Could this be something to do with head injury?
 

Please help.

My absolutely beloved husband changed seemingly overnight from the most kind, loving, sweet, gentle man into an absolutely evil monster and I am lookign for ides to find out why.

All I can think of is that he had a brain injury in early 2013, when he fell down the stairs onto a wooden floor about 15 feet directly onto his head. The force was such to the back of his head that is "exploded" the top of his head and he lost a large patch of skin and hair.

At the time, he did not lose consciousness so he never had an MRI or CT scan or whatever.

He had bad concussion for about 3 weeks where he showed extreme tiredness, extreme irritability and a loss of personality. After that though he seemed to go back to normal.

He then started over about six months to have sleep difficulties, some irritability and frequently missed work which is very unlike him. He was under a great deal of stress at the time so I put it down to that.

Then he had some sort of complete breakdown, after which he became unrecognisable.

Since then he seems to be cruel, mean, vicious, lacks empathy, is glib and very angry.

He was diagnosed with depression which was quite severe and is being treated for it but almost a year later despite treatment he is not much better.

It is like the person I loved is completely gone. He feels no love towards me, and he was really loving and devoted before and I am just confused and at my wits end.

Could this be something to do with his fall? If so what do I do?

Hello Amy. I am so sorry to hear about your struggles. You have found the right place to ask questions. I do no think an MRI or CT scan would do much help now, but the answer to your question is YES! It's scary and unreal how a brain injury can manifest itself. So many on here have a vast array of symptoms.

Stress, anxiety, sleep disturbances and personality changes are something that are all too common to many of us. For example. I went from a fully functioning mother of two, in nursing school and social butterfly to an anxiety filled social introvert that can barely take care of my family. As you have felt, the burden on the "well" spouse is beyond overwhelming.

Please try to hold close to the fact that this is not him but his head injury. There are several antidepressants (I am on two, one in the morning and then one at night for sleep) and therapy that may help.

Mark in Idaho will more than likely be along soon and is VERY knowledgeable about all aspects of brain injuries and treatments. You will find much comfort on this board as so many can relate to the problems.

Again, I'm sorry for the rough time that you have had. Unfortunately, this has no defined timeline or "cure-all" pill. But please don't be discouraged. I know it is hard to think of now but there is a reason for everything that happens. I don't really like the saying that God won't bring us more than we can handle because things happen in life that are just about more than we can take. I do think that this is the time to pray for courage, strength and to have an open heart that we may see God's plan for us.

Amy,

Welcome to NeuroTalk.

It sounds like your husbands personality change could be due to his concussion. The stress he experienced could easily cause a relapse of concussion symptoms and the personality change.

He needs help. You need to search for a doctor who understands his condition. A neuropsychiatrist may help. A rehab doctor/physiatrist (Physical Medicine and Rehabilitation) may help. Do you have a rehab hospital near by ?

If we knew the city you are in, we could do some online research.

In the mean time, it would help if you can get him on a vitamin and supplements regimen like the one in the Vitamins sticky at the top.

My best to you both.

Thank you so much for those responses. In the interest of keeping my post short I did not mention that unfortunately when this personality change hit and he became very angry and aggressive he moved out of the family home and largely refuses to speak to me.

It is hard to express how complete and shocking his personality change has been but he went from being the most lovely person in the world to being paranoid, hateful and nasty. He seemingly has no empathy at all for the feelings of me or the children.

There's no other woman or anything like that, he now lives alone, has lost a great deal of weight, rarely leaves the house other than to go to work.

He is being treated for depression with SSRI medication and while it did help him to stabalise to the point of functioning, it also damped his emotions further and since being on them he is absolutely devoid of human feeling of any sort and he readily admits this.

Unfortunately, as we live in the UK, access to proper care is weak at best. He did see a general practitioner who is monitoring the depression but for whatever reason the doctors seem oblivious to the fact that the SSRIs are not working.

I suggested to the doctor that this might be due to his head injury and the doctor said that it was unlikely and was probably just depression but I think the doctor fails to understand the extreme nature of his personality change!

I am trying to be supportive from a distance, but really am starting to wonder if I was just married to a sociopath who lied to me for years about who he was. Someone told me today that I should visit this forum for advice and I really hope somehow I can keep faith that there are medical reasons for all this and try and find ways to help.

There was a period of 6 months between the head injury and the onset of all of this. Or at least it was a gradual onset. For that reason I think the doctor dismissed it as unrelated.

My husband has the capacity to work and act relatively normal in front of most people - but behind closed doors he is mean, aggressive, has memory problems, is ragingly angry for no reason and admits he feels hatred at me and does not know why

Amy,

Have you contacted Headway ? Many in the UK find Headway to be helpful.

I do not think you married a closet sociopath. His great personality is who he is. His current personality is his injury talking. I suffered my first serious head injury when I was 10 years old. My personality changed drastically. As my mother puts it, She lost her sweet little boy. I lost all of my friends.

Hear is a good explanation of the injury caused personality change. Scroll down and read the paragraph on Personality. http://www.nasponline.org/publicatio...in-injury.aspx

Becoming knowledgeable may help you get him the care he needs.

If his SSRI is prescribed by a GP, he needs a much higher level of care. Which SSRI is he taking ?

Thanks so much Mark, I had never heard of Headway but will contact them and also explore that link.

I do feel like my sweet husband has disappeared.

The SSRI is Citalopram which I think is called Celexa in the US. It has had just a dreadful effect on him. He is cheerful all the time on it - but almost in a chilling way. Like the "laugh at a funeral" kind of way.

He is only seeing a GP...nothing beyond that, and unfortunately as he acts perfectly normal in front of the GP there's not very much I can do.

The only thing I have on my side is that he was convinced at first he simply needed to take his medication and he would be fine, and over time we are approaching a year of this and he is not remotely better so perhaps as time passes he might finally admit this treatment is not managing the problem he has.

He does seem to be peripherally aware there is something deeply wrong with him. He tried to come off the SSRIs last month as he knows the disconnect him -and when he did he was at my front door crying his eyes out, apologising and telling me he was sorry and did not understand any of what he's done. I feel like he is in there somewhere and I think he feels it too.

I just feel like this is way beyond normal depression.

I have been on citalopram since last November. I am in the process of weaning off it. Was 20 mgs daily. Now 10 mgs daily. It is not good to stop it cold turkey. I suggest he try taking L-Typtophan and L-Theanine supplements as he is getting off the citalopram and continue them after getting off the citalopram.

He will likely benefit from the vitamin regimen. I can't function without it. He is likely deficient in B-12, folic acid, D-3 and could benefit from Omega 3 and all the anti-oxidants (E, C etc) If he is aware of his struggles to the level you say, I would think he would be open to new ideas.

My best to you both.

Thanks Mark

He is open to things. I have managed to get him exercising three time a week and I do have him on Omega 3, B12, Evening primrose and a multivitamin. At times he does let me look after him and I read online it helps with depression. I will look into those other suggestions too - thank you.

If his more broad personality changes are down to his brain injury....does that mean it is permanent. What can be done?

Once you get him to his best level of recovery, the remaining personality issues can be addressed with counseling and other means. It would not hurt to start working on them now. He can be taught behavior modifications in place of his 'natural' reactions. Once he has come to understand how he is behaving and that much of it is due to his injury, he can learn coping mechanisms. Many of us have learned we need to just walk away from situations.

The flat affect (lack of emotion) can be due to injury or medication. Either way, he can learn to be more responsive, even if it is from a trained, mechanical type of behavior. I know this one well. I have struggled to be naturally responsive for over a decade.

For me, I see situations and have to analyze them. Rather than responding to how I feel, which is usually flat, I ask myself, should I express happiness, love, compassion, etc. Then I try to express than attitude. Yes, it is very dry and mechanical but it can work. Other than my memory struggles, this is by far my biggest struggle. As much as you miss the old him, he also misses the old him. Some of his behaviors may be due to his frustrations.

Regarding vitamins, unless the multi is a mega dose type, it is probably so lacking as to be almost useless. Multis are usually best for including the trace vitamins and minerals but low on dosage for the important vitamins like B-12, B-6, and others. He does need good D3. Low D3 can contribute to depression.

It would be worthwhile to get some blood work done. Thyroid, B-12, folate, magnesium, D3, and hormones plus some others I do not remember.

Sounds to me like he's hurting. He knows he's not as he was and is having difficulty coping, I agree with Mark about contacting Headway who can offer help and support. But I'm not surprised he was prescribed citalopram I reckon the NHS must have a massive warehouse of the stuff! Anti depressants can make you feel numb and detached, everyone reacts slights differently to them, old AD's like amiltryptaline or nortryptaline in low dose is the usually the first course to be offered PCS sufferers. I suspect he didn't realise he had concussion and ended up doing too much which has aggravated it.