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explosive anger


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Do any of you have a problem with explosive anger?  I seem to be always slightly irritated about most things, which occasionally blows up into frightening displays of anger (screaming, throwing and breaking things).  I always feel horrible after these episodes happen. Depending on the severity of the episode, I might be down for several days.  And of course, there's all the apologizing I have to do.  These episodes are different from the mixed episodes I get.  When I'm mixed, I'm incredibly agitated inside and it's plain from looking at me that there's something wrong.  I'm more likely to self harm when I'm mixed more than anything else.  The explosive episodes seemingly come out of nowhere, though they do happen more often when I'm tired, hungry, etc.  I try not to let that happen so it happens less frequently.  Still, the severity of these episodes really frightens me sometimes.  Most recently I got upset about a prescription not getting refilled, and I just lost my shit about it.  I was driving WAY too fast, flipping off other drivers, and when I got home I started throwing things.  Then I sent a very rude text to my pdoc.  My family just kind of shrinks back and avoids me when I'm like that.  Sometimes they can't, though, when I'm screaming AT them.  It sets up a lot of self-loathing that doesn't do me any good.

 

My pdoc is out of town at the moment but I'm scheduling an appointment as soon as I can for when he's back.  I did send him an email detailing everything going on in my head and apologizing.  He understood and said we need to be doing better with my meds if I'm having this much trouble.  I've been doing some research lately since not all of my symptoms fit under the umbrella of bipolar, and I'm pretty sure I have GAD and OCD as well (I've always had PTSD).  The OCD makes me obsess constantly about bad things happening, which I know contributes to my general overall tension from the GAD.  I'm sure always being in such a tense, potentially irritated state doesn't help the anger problem.  I just wish there was some time between getting angry and acting on it, because right now there isn't so I can't stop it before it happens.

 

I think I'm mostly venting since I know the first thing to do is see my pdoc, but it would be nice to hear others' experiences with anger and how you managed it.

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This is like reading something straight from my own head. No, you aren't alone. Lamictal has been the only med that could dampen the sudden fits of rage so intense they were physically painful.

CBT has been incredibly helpful for me. When I know why I feel the way I do, and can clearly see why those feelings make no sense, it's easier to dismiss them.

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I get explosive rage when I'm hypomanic. I only get dysphoric/irritable hypos, which I view as separate from mixed episodes (in my case, anyway.)

It'll come out of the blue like that, complete with emotional crash afterwards. But it'll only happen in an episode for me. Your mileage may vary.

Meds are my solution, though technically I'm also using lots of stuff I learned in my year's worth of cognitive behavioural therapy. Recognizing I'm experiencing escalating anger isn't always easy 'cause it tends to carry one away with it. But both catching myself and relying on feedback from a few trusted people helps, and then I treat it with meds.

Since mine IS based on episodes, this usually just involves treating the episode. But I can still become full of rage during that, and so I keep clonazepam and Seroquel on hand to help. Outside of episodes, anger and rage are much less likely but may show up in that 'hangover period' I get after episodes, or even be caused by anxiety ('fight response') or sensory processing overload/aspie meltdown kinda. Again, clonazepam and Seroquel, along with CBT skills, etc. That's how I manage mine.

Which has been working. I mean, my bipolar disorder was diagnosed in part due to these ragefits in hypomanic episodes. I assaulted someone, so. Haven't even come close, since.

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This is a total stab in the dark, but I notice you are on ativan. When I tried Klonopin, I got what are called "Klonopin Rages." Two hours after I took it, I'd become the Tasmanian Devil, screaming, throwing things, crying, breaking things. My husband had never seen me do that before and was totally freaked.

 

I don't even know if ativan has any kind of reputation for that. But I have a lot of paradoxical effects with medication, as you can see when Klonopin sent me through the roof instead of treating my anxiety. I just thought it was some more information you could use.

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yeah I had a paradoxical effect with Valium. But clonazepam is fine for me.

Seriously though, even if it's OCD and/or GAD related, I don't know about you OP but my versions of those flare up like, well, crazy when I'm hypo. But they are still their own things. BP, OCD, and/or GAD, best results will most likely come from a combo of meds and therapy. Everyone's different though, so some it's just a med or maybe just a bit of therapy like me, or maybe therapy is more effective for your problem than meds, etc.

I used to throw things, scream at people, leave ranting texts and voicemails, etc. I still *get* angry sometimes, that's normal, but not the ragefits, no. I'm very good at spotting early ragefit precursors, usually for me it means an episode so I then take action to medicate the episode. Or maybe I determine otherwise, but still it's me spotting the quickly building anger stuff before it gets to the throwing things and screamingfit point, and then choosing which actions to take in order to counteract it.

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That's interesting to know about paradoxical effects.  Fortunately that's not a problem for me with the Ativan, though I do remember that past use of Valium would render me very cranky in the mornings after taking it at night.

 

Mirazh, your description of your hypomania makes me wonder if I'm not in a constant state of hypomania that renders me pre-irritated about everything.  Which means a med adjustment is in order.  My episodes seem to be independent of being in a mixed state, though they can be worse when I'm mixed.

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