Personality Change

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Personality Change

• Identity and Relationships After Stroke

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What is Personality?

• Personality refers to our individual way of
  thinking, feeling and behaving.
• Generally when someone is talking about an
  individuals personality, they will talk about
  their behaviour, mannerisms, characteristics,
  feelings, beliefs, opinions and everything else
  that makes somebody the person they are.
• Psychologists have spent years trying to define
  personality, and trying to label the different
  facets and aspects (or traits) that make up
  personality, but there is still no agreement
  about what exactly personality is made up of.
• There are various tests of personality available.
  Some of these test certain traits (e.g.
  agreeableness, extraversion) whereas others may
  test for a type of personality.

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Common Personality Changes after Stroke

• Becoming short tempered
• An increase in aggression/anger
• Increased anxiety and worry
• Low mood and/or apathy
• Increase in frequency of shouting/swearing
• Reduced patience, or less easy going nature
• Uncaring, unsympathetic attitude
• Making inappropriate comments
• Increased impulsiveness
• Dissatisfied easily

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Personality

• There is a very thin and blurry line between
  emotions, behaviour and personality.

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Personality
6
Phineas Gage

• One of the most famous cases of brain injury
  causing personality changes is that of Phineas
  Gage.
• He became impatient
• Had little restraint, acted on his desires
• He used swear words regularly
• He became erratic, impulsive and indecisive
• Lacked respect and seriousness
• Became very stubborn, likely to disagree with
  others
• Previous to his injuryhe possessed a
  well-balanced mind, and was looked upon by those
  who knew him as a shrewd, smart businessman, very
  energetic and persistent in executing all his
  plans of operation. In this regard his mind was
  radically changed, so decidedly that his friends
  and acquaintances said he was "no longer Gage".

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Personality Change

• It can be extremely difficult to provide care and
  unconditional love/attention for someone who
  often seems ungrateful and/or treats their
  caregiver with little respect.
• Changes may only be noted by primary caregivers
  or family.
• Personality change after stroke is not something
  that remains static as with physical
  differences, there can be improvements/changes
  over time.

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What Can You Do?

• If a patient or relative is reporting personality
  changes, one of the first things you should do is
  try to identify the reason behind the changes.
• Rule out sleep problems Most of us have at some
  time experienced sleep problems whether due to
  internal causes such as an illness, or external
  causes such as a new baby. After a poor nights
  sleep, or multiple poor nights sleep we are
  often at our most irritable/impatient.
• Rule out emotional disorders Depression or low
  mood can cause any number of changes in
  behaviour, and often these are mistaken for a
  change in personality.

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What Can You Do?

• Are they receiving enough support? - Without the
  correct support, people can quickly become
  frustrated and impatient with both themselves and
  those around them.
• Talk to the stroke survivor With personality
  change, the stroke survivor may genuinely not
  realise that they are any different. If family
  and friends skirt around the issue and dont
  mention it for fear of upsetting the person
  affected, they may never realise that there is a
  problem.
• Communicate and provide information - sit down
  with friends and relatives and explain a little
  about personality change after stroke, ensuring
  they realise that it is a common issue and that
  it will often not be immediately obvious to those
  who dont spend day in and day out with the
  stroke survivor.

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What Can You Do?

• Educate - If a stroke survivor, or relative is
  reporting personality changes, they should be
  provided with information about personality
  change after stroke, including how and why it
  occurs. They will then understand not to take any
  negative changes personally and realise that the
  stroke survivor is not necessarily able to
  control their actions or behaviour in some
  instances.
• Use recording With permission from the stroke
  survivor, video or sound recordings can be a good
  way of illustrating how personality/behaviour has
  changed if they are unable to recognise the
  changes themselves.

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Summary

• Personality and/or behaviour changes can occur
  for a number of reasons after an individual has
  had a stroke.
• Often, it is not the stroke survivor themselves
  that reports the problem, but family and friends
  who can sometimes be on the receiving end of
  uncharacteristic behaviour.
• Relatives will need education to understand
  personality change, and support to help them to
  care for their loved one, and be patient with
  them, in what can be very challenging
  circumstances.
• Sometimes, helping the patient to see the issues
  will allow them to take control of the problem
  and work towards change.