The constant life-or-death situations Dean was forced into while in Purgatory created an extreme change in him. While he was stuck there, he became emotionless and paranoid of the fear of getting attacked. He killed monsters of Purgatory with ease and was always fighting for his survival. When returned to Earth, his new outlook on life was clear. He became hardened, emotionless, and at times ruthless; his humor and puns were nonexistent when hunting. That changed with Castiel's return from Purgatory after which he started to show his light-hearted side again.
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"For years I had been a "junkie"--addicted to prescription and over the counter drugs. used oral and topical anti-inflammatory corticosteroids for 9 years to suppress my eczema/psoriasis. The steroids' side effect nearly killed me and did nothing to cure my eczema. The side effects caused me to swell-up like a balloon and triggered terrible mood swings from deep depression to nasty outburst our rages. Functioning of vital organs such as my liver, kidneys, lungs and spleen were nearly shut down and I thought I would die." Shirley