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Dr. Andrew Rynne

Family Physician

Exp 18 years

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Having Tension,Anger & Depression. What medication should i take ?

Dear Doctor I am a male of 24 Years working in an IT service industry in south India. I am staying alone in a mansion at my work town. I am having a height of 163cm and Weight of about 80kg.I go everyday to play badminton or to health club for some regular excise. I have a problem of getting angry quickly if i hear a small issue against me or is done by others. I get also tensed in small issues and even for some thing change from what i did not expects. I want the result or thing done fast for some cases. I cannot control my feeling or cannot control my anger. I just fear of me bursting out to someone when i get angry or i actually feel in smashing something but i try to control doing these thing or will talk to my parents who tries to calm me down but still i become worried too much. I some time feel seriously depressed when i couldn t get some thing done or achieve some thing. Where as I see there are many people in my family and friends who just take thing very easy and is always cool. When i talk to my family on these thing they said It may be because i am having high BP. I also have problem of forgetting words while i am speaking even if i know or even some time forget what i had to ask or say when actually i am going to ask or say something to a person which i just thought and i just stand there thinking what i actually came to ask. I also get confused while i am saying some thing or get mixed up with the sentences when speaking which even confuses my friends or family. I speak loudly when I talk to someone which actually i may have started with a low Voice (I am not able to control my voice.) I also have problem or getting very less sleep. I rarely sleep more the an 5 to 6 hrs only if am really tired and even while sleeping i have lot of dreams coming which actually feels real and after getting up i feel still tired. I am try to control my anger and other problem but still end up in the same place. Can I know should I take some medication or see a doctor or change in my routine activity.Please suggest on what i can do. Thanking You in advance.
Thu, 19 May 2011
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General & Family Physician 's  Response
Dear Sharath Babu,
Thank you for choosing this platform to get answer to your queries. I appreciate your ability to analyse yourself so well and being able to pinpoint the problem area. It definitely is a step towards health living when we are able to realise our difficult areas and are willing to work on them. People working in the IT industry often have emotional difficulties due to their work routine , spending more time with the machine than with people and staying away from home when on projects..Its wonderful that you spend time excercising as its a good way to burn out ones agressive energies literally ..
How long have you been having these symptoms...sleeplessness, lack of impulse control and anger issues ...Issues related to work and perfomance as you have mentioned as in expecting fast results and dealing with small faliures or setbacks could be personality based difficulties..I suggest you meet a clinical psychologist for a thorough assessment of your situation to identify if its resulting because of your traits or situation and if its a diagnosable condition like a depressive dsiorder or anxiety disorder.
You may not require medication if your assessment shows the need for lifestyle and behaviour modification like anger and stress management but if there is a diagnosable condition then you may require medication which would assist you in seeking solutions to your difficulties.
Please do let me know how you followed up on your case from here on...
some tips:
1) recognise the physical signs your body shows before you get angry like feeling tension or faster breathing and remove yourself from the situation, drink a glass of water or go and wash your face...that would give you time to rethink
2) maintain good sleep hygine as in try and sleep at the same time everyday and stop watching tv or reading atleast 30 min before lying on ur could listen to soothing instrumental music..drink warm milk or take bath before going to bed.
3) Continue with your excercises and definitelu go in for a assessment with a psychologist

All the Best
Smriti Sawhney
clinical Psychologist
RCI Reg no A-12344
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  Anonymous's Response
Dear Doctor,

I am thankful to you reply and comments.I surely will try visiting a psychologist as soon possible.Will keep posting you on my future changes if any. About my sleeplessness,I can say that I use to sit late night studying and try finishing my assignments and also use to get up early morning for my further studies or for tuition class.I also continued this during my collages days too. After my working life started I get time only in the night to spend time on Television program or browsing net this some time goes till late night and also if I get some holiday i used to spend time watching program till late night. But I didn't take much care as i felt it normal but recently I found that my friends and family member can sleep more time even if they have also went through the same situation as I have gone through, this started disturbing me lot. I spend less time reading book as I cannot concentrate on it for a long time I get confused with the character or even what I am reading but the end of the book. I normally go for small articles or Newspaper reading. I feel this also as problem to me.Thus I spend much on computer and television. But I am good in capturing things which are explained to me practically or demonstrated. I use to have anger previously also but was not so serious at first but It started became a problem and when getting angry so intense just a quiet while. I may some time feel like shivering as i cannot control it or feel depressed too during this time. It mainly happens during some argument or when something changes from what i expected. I cannot keep my self in a cool state or control the situation. This what I can say about my sleeplessness and anger.

I hope these problem get solved as soon as possible since i doesn't want affecting me worse.

Thank you once again on your comments and suggestion.Will keep posting if found any change.
  Anonymous's Response
Dear Doctor.

Could you please suggest on psychologist doctors available in Kerala at Cochin - Eranakulam with whom i can discusses on my problems as discussed on it previously.

Thank You in Advance.
Psychiatrist Dr. Sudeshna Das Purkayastha's  Response
dear sharath babu,
ur problem is very genuine and shud not be neglected.there r 2 things ,the knowledge of which is required to reach a proper diagnosis ,which has not been mentioned in ur narration i.e.-the duration of ur problem & whether the onset of ur problem is after any particular incidence or not.but still based on whatever u have mentioned,i wud definitely suggest u to see a local psychiatrist first so that a clinical diagnosis can be reached without much delay and further management can be planned.By going through ur symptoms it seems u r suffering from mixed anxiety depressive disorder.but again there r other factors which have to be considered before reaching a final a brief assessment by a psychiatrist wud not only help in knowing the diagnosis but also start treatment immediately-whether medicinal or psychological.probably a combinition of both medicine and psychological therapy is going to help u to come out of this problem.

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ENT Specialist Dr. Puneet Maheshwari's  Response
welcome to health care magic
depression can be due to many reasone..of patients history

u may not require medication if your assessment shows the need for lifestyle and behaviour modification like anger and stress management but if there is a diagnosable condition
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