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What causes bouts of anger, SOB, discomfort, bruised feeling and in windpipe?

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Posted on Thu, 11 Dec 2014
Question: Hi
I am XXXX, 31 years old male.
I have been experiencing raging bouts of anger and snapping at people lately. Easily angered. A deep regret and sulking after that. So much so I feel I need medical help.
I just checked my BP today. It was 130/100.
Recent Past and current medications:
Off late I have been experiencing shortness of breath, discomfort, bruised feeling in the windpipe/ esophagus area, a feeling like some thing is stuck and small discharge of phlegm when I exert. These symptoms appear at night only. Day time I am comfortable. I have completed a course of antibiotics. Currently I have been prescribed medicine to help me with acid reflux and an anti allergic.
I did not discuss my anger problem with my physician. Are those 2 related?
Please help.
Thanks
XXXX
doctor
Answered by Dr. Chintan Solanki (41 minutes later)
Brief Answer:
Consult a psychiatrist, it may be intermittent explosive disorder

Detailed Answer:
Hi XXXX,

Thanks for writing to us.

I appreciate your attitude for seeking medical help for such problem.I checked your prescriptions. They mention medicines for gastric problems mostly and one medicine for difficulty in respiration.

Gastric discomfort can cause psychological disturbance sometime and vice a versa but it can not cause so much anger outburst you have mentioned.

Your symptoms of rag and snap followed by regret are suggestive of intermittent explosive disorder. It is a psychological problem and can be controlled with medicines and psychotherapy.

Your blood pressure is ok.

To diagnose this problem detail history and mental status examination by a psychiatrist is required.So you should consult a psychiatrist for such problem or ask your physician to refer you to some psychiatrist.


Hope I have answered your query.If you have further queries you are welcome. Also let me know about detail of your anger outburst with example and with duration and secondary problems due to such behavior.

regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Chintan Solanki (11 hours later)
Thank you Dr. Solanki.
An example of my anger outburst:
I have my own business and employees. A recent small indiscipline at work place got me very angry in no time. I yelled at everyone, including a stranger ( an ICICI sales representative) who happened to call me on phone at that time. Yelling was in a very loud voice. I may have used flowery language too. My wife and my father were present. That had to hold me ask me to calm down. That was around 7pm in the night and lasted about 20-30 minutes. But the regret and disturbance in my head lasted all night and the next morning also. I was very disturbed by my own behaviour.
As a consequence, my was very scared and upset all night. She is 6 months pregnant.
In a similar other occasion, I got my employees scared and crying. They are young sweet boys of 20- 22 years old.
Yesterday I was in a mall and got angry the sale men staff who were giving unclear information about a product I wanted to purchase. I was very close to yelling and snapping , but controlled myself.
The other day I was severely frustrated by my mother and I had to punch a cardboard box to relieve my stress. When I had just gotten married 5 years ago, and was living in another city, my mother got me frustrated over the phone and I had to smash the phone on the ground to feel relieved.
My wife says I get angry, cranky and snap at people if I am hungry and have not eaten.

Please let me know if I can consult a psychiatrist online or do I need to consult in person locally.

Is my breathlessness and expectoration at night connected to my anger.
My local physician said 130/ 100 was high and will monitor again after 10 days.
This got me worried.

Thanks
XXXX


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Follow up: Dr. Chintan Solanki (6 minutes later)
I just noticed you are in XXXXXXX As a coincidence I have studied from The National Institute of Design , Paldi, XXXXXXX I was there from 2002 to 2006. My wife and I are both graduates from the same Institute same batch.
doctor
Answered by Dr. Chintan Solanki (14 hours later)
Brief Answer:
Personal consultation with Psychiatrist needed

Detailed Answer:
Hi XXXX,

Thanks for follow with examples and hope you liked ahemdabad and peole of ahmedbad during your stay.I reside near kankaria and used to pass by NID daily.

The episodes of your anger outburst are comletely suggestive of diagnosis intermittent explosive disorder. And one more differntial aspect I am thinking about is depression.

If you have any social,economical,emotional or relationship stress, you may have depression and irritability is one of the hidden symptom of depression.

For proper diagnosis, detail history of your past, family history, work and eduaction history, personal history, substance use and mental status examination are required.

After reaching to proper diagnosis treatment can be done.Whic includes medicines and/or psychotherapy as I mentioned before.

It is practically not possible to do above things through this online forum at present. You need to consult psychiatrist in personal.

I again would like to tell that it is really good that you are aware about your problem and seeking help.

Blood pressure 130 systolic(upper) is ok but 100 diastolic (lower) is high. ( I am sorry I misread 130/88 during first answer and replied you that it is ok). You need to recheck again if it is high always, evaluation for the same needed by ECG, chest x ray and 2 D echo.

Chances are there that anxiety can elevate the BP for short time.But only increment in diastolic BP is not possible.

Your breathlessness may have connection with anger but not the expectoration.It requires proper physical examination of circulatory and respiratory systems to reach to some conclusion.

Hope I have answered your queries.If still any query, I will be glad to anwer.

Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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What causes bouts of anger, SOB, discomfort, bruised feeling and in windpipe?

Brief Answer: Consult a psychiatrist, it may be intermittent explosive disorder Detailed Answer: Hi XXXX, Thanks for writing to us. I appreciate your attitude for seeking medical help for such problem.I checked your prescriptions. They mention medicines for gastric problems mostly and one medicine for difficulty in respiration. Gastric discomfort can cause psychological disturbance sometime and vice a versa but it can not cause so much anger outburst you have mentioned. Your symptoms of rag and snap followed by regret are suggestive of intermittent explosive disorder. It is a psychological problem and can be controlled with medicines and psychotherapy. Your blood pressure is ok. To diagnose this problem detail history and mental status examination by a psychiatrist is required.So you should consult a psychiatrist for such problem or ask your physician to refer you to some psychiatrist. Hope I have answered your query.If you have further queries you are welcome. Also let me know about detail of your anger outburst with example and with duration and secondary problems due to such behavior. regards, Dr.Chintan Solanki.