Defeating a brain tumor involves much more than just “surviving” the surgical operation and the endless sessions of radiotherapy or chemotherapy. It goes beyond that. “Survivorship” is a constantly evolving process. So, even after the successful wrap up of your brain surgery, you’ll be closely monitored for any changes or recurrence through periodic follow ups, depending on the type and grade of tumor you fought. Another fact that cannot be denied is that the brain tumor and its treatment do leave the patient transformed on an emotional and physical level.
After the long process of diagnosis and treatment, it’s quite probable that you may not feel the same. There is a change experienced in the behavioral pattern and the process of thinking in most patients during and/or after the brain surgery. However, the degree of modification in personality differs from one person to another. Some of the differences are barely noticeable, others are mild and some quite dramatic- for example: abusive behavior or a disturbing phase of depression.
What Causes Personality Changes
Some of the factors that contribute to personality variations are:
The size of the tumor– Large sized brain tumors bring about more significant changes than smaller ones.
However, location plays an important role too. Tumors that are smaller in size but are developing in an important lobe of the brain can unleash the same extent of destruction as a large tumor mass.
Type of tumor– Slow growing brain tumors, such as Pilocytic astrocytomas, do not bring about much change because the tissue has sufficient time to adapt. On the other hand, pituitary tumors have quite an impact on your personality by causing over- or under-production of hormones. Such variations in the hormonal balance cause changes in emotions, mood, sexual function and bodyweight.
Side effects of Neurosurgery
Every surgery is planned to remove the troubling growth, but it can cause certain personality variations too. The changes begin right from the treatment phase. Radiation therapy, chemotherapy and medications also have their effect on personality. How? Radiotherapy produces swelling of the brain, which leads to symptoms of abrupt headache, vomiting and feelings of irritability.
After radiation therapy sessions, the majority of patients feel very fatigued. This has its impact on behavior too. Likewise, chemotherapy causes a certain decline in routine physical functions. Loss of hair, appetite, and consequent anaemia have a discouraging effect.
‘Chemobrain’ is a phenomenon which is commonly experienced by those undergoing chemotherapy and is marked by differences in thinking and overall personality. After this therapy, changes in cognition and emotions may be as follows- Loss of memory, attenuated thinking and attention span, exhaustion and anxiety. Other biologic therapies have reported changes such as slow memory decline, reduced motor skills, reasoning ability and mood disturbances.
Dexamethasone given for edema control makes the patient feel restless and depressed. Drug interactions such as those between anti-epileptic and chemotherapy drugs cause confusion, speech slurring, impairments in gait and excessive drowsiness. Lack of proper sleep, dispiritedness and uncontrolled aggression is sometimes observed. Modifications of the dose can effectively control such side effects.
These are changes in personality that are not related to medicine and occur from the time the patient faces the confirmation of a tumor in the brain. Emotions go haywire and can result in extreme anger, weeping for hours, laughing at things that are not funny and extensive depression.
Depression- Depression is related to disruptions in the activity of the brain. Approximately 90% of brain tumor patients exhibit signs that are consistent with depression, especially post surgery. You may feel frustrated, sad, alone, along with feelings of self worthlessness. Many lose interest in their usual activities as well as hobbies, feel miserable and they become socially isolated.
Disorientation- Many patients frequently complain of difficulty in focusing and of episodes of intense distractibility. Those who have recently undergone brain surgery find it complex to manage too many details all at once. The same occurs with the number of people he/she sees once out. This is probably caused by overstimulation. To manage this effectively, the patient should be asked to keep notes on what type of situation or sounds trigger the most problems. For example, if the radio is on in the background while speaking over the phone and causes disorientation, the radio must be turned off immediately.
Caregivers must choose their words carefully. For instance, it’s better to break down a “to do list” into easier sub-parts. The chore of cleaning the kitchen can be segregated into many small tasks such as washing the cups, placing them in the cupboard and so on.
Aggression- Combative behavior or aggression is also seen in a few cases. Sometimes it is due to the prescribed medications. Such situations can be managed by regulating the dose of the drug and by giving tranquilizers to stabilize the mood. How to deal with such situations? Agitation and in rare cases, violence, surface after a few warning signs. Try to keep note of such signals. Maintain a calm environment by reducing the bright lights and noise in the house during such a phase. Do try to have a conversation and find out what the problem is.
You might experience new behavior patterns such as a tendency towards obsessive compulsive habits or forgetting things more frequently. If you have witnessed some of these alterations in your personality, you must inform your medical team. There is help available. A licensed psychologist can prove to be of great help in your situation. Accordingly, a rehabilitation plan can be designed for you.
Keeping your feelings bottled up will make you feel low and dejected. Speak openly about your problems to overcome these traits. Together with therapy and medication, you’ll regain normal functioning soon enough.