CONQUER ANGER BEFORE IT CONQUERS YOU – AN APPROACH TO INTERMITTENT EXPLOSIVE DISORDER

Anger is a complex emotion experienced by all people to some degree throughout their lives. While it is a natural and typical feeling in the majority of cases, some people may have difficulty controlling the emotion or preventing it from becoming a factor in their daily lives. Health issues linked to unresolved anger include high blood pressure, heart attack, depression, anxiety, colds, flu and problems with digestion.

Anger disorder, more properly known as Intermittent Explosive Disorder (IED) is a psychological condition characterized by sporadic episodes of aggression, violence, and destructive behavior. People who suffer from anger disorder are unable to control themselves, exploding with rage in a way which is often out of proportion to the event which triggered the anger. People with intermittent explosive disorder may attack others and their possessions, causing bodily injury and property damage. They may also injure themselves during an outburst. Later, people with intermittent explosive disorder may feel remorse, regret or embarrassment.

Causes

The exact cause of intermittent explosive disorder is unknown, but the disorder is probably caused by a number of environmental and biological factors.

·        Environment. Most people with this disorder grew up in families where explosive behavior and verbal and physical abuse were common. Being exposed to this type of violence at an early age makes it more likely these children will exhibit these same traits as they mature.

·        Genetics. There may be a genetic component, causing the disorder to be passed down from parents to children.

·        Brain chemistry. There may be differences in the way serotonin, an important chemical messenger in the brain, works in people with intermittent explosive disorder.

People with other mental illnesses such as mood, anxiety or personality disorders  or certain medical conditions such as Parkinson's disease or traumatic brain injury  may display aggressive behaviors. However, they would not be diagnosed as having intermittent explosive disorder because the cause is from another condition.              

A number of factors increase risk of developing intermittent explosive disorder:

·        History of substance abuse. People who abuse drugs or alcohol have an increased risk of intermittent explosive disorder.

·        History of physical abuse. People who were abused as children or experienced multiple traumatic events have an increased risk of intermittent explosive disorder.

·        Age. The start of intermittent explosive disorder most commonly occurs in people in their teens and 20s.

·        Being male. Men are more likely to have intermittent explosive disorder than women

Symptoms

Explosive eruptions, usually lasting less than 30 minutes, often result in verbal assaults, injuries and the deliberate destruction of property. These episodes may occur in clusters or be separated by weeks or months of nonaggression. In between explosive outbursts, the person may be irritable, impulsive, aggressive or angry.

Aggressive episodes may be preceded or accompanied by: Irritability, Increased energy, Rage, Racing thoughts, Tingling, Tremors, Palpitations, Chest tightness, Feeling of pressure in the head

Depression, fatigue or relief may occur after the episode.

People with intermittent explosive disorder have an increased risk of:

·        Self-harm. They don't always direct their anger at others. They're at significantly increased risk of harming themselves, either with intentional injuries or suicide attempts. Those who are also addicted to drugs or have another serious mental disorder, such as depression, are at greatest risk of harming themselves.

·        Impaired interpersonal relationships. They're often perceived by others as always being angry. This can lead to relationship problems, divorce and family stress.

·        Trouble at work, home or school. Other complications of intermittent explosive disorder may include job loss, school suspension, auto accidents, financial problems or trouble with the law.

Diagnosis

Diagnosis is made using a psychiatric interview to affective and behavioral symptoms to the criteria listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders). This manual is used by mental health providers to diagnose mental conditions to reimburse for treatment.

DSM criteria include:

·        Multiple incidents of failure to resist aggressive impulses that resulted in deliberate destruction of property or assault of another person

·        A degree of aggressiveness during incidents that's completely out of proportion to the event that triggered the behavior

·        Aggressive episodes that aren't accounted for by another mental disorder and aren't due to the effects of a drug or a medical condition.

·        Other conditions that must be ruled out before making a diagnosis of intermittent explosive disorder include other mental disorders or substance use problems.

Management:

Psychotherapy
Individual or group therapy sessions can be helpful. A commonly used type of therapy, cognitive behavioral therapy, helps people with intermittent explosive disorder identify which situations or behaviors may trigger an aggressive response. And, more importantly, this type of therapy teaches people how to manage anger and control inappropriate responses using techniques such as relaxation training, thinking differently about situations (cognitive restructuring) and learning coping skills.

Tips for Taming Your Anger

·        Take better care of yourself. Often it’s possible to curb anger simply by cutting back on stimulants like caffeine and nicotine, which can shorten your emotional fuse. Getting more sleep can also help.

·        Talk over your feelings. Having a heart-to-heart with a friend or family member can help you understand and overcome your anger. “Hearing honest feedback from others can be a great way to understand and change our emotional responses,

·        Practice delay and distraction. Counting to 10 really works for some people, as does wearing a rubber band on your wrist and snapping it each time you feel angry. Mindfulness meditation can help, as can humming a favorite tune or saying a prayer

·        Practice relaxation techniques. Regular use of deep breathing, relaxing imagery or yoga may help you stay calm. Physical activity can potentially be an effective way of expressing anger.

·        Develop new ways of thinking (cognitive restructuring). Changing the way you think about a frustrating situation by using rational thoughts, reasonable expectations and logic may improve how you view and react to an event.

·        Change your environment. When possible, leave or avoid situations that upset you. Also, scheduling personal time may enable you to better handle an upcoming stressful or frustrating situation.

Homoeopathic Management

Homoeopathy considers the person as a whole, and takes account of the physical and psychological characteristics of the patient. It involves a detailed case history, which serves as ray of hope to both the patient- i.e., the one who is abused, as well as the offender. The patient has an opportunity to be heard and understood from her own perspective .After careful case taking and analyzing the case, the homeopathic physician decides on the remedy which suits the patient’s needs. Other therapies like yoga, meditation, music therapy, dance therapy, hypnotherapy, anger management, and family therapy are available as adjuncts. The remedy is chosen depending upon the patient’s characteristic traits and symptoms. This list of remedies is meant for use with the guidance of a qualified homoeopath.

Aconite Napellus - This is one of the common medicines that are used for the treatment of fear. This medicine is basically for people who are always anxious, fearful, and in a state of anguish.

Nux Vomica -  This person is very ambitious, intelligent and capable, with a strong sense of duty. He is very irritable and wants everything around him to be perfect and in order. He is disturbed by others around him, is impatient and cannot stand disorder or objection. He is ready to quarrel at any time for these reasons. At first he tries to suppress his anger and not to quarrel, then with next unimportant matter he bursts out shouting, cursing even throwing or tearing things. He loses his self control. They weep from irritability (Plat.).The second stage is characterised by destructiveness. Here the wife can hit her husband or have the impulse to throw the child into the fire or kill it, (Sulph., Thea.). In the deeper stages this impulse becomes a fear and is followed by weakness and depression.

Anacardium - suited to individuals who are irritable, irresolute, easily angered, lack confidence. Suspicious, irresistible desire to swear and curse; malicious, destructive, offended easily. Laughs at serious matters and become serious about laughable matters. Aversion to work. Forgetful- forgets names of near ones. The characteristics seen in this remedy are- shrieking and cursing when in rage, violent anger, abusive behavior towards partner and children, revengeful.

Belladonna - This remedy is characterized by great intensity and vividness in the patient and in the disease process. In anger they explode, they burst out, they become violent. They pull, they bite, they strike, they knock their head. Their face becomes frightful and red. The rage is strong, but without passion and malice (like in Stram.) and stops suddenly. They feel pulsation of the arteries during rage.

Staphysagria - Sensitive to scolding, insults. Suppression of anger, emotions; become speechless in arguments; sympathetic. Suited to individuals who do not allow themselves to express their emotions. His body may tremble in anger. Especially indicated when physical complaints appear after suppression of emotions and suppressed anger.

Magnesium Muriaticum- This remedy can be indicated after the loss of a care giver where one feels abandoned and forsaken, left on her own, not able to fend for herself. This may be accompanied by digestive ailments.

Natrum Muriaticum - This remedy is often indicated in a “romantic loss” in very introverted people. They feel the loss as a breaking in half of their own identity. They will cry horribly while alone looking at pictures and listening to music, yet dread to show their feeling in public. This homeopathic remedy is especially indicated in cases where long term illness progressed from the loss.

Ignatia-  This is the first remedy a homeopath thinks of when someone has suffered the “loss of a loved one”. This remedy often applies when there are symptoms of a lump in the throat, spasms in the body, feelings of disappointment in one’s life dreams.