In the movies, a head injury is often portrayed as something that causes memory loss, followed by a series of hilarious and dramatic events, followed by a recovery and a “happily ever after.” For those of us who have actually lived through a loved one having a stroke, traumatic brain injury or a disease that changes the brain like dementia, it can be a lot less entertaining.
Did you know that those individuals who do suffer a brain injury will more than likely have an actual change in their entire personality? 59% of individuals with an acquired brain injury have some noted change to their personality. This can have a large impact on many areas of their life, but also greatly impacts those people who are in a relationship with them.
For years as a nurse and then a nurse practitioner, I witnessed many examples of this. For instance, someone who was a church leadership position may have had a stroke, resulting in the vocabulary of a sailor. Or a quiet and timid elderly woman may develop dementia and now constantly act out in sexually inappropriate ways. To say this is a shock to a family, in an understatement.
Another perspective on this is for those who have significant others who suddenly have a 180 degree change in personality. Mark is the perfect example of this. Mark was very serious and very intense all of the time. I used to joke that I was going to buy him a sense of humor for Christmas. After his recovery from his brain injury, when he became stable and we were able to see this version of Mark, post-brain injury, he was completely opposite. Mark now laughs all the time. Mark laughs at everything and anything. While this was so funny at first, 7 years later it has presented as a challenge at times. If I cry because something bad happens, Mark laughs. If someone tells us bad news, Mark laughs.
Often those who are closest to a brain injury survivor can find this to be very distressing and often find it difficult to adapt to. You are not alone. This is hard. While you may not have been the one who suffered the brain injury, this result will have a direct impact on you personally as well as on the dynamic in your relationship. Whether you are the child of the person impacted by a brain injury or the spouse or even the sibling. I am here to tell you that it is totally normal to feel like “Who is this person?”
Some of the most common changes are often depression, inappropriate laughing or crying, impulsiveness, lack of self-awareness, agressivenss and agitation. These changes are often caused by the specific type of brain injury and which area of the brain has been impacted by the injury or disease. There are treatments available to help with managing these changes and symptoms, but I will warn you that they will likely not be improved overnight.
Medications, therapies, relearning social cues and situations are all methods of helping your loved one with a brain injury ease back into the world and social situations. Personally, the most successful cases I have seen have been families that use multiple modalities to help resolve any concerns or issues that might prevent the person from living a life with quality.
There are medications that help with spontaneous crying. There are ways to help set up the environment your loved one is in to remind them to avoid impulsive actions that might lead to injury. There are special therapy groups that help to relearn how to pick up on social cues. A great place to start is any local support group that is specific to your loved one’s injury, disease or cognitive disability. Also, work with your loved one’s health care team. Many local healthcare systems have inexpensive or free support groups that involve multiple specialists that can help build a comprehensive plan to bring things to a new normal for you and your loved one.
Mark is not the same person I married at all. In all honesty, the shift has been difficult. There are certainly times when an old video will pop up on my Facebook memories and I will hardly recognize the old Mark. For a long time I felt so much guilt when I would miss the old Mark, like I should just be grateful he didn’t die. I know now that I can still love and care for this new version of him, while I miss the fella I actually married.