However, apathy may add further stress to a family that is already heavily stressed by the illness. It can also place a tremendous burden on the spouse or significant other who must take on additional responsibilities of the household, personal and family relationship that would have been done by the person with apathy. Many of these neuropsychiatric disturbances seen in pituitary disease are directly related to the size of the tumor and the effect the tumor has on surrounding brain structures as the tumor extends beyond the sella turcica. Hormonal alterations occurring as a result of the tumor also play an important role in the etiology of these neuropsychiatric symptoms. Forward extension of the tumor may involve the frontal lobes directly by causing compression of normal brain tissue.
People tend to be more irritable and depressed-appearing.
Forward extension may plain also occur laterally to the temporal lobes. Problems, here, tend to be more personality-focused, with increased irritability, intensification of previously dominant personality traits, coping mechanisms, and adaptive styles. As mentioned above, emotional and behavioral problems are also the result of hormonal alterations. There is much research which has documented the psychiatric effects of hyperprolactinemia, hypercortisolism, and increased levels of growth hormone. A common syndrome to all of these altered hormonal states is depression.