ASK A PSYCHOLOGIST

I’m angry almost all the time, including feeling hostile toward strangers for almost no reason (for example, if someone is looking at me). I have a constant feeling that I need to fight someone to prove something I’m not sure needs proving. I have a tendency to get loud and hostile even toward family. I become easily aggressive, even belligerent, and sometimes get physical with strangers. If someone does something to upset me, I feel like I can’t just walk away. What do you call my condition, and what kinds of medications are available?

What you describe may fit the diagnostic label, Intermittent Explosive Disorder. Simply put, this disorder involves repeated episodes of impulsive anger and aggression that are disproportionate to the situation. So, such individuals frequently lash out at others, break things, and overreact to frustrations and perceived offenses. It’s not clear why some people have such extreme anger problems, but the condition appears to be more common than previously recognised. Often these same individuals experience depression, bipolar disorder, and/or anxiety. So, perhaps it’s not surprising that the medications used to treat Intermittent Explosive Disorder are some of the same ones used to treat these mood disorders. Although medication may help dampen the fuse that sets off an angry outburst, it’s not liable to be a sufficient solution. Typically, cognitive-behavioural counseling is recommended in addition to medication. Such counseling helps the individual begin to identify the self-talk and assumptions that fuel extreme reactions to irritating situations and people. With practice, the person learns to intervene in response to anger triggers, rather than react to them. Like most skills, developing frustration tolerance requires guidance and practice, and becomes easier and more effective as a result.

I’m a 47-year-old woman, and yet, I feel like I don’t know who I am. My question is this: Where does one begin when they have no clue as to what they want or where they belong?

All of us have identifiers – age, marital status, employment, nationality, etc. We also define who we are in other terms related to religion, culture, interests, etc. From the content of your brief question, I would guess that you’ve lost your personal and psychological foundation. We all live with a variety of assumptions about our life course, our families, our history, and our future. There are times when those assumptions are shaken or even destroyed. During these difficult times, an individual loses their identity and their assumptions about their life course. The most common way this happens is during a depressive disorder. I’d first take an inventory – what is your current foundation and identifiers? Determine your level of stress and responsibility. Check your physical symptoms for evidence of depression or anxiety disorder such as sleep/appetite/energy/concentration disturbances. While mentally exploring your life situation, resist making significant decisions until you find your foundation. If necessary, seek mental health assistance in sorting out your feelings and concerns. When lost in the forest, folks often backtrack out, going back the way they came in. Your foundation may have been shaken, but it’s still there. You’re more than just a “47-year-old woman”. Remember who you are, then seek ways to improve your situation and reorganise your psychological foundation. You won’t find your foundation by getting a new tattoo, buying a motorcycle, or leaving your current lifestyle to study fish in the Amazon River. If we’re psychologically lost, we’re lost no matter where we are. Help is available.

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