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How brain tumors cause personality changes

In general, there are three main ways a brain tumor diagnosis can cause mood or personality changes. It is important to know that not everyone experiences these changes.

Stress from receiving a brain tumor diagnosis

No matter how aggressive they are, brain tumors can affect aspects of what makes you feel like yourself.

Malignant brain tumors, such as glioblastoma, can be aggressive and difficult to treat. A malignant brain tumor diagnosis is often sudden and overwhelming. This stress can affect how you feel, perceive the world and interact with those around you. Loved ones may notice changes in your personality as you navigate this emotional time.

Benign brain tumors can also cause stressors that might impact your mood and personality. You may feel uncertainty about what the diagnosis means to you or struggle with symptoms related to the tumor or treatment.

For example, acoustic neuromas are slow-growing, non-cancerous tumors. They grow around one of the nerves that goes to the inner ear, so surgery to remove the tumor sometimes causes facial drooping. Appearance changes like this can contribute to someone who was previously very extroverted becoming more withdrawn.

Some people¡¯s emotional distress may lead to anxiety or depression. Some people may also experience dissociation. This is a psychiatric condition in which you feel like you¡¯re not inhabiting your body, or that you¡¯re having an out-of-body experience. This may change how you react to certain events in your life. Loved ones might see this as a change in personality or behavior.

Medications to treat brain tumor symptoms

Your doctor may prescribe medications to help you manage your brain tumor symptoms. While the medications are used to help alleviate physical symptoms of the tumor, they could have negative effects on your mood and behavior.

• Levetiracetam is a medicine used to stop seizures, a common brain tumor symptom. But it can cause mood reactions that make people irritable, anxious or aggressive.
• Steroids are used to reduce swelling in the brain caused by tumors, or after radiation therapy or brain tumor surgery. Some people feel very euphoric and energetic while on steroids. Others can become anxious, agitated or manic and unable to sleep or control their thoughts.

Location of the brain tumor

The brain tumor¡¯s location can affect your mood and behavior. That¡¯s because specific parts of the brain are responsible for different elements of mood, behavior and personality. Tumors can disrupt these functions.

Take, for example, the frontal lobes, which control your motivation, restraint and impulse control. A tumor that damages both frontal lobes may cause you to become extremely withdrawn, making it hard to engage with others or initiate activities you used to enjoy. Some people struggle to control their impulses, finding it difficult to stop themselves from making decisions that could harm them.

The insula is a complex part of your brain¡¯s cerebral cortex. It¡¯s involved in regulating your emotions. People with tumors in the insula can have a variety of mood symptoms, including anxiety and a racing heart sensation. In addition, some types of seizures that come from this part of the brain can make your heart beat very fast or make you feel like you¡¯re having a panic attack.

No two brain tumor diagnoses are alike

Mood, personality and behavior are complex. Everyone is different, and a brain tumor will not affect everyone in the same way.

How a brain tumor affects you depends on the tumor¡¯s size, where it¡¯s located and the part of the brain that¡¯s affected. Other factors can influence behavior as well, such as treatments you receive, your overall health and the kinds of support you have access to. Emotional responses are varied and unpredictable, but support and medical care can make a big difference.

Are personality changes from brain tumors long-term?

It depends on what¡¯s causing your personality changes. If your mood changes are being triggered by levetiracetam, we can switch you to a different anti-seizure medication. If steroids are causing the changes, your symptoms may get better once we taper off the steroids.

For some people, things may start to get better as they adjust to a brain tumor diagnosis.

It¡¯s dynamic. Some personality changes can be long-term, but others can improve over time. It¡¯s best to talk to your doctor about prognosis and treatment options.

Advice for caregivers

Caring for someone with a brain tumor can be challenging, especially because the patient may not be aware that they're behaving differently than they did before their brain tumor diagnosis.

That means both the patient and caregiver are learning how to navigate changes in the patient¡¯s mood and behavior.

The phrase ¡°you can¡¯t pour from an empty cup¡± really rings true here. It¡¯s important to be kind to your loved one facing a brain tumor. And it¡¯s just as important to remember to be kind to yourself, too. It¡¯s common for caregivers to feel frustrated when their loved one¡¯s mood or behavior is different than it used to be and even feel guilty about experiencing that frustration. While it¡¯s good to be as understanding and accepting as possible of your loved one, it¡¯s also human to grieve the person you knew before their diagnosis.

This can be hard for caregivers. You may think, ¡®What I feel doesn¡¯t matter or shouldn¡¯t matter because the focus is on my loved one.¡¯ Yes, your loved one is the person dealing with a brain tumor. But caregivers need to give themselves grace, too. We¡¯re all dealing with these things the best we can.

Sometimes there aren¡¯t easy answers or quick fixes, but having a strong support system helps. It¡¯s important to take care of yourself, and remember: it's OK to ask for help. 

How to cope with personality changes due to a brain tumor

Coping with personality changes due to a brain tumor isn¡¯t something you have to go through alone. Talk to your doctor if you or your loved one is struggling with a brain tumor diagnosis. They can help you get the support you need.

If you¡¯re an MD Anderson patient, you have access to several resources.

• Psychiatry
• Supportive Care Center
• Neurocognitive testing with Neuropsychology
• Social work counselors
• Chaplain

Your moods, emotions and behaviors are so complex and layered, so we really try to take a team approach to address them. Brain tumors don¡¯t just have a physical impact on your health. We want to make sure we treat the brain tumor and take care of your mental health as well.

With treatment, support and time, many patients and their loved ones find ways to adapt, and in some cases, symptoms can improve significantly.

, is a neuro-oncologist at MD Anderson.

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