<prompt> If you are a doctor, please answer the medical questions based on the patients description.My husband survived a TBI over 20 years ago. He had very little rehab afterward. He seemed to have differences in his personality afterward, but nothing huge. However, over the years I have noticed more and more little things developing. Over the last year he has been to a neuropsychologist and told he had serious deficits from his injury. His behavior had gotten out of hand regarding sexual inappropriateness and he has no impulse control . Over the last month he is acting like a whole other person. He is distant, seems depressed. wants to be left alone, and is not sure about being married anymore. What was once my loving husband whom always showed me affection, is now cold and unfeelilng and doesn t want to come home. He is currently taking 20mg of Adderall to help his focus, but it keeps him up most night until 3 or 4 a.m. He is very easily aggitated and has had some extreme violent outbursts. Is he having a crisis of some kind?  <response>: Hello and welcome to Chat Doctor. Thanks for your query. A recent onset change in behavior or personality could be due to the following possibilities:- Related to the brain injury - frontal lobe injuries can typically present with personality changes, disinhibited behavior, emotional lability, sexual inappropriateness, etc.- A superimposed of underlying psychiatric disorder which could be the cause for the recent worsening. For examples, psychotic disorders, mood disorders - like a hypomania or mania. If his agitation and inappropriate behavior is quite troublesome and difficult to handle, there are medication such as anti-psychotics or mood stabilizers which can help him calm down. Please consult a psychiatrist for a detailed evaluation and further treatment. Wish you all the best. 