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Have severe anger problem, shivering hands and breathing problem. Prognosis?

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Hi I want to consult a good doctor for Anger Management. I have severe anger problem and when I loose temper, my heart beat runs faster, I am not able to breathe and hands starts shivering. I am not in control of my body and end up with a dirty fight.Need some solution which can be mix of medication, psychology and mind exercises.
Posted Wed, 13 Mar 2013 in Mental Health
Answered by Dr. Jonas Sundarakumar 54 minutes later
Welcome to Healthcare Magic and thanks for your query.

From your description, it appears that your predominant problems are poor control of your anger and emotions. It's a good thing that you have been able to realize your problem and have sought help.

Now, very often the basic underlying problem for such anger issues is poor impulse control and inability to regulate your emotions sufficiently. This is what may be causing you to become easily upset, have anger outbursts and say or do things which you do not mean.

In my opinion, this does not seem to be a psychiatric disorder, but rather seems to be unhealthy trait in your personality. Now that you have been able to realize your problem, the next step would be to take active steps to better yourself. You should be prepared to put in sincere efforts, take help and guidance from a professional, and be patient to slowly start practicing better emotional regulation.

There are also certain medication which can help you - for example, low doses of certain mood stabilizers like Carbamazepine can be effective in controlling impulsivity and emotional dysregulation.

I would advise you to consult a psychiatrist in person for a detailed psychological assessment, so that further treatment can be planned. Like you have rightly said, a combination of medication and psychological therapies would yield the best results.

In addition, I would also give you the following suggestions:
1) Start making a daily diary record of the major instances where you had become impulsive and lost your temper. Now, there should be three columns in this diary: A-B-C...
A for "Antecedant" i.e., what issue or problem anteceeded or preceeded your impulsivity
B for "Behaviour" i.e., what was your behavioural response or reaction
C for "Consequence" i.e., what was the consequence of your behaviour
Now, when you start making a regular record of the A-B-Cs, you will very soon be able to find patterns or similarities in your behavioural responses. As this gives you an better insight, you should slowly try to figure out how the "B" could have been modified in order to avoid a bad "C".

2) Practice relaxation techniques like XXXXXXX breathing, progressive muscle relaxation, yoga, etc. Often underlying anxiety and tension are major precipitants for emotional dysregulation. So, maybe, if can dedicate 10 minutes of your time every morning to frist bring your mind to a relaxed state, it will go a long way in helping you handle the pressures of the day better.

3) Stress-management and coping skills are something you have to master. If you do this, then situations or problems will not seem that 'irritating' or 'frustrating'. Stress is one of the major contributors for a variety of psychological problems. So, don't take too much which you cannot handle. Periodically take breaks to de-stress or recuperate yourself. There are also CDs or downloadable material available on the internet on stress management which can be beneficial to you.

4) Avoid substances like alcohol, tobacco, coffee, caffeinated drinks or energy drinks, etc. as these can all worsen anxiety and worsen emotional dysregulation. -

5) Follow a healthy lifestyle - with adequate physical exercise and a nutritious and balanced diet. This not only keeps your body healthy, but also helps your mind.

6) Finally, practice, practice practice. Set small and realistic goals for yourself. Remember, it is impossible for an someone to change his personality overnight. So, work slowly and set gradual targets. Practice the anger / stress management and relaxation techniques regularly and repeatedly. Record your improvements - as they will improve your confidence and motivate you to do better.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
Follow-up: Have severe anger problem, shivering hands and breathing problem. Prognosis? 10 minutes later
Thank you very much Doctor.

Can you please recommend a good Psychiatrist or a clinic in Bangalore?

Thanks again.

Answered by Dr. Jonas Sundarakumar 19 hours later
Hello again,

Since the treatment of your problem would require not just medication, but well-structured psychotherapy sessions, I would suggest that you see a psychiatrist in a big set up, rather than in a private clinic. NIMHANS and St. John's are good centres where well-planned psychological therapies are done meticulously. If you are hesitant about visiting NIMHANS, then you can consider St. John's, which has a team of dedicated psychiatrists.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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