alterations. Others might be triggered by the stress of adjusting to life changes and physical constraints as a result of the stroke.

Some personality changes may improve on their own, while others may require treatment or medication.

What is personality change?

Personality characteristics are broad categories of individual variations that relate to how we interact with our social environments. They support our ability to think, behave, and feel consistently in a variety of contexts and across time.

Early childhood temperament variations, which are partially genetically driven and influence exposure to social situations, are assumed to be the source of adult personality characteristics. There are five personality dimensions in all.

The five factors are: “extraversion or positive emotionality (incorporating traits such as sociability, energy, shyness and dominance/subordination); neuroticism or negative emotionality (including lower‐order traits such as proneness to anxiety, irritability, sadness, insecurity and guilt); conscientiousness (factors such as reliability, carefulness, persistence and self‐control); agreeableness (cooperativeness, consideration, generosity, kindness and politeness); and openness to experience (imaginativeness, insight and aesthetic sensitivity)”. 

Individuals differ in all of these characteristics, therefore each individual is regarded to have a unique set of traits. Personality factors influence the quality of social and familial connections, marital status and satisfaction, career choices, political opinions, and crime with moderate consistency.

Your personality might evolve during the course of your life. It’s natural to have mood swings from time to time. Unusual personality changes, on the other hand, might be an indication of a physical or mental problem.

A personality shift can manifest itself in a number of ways –

• A personality shift is indicated by behaviour that differs from how you would normally behave in the same situation.
• A person’s mood, aggression, or euphoria are abnormally moody, aggressive, or euphoric in comparison to their regular behaviour in comparable conditions, indicating a personality shift.

Examples of personality change –

• Being unconcerned in conditions that would typically induce anxiety or worry.
• Being glad when hearing bad news.

What can cause a sudden personality change?

While a gradual shift in personality isn’t uncommon, an accident or sickness might create an abrupt transformation.

A generally joyful individual might become depressed as a result of grief, unpleasant news, or disappointment. After hearing the sad news, a person’s mood might be affected for weeks or months.

Some people have had bizarre or aberrant behaviour for years, which might be caused by disease or injury. After being exposed to a stressful scenario or seeing an unpleasant incident, a person’s demeanour may shift.

These behavioural changes may be caused by a mental health condition, such as –

Anxiety.

When a person feels apprehensive or unpleasant about a situation, they are said to be anxious. It’s natural to feel anxious from time to time, but when it happens without warning, it might be an indication of generalised anxiety disorder.

Panic attacks.

Panic episodes are intense bouts of dread. Fear might appear to be illogical at times. A person suffering a panic attack while seeing an elevator or speaking in public is an example of such a circumstance.

Post-traumatic stress disorder.

This mental health disease, also known as post-traumatic stress disorder (PTSD), is characterised by acute terror, flashbacks, and, in some cases, hallucinations. Traumatic memories, such as a terrorist attack or a vehicle accident, might cause PTSD.

Bipolar disorder.

Bipolar disorder is characterised by mood swings that are intense. Mood swings may range from exhilaration to severe sadness, and they might modify how a person reacts to specific encounters or events, depending on their mood.

Schizophrenia.

Schizophrenia makes it difficult to think clearly, interpret circumstances efficiently, behave appropriately in social situations, and discern what is genuine from what isn’t.

Strange or odd behaviour might be caused by medical problems that cause hormone levels to fluctuate. These conditions include –

• menopause
• premenstrual syndrome (PMS)
• andropause (male menopause)
• hyperthyroidism or hypothyroidism (an overactive or underactive thyroid gland, respectively)

Medical emergencies that can cause strange or unusual behaviour include-

• heart attack
• stroke
• dehydration
• malnutrition

Conclusion – 

This blog post aimed to answer the question, “Do strokes cause personality changes?” and reviewed the various aspects of a stroke and personality and their relationship to help determine if strokes can cause personality changes. Please feel free to reach out to us with any questions or comments you may have.

References – 

Personality Changes Post Stroke. American Heart Association. (2018, November 30). Retrieved from  https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects-of-stroke/personality-changes-post-stroke#:~:text=A%20stroke%20changes%20life%20for,seem%20to%20care%20about%20anything.

Moawad, H. Personality Changes That Can Be Caused by a Stroke. (2021, October 05). Retrieved from  https://www.verywellhealth.com/personality-changes-caused-by-a-stroke-4112351

Stroke: Emotional & Behavioral Changes. Cleveland Clinic. (n.d.). Retrieved from  https://my.clevelandclinic.org/health/articles/13485-stroke-emotional–behavioral-changes

Changes to behaviour. Stroke Association. (n.d.). Retrieved from  https://www.stroke.org.uk/effects-of-stroke/changes-to-behaviour

Emotional changes after stroke. Stroke Association. (2012, April). Retrieved from  https://www.stroke.org.uk/sites/default/files/Emotional%20changes%20after%20stroke.pdf

Hoffman, H. Can a Stroke Cause a Personality Change? (2019, February 4). Retrieved from  https://www.saebo.com/blog/can-stroke-cause-personality-change/

Reese, D. Depression, Anxiety, Other Emotions After a Stroke. (2021, July 20). Retrieved from  https://www.webmd.com/stroke/after-stroke-emotions

Kim J. S. (2016). Post-stroke Mood and Emotional Disturbances: Pharmacological Therapy Based on Mechanisms. Journal of stroke, 18(3), 244–255. Retrieved from  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066431/

Behavior Changes After Stroke: Why They Happen & What It Means. Flint Rehab. (2021, August 24). Retrieved from  https://www.flintrehab.com/behavior-changes-after-stroke/