Help, I can’t control my anger!

By Ruth Nyebuchi-Philips 

The prevalence of metal health disorder is alarming, yet under diagnosed or even recognized. Today I’ll be going a little far away from what we call “mad” and “crazy”.

Intermittent explosive disorder is characterized by repeated outbursts of uncontrolled anger and/or violence that is not in keeping with the cause or reason for the degree of violence. It can be seen in intimate partner violence or abuse, road rage, temper tantrums, breaking or throwing away objects.

 

Case

Mr A is a man of God, hardworking who cannot pass a chance at running down his secretary for slight errors, he claims he doesn’t know what comes over him, but he had to speak his mind. It is so bad right now that nobody wants to work with him

History of his younger days suggested that he was easily provoked, people were scared of him, because of his actions, he fought in public, could beat his wife because another man looked at her. This could happen twice or thrice a week.

After he’s done all in his mind, he feels horrible with himself, he remembers he’s a clergy man and starts apologizing. He goes out of his way to appease his wife, takes her out but God help her if another man looks at her, it begins with war of words and the cycle begins again.

His in-laws have taken him to the police on two occasions but brother cannot help himself to pounding flesh. The wife has left him. He currently searching for a new bride.

Meat of the matter

The Diagnostic and Statistical Manual V for classification of mental health disease states the following criteria for Intermittent Explosive Disorder:

  • Recurrent outbursts that demonstrate an inability to control impulses, including either of the following:
  • Verbal aggression (tantrums, verbal arguments or fights) or physical aggression that occurs twice in a week-long period for at least three months and does not lead to destruction of property or physical injury (Criterion A1)
  • Three outbursts that involve injury or destruction within a year-long period (Criterion A2)
  • Aggressive behavior is grossly disproportionate to the magnitude of the psychosocial stressors( ie wetin dey disturb you like lack of money or work) (Criterion B)
  • The outbursts are not premeditated and serve no premeditated purpose ( you no plan to do am but e dey like say them push you) (Criterion C)
  • The outbursts cause distress or impairment of functioning, or lead to financial or legal consequences (e don affect your life,your relationship with your dose, family,affect your work then sack you or demote you) (Criterion D)
  • The individual must be at least six years old (Criterion E)
  • The recurrent outbursts cannot be explained by another mental disorder and are not the result of another medical disorder or substance use (Criterion F)

 

It is important to note that DSM-V now includes two separate criteria for types of aggressive outbursts (A1 and A2) which have empirical support:

Criterion A1: Episodes of verbal and/or non damaging, nondestructive, or non injurious physical assault that occur, on average, twice weekly for three months. These could include temper tantrums, tirades, verbal arguments/fights, or assault without damage. This criterion includes high frequency/low intensity outbursts.
Criterion A2: More severe destructive/assaultive episodes which are more infrequent and occur, on average, three times within a twelve-month period. These could be destroying an object without regard to value, assaulting an animal or individual. This criterion includes high-intensity/low-frequency outbursts.

 

Hope

It is treatable, by:

  1. Psychotherapy (talking therapy by a psychologist or psychiatrist)
  2. Medications.

 

First you have to identify it. Kindly visit a Psychiatrist close to you.

 

Ruth Nyebuchi-Philips  is a resident psychiatrist in training at the University of Port Harcourt Teaching Hospital.

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