Sudden personality change in a 54 year-old man

May 6, 2005 5:20 PM

What would be the cause of a sudden and radical personality change in a 54 year old male?

An older friend of mine has recently undergone a nearly complete personality switch. He was a salt-of-the-earth kinda guy, extremely reliable, very attentive and loving to his wife, somewhat taciturn but definitely the sort of person you would want on your side. His relationship with his wife was solid and they never fought seriously or had any difficulty in the eight years they were together.

He recently had a vasectomy (his wife is quite a bit younger and they already have one daughter and didn't want another) and afterwards 'somewhat taciturn' has morphed into being 'completely unresponsive emotionally'. He has started fights with her, won't tell her how he feels beyond "I don't think I love you anymore", and has been competely emotionless about her deciding to take their daughter and move out for a while. He's even confessed to using other women for emotional support (there's no evidence of any affairs).

All of this happened almost immediately after the vasectomy and was a complete turnabout from his normal personality. Its not as if their marriage was slowly deteriorating. Everything was great and then one day it wasn't.

So my question is: what caused this? The main reason I ask is because I think, without any evidence to support this, that something physically happened to him (beyond the vasectomy, of course). He's a smoker with abnormally low blood pressure and often suffers from severe nosebleeds, but no other medical conditions that I know of. My original theory was that perhaps he had a small stroke with no physical problems but with the complete switch in personality. However, the research I've done online doesn't seem to indicate that this is the case.

posted by pandaharma to Health & Fitness (21 answers total)

Did he have to go on steroids related to the surgery for some reason? They can cause wild and radical mood/personality swings.
posted by scody at 5:33 PM on May 6, 2005

Could be a stroke, or he could be using drugs. He probably needs to see a doctor. If you are indeed a friend, you can do him and his wife a favor by encouraging him to do so. It will take some diplomacy.
posted by yclipse at 5:43 PM on May 6, 2005

This could be any number of things - for any real answers you're going to have to get him to a physician for a CT scan and perhaps to a therapist of some kind.

That said: My father's personality underwent a similarly dramatic shift, but it happened over time. He's since been diagnosed with vascular dementia, brought on by several small strokes.

Research online won't determine if your friend has suffered similarily. If it's clear that something has gone wrong, he needs to be seen by a professional.
posted by aladfar at 5:47 PM on May 6, 2005

Response by poster: I wish I could drag him to the doctor but, despite being quite a bit older than me, he would definitely take me in a fight and he would fight about any doctor visits. Plus, I'm about 1,402 miles away from him so I can't just drive over to his house and kidnap him.

I know advice and research online is no substitute for a doctor but since I can't get him to a doctor, I was hoping for suggestions and answers which I could then pass along to his wife.

Just got some additional information from his wife: the blood pressure is high, not low. He is not taking steroids. Other than nicotine, the occasional scotch, and high blood pressure medication, he's not on any drugs.
posted by pandaharma at 5:56 PM on May 6, 2005

Sorry, what makes us think this is a medical issue? Having a vasectomy can have very serious emotional repercussions, which he may not have been fully aware of when deciding to proceed with the operation.

Maybe he really is unsatisfied with the relationship, but was hiding or otherwise not fully accepting his feelings until they came to a head.
posted by trevyn at 9:40 PM on May 6, 2005

Sudden and radical personality changes make most health care practitioners think about ruling out things like tumors, strokes, and other blood clots first. Secondary to rule out are drugs and other substances. These are all serious - if he's still with it enough to make his own decisions, obviously it's up to him, but I would strongly advise him to get to a physician, as it could be something that's treatable if attended to, and quite serious if not.
posted by jasper411 at 9:55 PM on May 6, 2005

I don't know that there's enough information here to speculate in any informed way. Are there any friends who see your friend regularly who can contribute their observations?
And is there anyone at his workplace that can comment?
Perhaps his wife could call the surgeon and express her concerns and ask for advice.
posted by peacay at 10:11 PM on May 6, 2005

Response by poster: He owns a store and his employees have observed the rapid changes in personality. So its not just that he's unhappy with his wife; he's treating everyone differently.

I had thought of this situation being just an emotional response to the vasectomy. He didn't want to get it and so a large part of it could be a pissed off reaction.

I know it wasn't necessarily a medical thing but the rapid change definitely made that possibility a chief suspicion.
posted by pandaharma at 10:45 PM on May 6, 2005

Could he be manic depressive, and be having an episode since it's the spring? It could have been mild, but suddenly changed for whatever reason. Perhaps look at the symptoms of Bipolar Disorder, and see if they correspond for some reason. It is thought that the spring brings on the episodes more frequently and/or more severely. IANAD though!
posted by fionab at 10:54 PM on May 6, 2005

If he has any known friends that are still in the picture, maybe one of them could try to persuade him to get checked out. I still think his wife needs to speak to someone and in the absence of any more defined psychiatric or mentation deficit symptoms, the surgeon would be the first port of call. Alternatively or in addition, she may want to consult with a marriage counsellor in the event that it is indeed a stress or emotive reaction to the vasectomy.
I think it's not unknown for an anaesthetic to bring on latent psychiatric problems but again, I wouldn't push this as an explanation -- backburner idea.
There's lots more questions no doubt that could be asked of the wife and pehaps employees and friends to arrive at an explanation/plan of action. It's not really possible online to pursue it effectively I think. But if there's someone that remains close to him, then their assistance getting the husband to either open up a bit and discuss the present circumstances or peruade him to see a Doc. would be my first thought. Good luck.
posted by peacay at 11:04 PM on May 6, 2005

It does sound like the vasectomy could be a (large) part of it. Especially if he didn't want it. If that's the case, though, I don't know what the "fix" would be. From your descriptions, he sounds like the type of person who would be unwilling to go to a doctor and/or therapist.
posted by 6550 at 11:44 PM on May 6, 2005

Could have been a stroke, or change in hormones maybe.

My dad is a completely different person, post-stroke. Sometimes I feel like I'm not talking to my 61 year old father, but a 12 year old kid brother because I have to explain everything. Much of his sense of humor is missing and he's lost pretty much all empathy for others.
posted by mathowie at 11:46 PM on May 6, 2005

Interesting case.

My #1 bet is midlife crisis - depression, anxiety, whatever they're calling it these days.

#2 is brain metastasis from lung cancer, probably to the right frontal lobe.

Of course this kind of armchair work is meaningless. He needs a doctor visit, a counselor/therapist, and a whole lot of other things that it sounds like he's not going to get.
posted by ikkyu2 at 3:45 AM on May 7, 2005

Here's one other suggestion.

One day I was a very laid back, normal, happy person. Life in general was pretty good.

Within the period of a few weeks/months, I was severely depressed every day, to the point of being suicidal. Everything was bleak, nobody could help, and everything just got worse and worse. Eventually I figured out how to control the depression, but it's never really gone away. It's like there's always a dark cloud waiting, ready to encompass me again if I'm not careful.

I believe the change took place one night when I was working as a shift manager at a fast-food joint. I was going out to my car with the night deposit when someone jumped me and beat me about the head with a 2 foot chunk of a shovel handle (the police recovered it not far from the scene) until I blacked out long enough for them to take the money and run.

I went to the hospital, of course. They ran tests, the doctors said everything was ok, but I think the beating damaged some part of my brain enough to really change my personality.

Did this friend of yours fall, or receive a blow to the head that you know of?
posted by ensign_ricky at 8:32 AM on May 7, 2005

ensign-ricky, you underwent severe personal trauma; you don't need a bruised brain in order for that to cause serious depression! It's good to be aware that your personality is chemical, physical, but it's as important to remember that your body is emotional & mental, and can really be affected by events & meanings. Don't convince yourself it's irreversible, and don't dismiss the emotional significance of the incident.

As for the original poster, it sounds to me like the vasectomy is pretty obviously significant. You say he didn't want it and he became much more difficult & uncommunicative after having been pushed to get it anyway. I would not jump to the conclusion that some other, unrelated medical problem coincidentally manifested right at that point, causing issues of anger and resentment... It seems like getting pushed to have a surgery you didn't want could cause that all on its own.

And remember that for a fair percentage of older men, a vasectomy has a somewhat different meaning than it does for our generation. It's becoming more normal and not associated with taking away one's "manliness" or whatever, but this is a recent cultural shift; for this guy it may feel like his wife forced him to be neutered and he's upset about it.

It's hard to say with limited info, and perhaps there's more to it, but I would address the obvious triggers first, and the vasectomy seems the most likely culprit. Also, it's worth remembering that you don't really know how good things were before. I've known couples I thought were in great shape, and after the fact it turns out things were much worse than they seemed. Maybe you're only getting one side of the story; maybe the wife was oblivious to problems that were there all along.
posted by mdn at 8:53 AM on May 7, 2005

it sounds to me like the vasectomy is pretty obviously significant.

I agree - I really can't imagine my partner forcing me to get a vasectomy (or make any really life-changing decisions) under any circumstances. Doing so seems like a sign of really deep lack of communication in the marriage, and I expect that in the aftermath of the surgery, it finally hit home to him.
posted by advil at 11:47 AM on May 7, 2005

This won't help, but it's a similar situation. One of our neighbors (and a very good friend of my wife's) went through something similar at about the same age. She had surgery for cancer, and shortly afterward divorced her husband of 25 years and generally let her two teenaged kids go downhill (the younger son is now a delinquent). In her view, this had nothing to do with her behavior or divorce. The kids are with the father now and hopefully can be reclaimed. The amazing thing is that she was a model of constancy and reliability prior to her surgery. It had us scratching our heads, very similar to your situation.
posted by Doohickie at 12:06 PM on May 7, 2005

My father had a stroke several years ago, and became a mean sonofabitch for about two years afterward. He's mellowed A LOT now, but talking to him about it, he mentioned that he felt like he was suddenly facing his mortality and he was PISSED OFF about it, and he was going act like he was pissed off goddammit, and he didn't care who he pissed off in the meantime. He managed to alienate most of my family during that time, and we're still dealing with the fallout.

I really believe that a fair amount of the behavioral change was also due to physical changes in his brain, but I don't think at the time that I realized how just plain MAD he was. And the problems caused by the stroke kept him from being able to express that anger in any useful way -- he just lashed out at everyone.

So it could be an emotional reaction to the vasectomy, combined (I'm speculating) with an existing inability to express emotions in a healthy way, excerbated by hormones/stroke/some other medical problem.
posted by occhiblu at 2:11 PM on May 7, 2005

A couple of thoughts, maybe relevant:

-- You normally can't just schedule a vasectomy and walk in and have it done - there typically is a mandatory counseling session, or at least some discussion with a doctor before it's scheduled. So there is a puzzle of him "not wanting to get it" and yet doing it.

-- A vasectomy is an out-patient operation, 30 minutes under local anaesthetic. Certainly less (physically) traumatic than a broken arm, for example.

-- Vasectomies are reversible, and at least 60 percent successful (may be much more) these days. The sooner after the vasectomy, the higher the success rate. Cost is on the order of $10-15,000.
posted by WestCoaster at 5:56 PM on May 7, 2005

Other than nicotine, the occasional scotch, and high blood pressure medication, he's not on any drugs.

Almost exactly a year ago, I was diagnosed with high blood pressure. I was at the doctor for an unrelated medical event when the diagnosis was made. For the past year, I have been on numerous medications for the treatment of this disease as success with these drugs seems hit or miss. Some of the medicines did a fantastic job of lowering my blood pressure, but made me, well, a different person. Some of the medicines made me feel as if I was drunk and some did not, but one thing I have noticed is that all of them, in different degrees, affect my temper and disposition.

Currently, I have achieved a level of success as far as the blood pressure and my moods are concerned, but it is far from perfect. Just this morning, in fact, I blew up uncharacteristically at a meeting I was leading. Unequivocally, that would not have happened were I not on this medicine.

Furthermore, I am convinced that my case is not just anomalous because my cousin, unbeknownst to me, was diagnosed with hypertension around the same time I was. When we each found out that the other was trying different regimens to find the right solution, we shared our concerns about what the medicine was doing to us mentally and emotionally. Our experiences were almost a perfect match and, frankly, not drasatically different from the case you describe.

I would strongly suggest you not rule out the treatment for the hypertension as a cause of this. I am not a medical professional, but I would be more than happy to discuss the specifics of my case with you via email if you think it would help.
posted by samuelad at 8:40 PM on May 7, 2005

I'm not a doctor but my first thought concurs with ikkyu2: mid-life crisis.

And unless the wife put undue pressure on him (I'm leaving if you don't get a vasectomy!), it's hard for me to believe a 54 year old man did something he didn't want to do. However, if she did pressure him, that might've triggered the personality change. I'd be pissed off at everything (including, and especially, myself) if I let someone pressure me into something I didn't want to do.
posted by deborah at 12:27 PM on May 9, 2005