Psycho-Babble Medication Thread 64067

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is anger a sign of depression or.....?

Posted by N.P. on May 24, 2001, at 0:09:31

Here's something that realy concerns me, so if anyone have any comments please do post them. Since I can not get doctors opinion on that.. My husband refuses to go to Pdoc. He has anger attacks. Nothing dangerous , all verbal, not even foul language, but it really makes marriage to him a misery. Sounds stupid - I admit it - but when he is "normal" he is a realy good man. He is too much into computers (his profession), music and any kind of screen (TV, VCR, computers). He only procrastinates about certain things. Like reading to kids - that is like - impossible. He'd rather play computer games with them. And back to anger. When he is angry he'll get me or kids no matter what we do. He just needs somebody to be unhappy. To cry even maybe. He had lousy parents that fought a lot, yelled at him and used corporal punishment untill he was nine. But he doesn't use that as exuse. He just thinks that he is "right" when he's angry. That there's a perfect reason to be angry. Of course my goal is to convince him to go to phychiatrist, but meanwhile... Does anyone have any comments? .. Thanks..

 

Re: is anger a sign of depression or.....?

Posted by Mike Rubinsek on May 24, 2001, at 1:37:41

In reply to is anger a sign of depression or.....?, posted by N.P. on May 24, 2001, at 0:09:31

Your husband is EXACTLY like my dad...a classic case of undiagnosed ADHD. I have it my brother has it, but my Dad won't see a shrink because of the stigma. But if you could get your husband somehow into someone highly recommended (like my Mom is trying to do) His chemical inbalance can easily be fixed..It's making the appointment that's the hardest part! But think of the benefits!


Here's something that realy concerns me, so if anyone have any comments please do post them. Since I can not get doctors opinion on that.. My husband refuses to go to Pdoc. He has anger attacks. Nothing dangerous , all verbal, not even foul language, but it really makes marriage to him a misery. Sounds stupid - I admit it - but when he is "normal" he is a realy good man. He is too much into computers (his profession), music and any kind of screen (TV, VCR, computers). He only procrastinates about certain things. Like reading to kids - that is like - impossible. He'd rather play computer games with them. And back to anger. When he is angry he'll get me or kids no matter what we do. He just needs somebody to be unhappy. To cry even maybe. He had lousy parents that fought a lot, yelled at him and used corporal punishment untill he was nine. But he doesn't use that as exuse. He just thinks that he is "right" when he's angry. That there's a perfect reason to be angry. Of course my goal is to convince him to go to phychiatrist, but meanwhile... Does anyone have any comments? .. Thanks..

 

Re: is anger a sign of depression or.....?

Posted by Hopeful on May 24, 2001, at 5:54:09

In reply to Re: is anger a sign of depression or.....?, posted by Mike Rubinsek on May 24, 2001, at 1:37:41

I believe (note I said believe) that there could be like you said as a result of past family life some sort of deep seeded problem that keeps your husband "locked in" to that past. If he is the classic ADHD kind of a person then him snapping is not entirely unusual. Seems lots of ADHDs just don't have patience. Part of the condition. Whether he enjoys keeping you in misery could just be a symptom of him having to feel he has "control" over something. Note that he loves the computers, electronic thingys and such. All those things allow him to be "in control" and gives him the "fix" he needs to go on. Understanding is always the beginning to your being able to deal with his personality traits. Remember you married this man for better or for worse. If he is indeed a kind-hearted man then you letting him have his "fix" from the computers and such won't hurt. Granted he needs to give the children the important time and attention that all children need to become healthy balanced future adults. You need to find the balance of how much you are going to allow him to be "himself" and how much you need him to be a dad. It's a tough balancing act because you also want him to be a husband. The thing I always tell my friends who are going through tough times is that they must always remember that "life spares no one the pains and troubles." Being understanding and loving will go a long way in dealing with your situation.
Another important point to remember is that no one and I mean no one ever got better seeing a head doctor without wanting to change. If you show and give him and the children your undying love and support all should workout for the better. Yes, life is not perfect, yet to strive for a good life is a great thing to desire and pursue! Wishing you all the best. Take care.

 

Re: is anger a sign of depression or.....?

Posted by CraigF on May 24, 2001, at 8:20:36

In reply to Re: is anger a sign of depression or.....?, posted by Hopeful on May 24, 2001, at 5:54:09

Sounds much like my dad, who is bipolar. He would get very dogmatic and angry during his manias. No one else knew what they were talking about and he was always right.

Please don't let us diagnose him, however, or scare you. We have trained ourselves to pick up on patterns, but not to diagnose.

Good luck

 

Re: is anger a sign of depression or.....?

Posted by LLR on May 24, 2001, at 10:31:39

In reply to Re: is anger a sign of depression or.....?, posted by CraigF on May 24, 2001, at 8:20:36

> Sounds much like my dad, who is bipolar. He would get very dogmatic and angry during his manias. No one else knew what they were talking about and he was always right.
>
> Please don't let us diagnose him, however, or scare you. We have trained ourselves to pick up on patterns, but not to diagnose.
>
> Good luck

this sounds so much like me..and i hurt so for my husband...i am like barbed wire when i strike..i am not happy and i don't want him happy..but not on purpose..i don't mean to..words just come out of my mouth...God bless him. we are really hurting.
my Pdr has just put me on a new so called mood something or the other..seroquel, that i take at night...but my mind is playing with me today...i have only had the 1/2 tablet last night so it has not been able to control the anger and mood swings yet....sorry ...I hurt for us and for the family members who have to deal with this !

 

Re: is anger a sign of depression or.....?

Posted by loosmrbls on May 24, 2001, at 11:09:58

In reply to is anger a sign of depression or.....?, posted by N.P. on May 24, 2001, at 0:09:31

It really is impossible to make a diagnosis on this information. It is obvious he has mood lability and irritability, but those symptoms go along with numerous conditions -- including depression. His love of computers certainly suggests withdrawal from interpersonal relations.

To be diagnosed with ADHD, symptoms have usually been present since a young age (before age 7 by DSM standards) -- was he disruptive, hyper, talkative as a child?

I think much more likely is dysthymia, major depressive disorder (mild to moderate severity), or even borderline personality.

You have to put your foot down about him seeing a ddoctor. Otherwise, your marriage and your children may suffer (not to mention you).

 

Re: is anger a sign of depression or.....?

Posted by Noa on May 24, 2001, at 12:35:29

In reply to Re: is anger a sign of depression or.....?, posted by loosmrbls on May 24, 2001, at 11:09:58

The mood lability, anger outbursts, avoidance of reading to the kids and other activities, possible social withdrawal or possible preoccupation with certain activities could potentially be explained by several causes, alone or in combination. (there is the abusive childhood, for example, or perhaps there is some kind of mood disorder, or perhaps ADHD, or maybe even a reading disability to boot, or some other cause---those are things to explore once you consult a professional, and they are conjecture at this point).

I think you want to stay away from jumping on a diagnosis or treatment and focus more on communicating to him how his moodiness and outbursts affect you personally as his wife, and that you need him to seek consultation because not only are you concerned about his well being but also about the well being of yourself and of the marriage. You don't want to scare him by cornering him into some preselected dx or treatment plan. He is skeptical about trusting a mental health professional as it is, so you want to help him check out one or two or three to see how they are--are they someone that will respect him and listen to his point of view or will they call him crazy and impose some treatment against his will, which is often people's fear.

Good luck.

 

Re: is anger a sign of depression or.....?

Posted by Waterlily on May 24, 2001, at 15:45:52

In reply to is anger a sign of depression or.....?, posted by N.P. on May 24, 2001, at 0:09:31

Yes, I have a comment. Your husband sounds like my dad in the 3-4 years before his suicide. Don't let that scare you, because I don't know that your husband is depressed or not. I'm just remarking on the similarity and that it would probably be a good idea to talk to a mental health professional about it. Hope all goes well for you.

 

Re: is anger a sign of depression or.....?

Posted by Fred Potter on May 24, 2001, at 16:40:22

In reply to is anger a sign of depression or.....?, posted by N.P. on May 24, 2001, at 0:09:31

N.P. You've just decsribed my wife. I don't know the answer. Is there also a childish flavour to his anger (as with my wife)?
Fred

 

Re: is anger a sign of depression or.....? N.P.

Posted by Sulpicia on May 24, 2001, at 16:46:37

In reply to is anger a sign of depression or.....?, posted by N.P. on May 24, 2001, at 0:09:31

>Ditto the other posters.
And adding that there is no reason to live in misery.
He'll be real bear to get to a pdoc *BUT* children make
things a bit easier.
You'll need to figure out a fairly honest [don't get strict on me here]
strategy to arrange "family counseling".
Have a look at the kids' end of year reports' if possible, or
perhaps they are in fact manifesting some maladaptive responses to
his behavior already -- use this as the motivation.

You may find he will be much less resistant since it's "for the kids."
And frankly, with or without him, you and the kids will get some support
and strategies for coping with him.
No doubt he cares for you all -- lots of disorders prevent demonstration of same.

 

Re: is anger a sign of depression or.....? N.P.

Posted by kazoo on May 27, 2001, at 2:19:44

In reply to is anger a sign of depression or.....?, posted by N.P. on May 24, 2001, at 0:09:31

It's the other way around, my dear. Depression is anger turned inward.

Bring the spirituality of life back into your husband's life, and his anger will dissipate.

Get rid of, or limit the use of, those damaging distractions, such as video games and that other crap, and focus on those values which make life worth living: family, friends and people.

Altruism is the way to go. Random acts of kindness does wonders for the mind and soul. It make you feel good even if there's no quid-pro-quo.

Discover, or re-discover, the true inner being. You will find a bouquet of long-stemmed American beauties there.

The cure is all around you. Look.

Simple solutions for complex conundrums are always available, always the best, and always effective.

Communication is the bridge that spans your consciousness to others. There are no tolls on that bridge either. All you have to do is listen wisely.

There's no disgrace in "starting over" in any relationship, or in any adverse behavioral mode, so exercise compassion as freely as the warm summer wind.

By being yourself, he'll see the beauty within.

And, of course, love is the honey that bonds ... use profusely.

kazoo

 

Re: is anger a sign of depression or.....?

Posted by N.P. on May 27, 2001, at 13:32:36

In reply to Re: is anger a sign of depression or.....?, posted by Fred Potter on May 24, 2001, at 16:40:22

Fred,
I have finally understood that it's just out of their controll. They can not fix it by themselves, neither can they snap out of it at out request. Just like I couldn't do more housework and pay more attention to kids when I'm depressed (thanks god my depression is mild and responds pretty good to Saint Johns wort supplement). There's more to that story... It escalates. Just like with mine, .. I can't do more, I have guilt about neglecting house and kids, guilt makes the depression more severe. So, the solution is - first AD medication , then all the therapies including individual, group, books, etc. I hope this will work out for me and for you. Also read the other posts to this thread. Take care.
N.P.

> N.P. You've just decsribed my wife. I don't know the answer. Is there also a childish flavour to his anger (as with my wife)?
> Fred

 

Re: is anger a sign of depression or.....?

Posted by Elizabeth on May 27, 2001, at 14:42:50

In reply to Re: is anger a sign of depression or.....?, posted by loosmrbls on May 24, 2001, at 11:09:58

> It really is impossible to make a diagnosis on this information.

This is always true on internet discussion boards...and of course, what you'll be getting is not a true diagnosis, but an educated guess (few professionals are willing to hazard an online diagnosis, IME). Still, it's something to start from.

> It is obvious he has mood lability and irritability, but those symptoms go along with numerous conditions -- including depression.

Mood lability (mood swings, including shifts from one dysphoric mood to another -- e.g., anxiety to anger to sadness) is definitely not what is meant by "depressed mood" in the diagnostic criteria for depression. In the context of depression, "mood-reactivity" refers to the ability to be cheered up on by pleasant events (but usually, the person has lost interest in former interests and will not actively seek out pleasure). The "mood reactivity" associated with borderline personality includes excessive, "out-of-control" anger that is out of proportion to whatever the person claims to be angry about. N.P.'s description of her husband's behaviour does sound somewhat like BPD -- inappropriate or out-of-proportion anger attacks that are intense but brief, stormy or unstable relationships and home life, the appearance of manipulativeness, the belief that his behaviour is "normal" or "acceptable," etc. -- but I think that personality disorder diagnoses are red herrings. (To say that BPD is the result of a lousy home life ignores the question of why only some of the many people who had lousy childhoods grew up to become "borderlines," and why some "borderlines" had extremely difficult childhoods (sexual and physical abuse, etc.) while others had only moderately difficult ones.)

Irritability is sometimes a prominent feature in depression -- some people express their depressed mood in this way -- but it seldom dominates the picture. Brief anger episodes in the context of an otherwise normal mood are not characteristic of depression; a depressed/dysthymic person with anger attacks would be gloomy, pessimistic, perhaps sarcastic. Also, irritability or anger by itself is not sufficient for a diagnosis of depressive disorder. Although I agree with loosmrbls that there isn't enough information, depression isn't what comes to mind based on the description given.

To me, this sounds like something that I've heard referred to as "ADHD spectrum disorder" -- see the writings of Akiskal for a discussion of spectrum theory of mental disorders. Basically what I mean is that the problems described don't fit into any of the current pigeonholes described in DSM-IV, but ADHD looks like the closest match based on the available information. (There are also some features associated with borderline personality disorder, which appears to be related to ADHD in many cases.)

Although they do often have difficulty with concentration and attention, people with ADHD are known to focus intensely on certain activities; what particularly caught my eye was the suggestion of "computer addiction." This seems to be very common among people with ADHD (in my experience). Angry outbursts are also common among adults (as well as children) with ADHD. These outbursts are thought to be due to impatience or poor frustration tolerance.

As loosmrbls points out, ADHD is a life-long, temperamental disorder. N.P., could you tell us anything about what your husband was like as a child? That would be very helpful. A chaotic home life, as you described, is especially harmful to a child who is sensitive, impulsive, and inattentive. I can easily imagine that such a child would not "grow out" of these traits if he grew up in a chaotic environment.

It would also be helpful to know more about what your husband's personality is like when he is not having anger attacks -- what do you see as his strengths and weaknesses?

Medically, the most effective treatments for the ADHD-borderline spectrum of disorders are probably antidepressants (e.g., SSRIs, Effexor, MAOIs -- but *not* tricyclics), psychostimulants (Ritalin, Dexedrine, Adderall, Cylert), and anticonvulsants (Depakote, Tegretol, Lamictal). There are also cognitive-behavioural psychotherapies that can be effective, but I think they are probably less effective if the mood aspects of the disorder (in this case, the anger attacks) are not treated first.

I hope that this makes sense and can help lead you to a solution. I know your husband seems like the "bad guy" when he's having these episodes of anger, but my guess is that they are a source of shame and pain for him as well as for you and your children.

Best wishes,
-elizabeth

 

Re: is anger a sign of depression or.....? Elizabeth

Posted by SLS on May 27, 2001, at 20:00:31

In reply to Re: is anger a sign of depression or.....?, posted by Elizabeth on May 27, 2001, at 14:42:50

Hi Elizabeth.

> Medically, the most effective treatments for the ADHD-borderline spectrum of disorders are probably antidepressants (e.g., SSRIs, Effexor, MAOIs -- but *not* tricyclics),

Why not tricyclics? Are they counterproductive when there are BPD symptoms? In the past, tricyclics were considered effective for treating the behavioral aspects of ADHD in adults.

Excellent post, by the way.

- Scott

 

Re: is anger a sign of depression or.....?

Posted by N.P. on May 28, 2001, at 12:38:23

In reply to Re: is anger a sign of depression or.....?, posted by Elizabeth on May 27, 2001, at 14:42:50

Thank you Elizabeth (and everyone who made comments to this thread).
I'm afraid that I will not be able to give full pucture of my husband's childhood. He avoids this topic mostly. Espesially talking about his parents. He might tell me more since I made a statement yesterday that I'm not on their backs because I realize that they loved him and wished him well, but they just did not know the other way to raise the child. He really liked that. So looks like deep inside of him he has a guilt for what his parents done to him. That's why any attacks on his parents' deeds he takes personally as if someone was attacking him. Another residue of his childhood nightmare is guilt for almost anything that happens around him. Let's say he knocked something from the table. He gets incredible amount of frustration and guilt (because he was shamed and scolded a lot for almost anything that happened to him). And since he needs to deal with those negative emotions he .... tries to find someone else to blame.. For the accident... Lets say "Who put that darn thing on the table?!!!!!!!!!". It takes me a great deal to stop him when he tries to blame kids for everything. And me. But at least I'm a grownup and can handle it.
Strong sides.. He's reliable. Financially we're protected. He will handle any money matters well. And he's very eager about doing that. If he likes the idea he'll do almost impossible. He's been always getting best deals for everything. But you are right - he concentrates on certain activities only. He loves music. But that drives me crazy too, because he'd be with us (or with the company) and would turn it on loud instead of having conversation. Plus he listens to things at least thousand times. There's always music around him. On computer, on all of his CD players, in the backyard, in the cars - everywhere.
And about childhood.. Untill like third-fourth grade he was always getting lowest grades and misbehaved and his parents would punish him a lot because of worstest reports and complains from teachers. And then he shifted to better grades. In college he had all "A", even though he hated some of the disciplines but still managed to get A's.
He loves kids. If he's more than a day away from home he misses them. But he definitely doesn't understand them. I have to explain him every day that kids are not little adults. I just hope that he'll go to a doctor and the doctor will be great and gives him the right meds. And that will ease the process of getting him into therapy. Whoo... to much to hope for.
Thanks again everyone for your support.

N.P.


> > It really is impossible to make a diagnosis on this information.
>
> This is always true on internet discussion boards...and of course, what you'll be getting is not a true diagnosis, but an educated guess (few professionals are willing to hazard an online diagnosis, IME). Still, it's something to start from.
>
> > It is obvious he has mood lability and irritability, but those symptoms go along with numerous conditions -- including depression.
>
> Mood lability (mood swings, including shifts from one dysphoric mood to another -- e.g., anxiety to anger to sadness) is definitely not what is meant by "depressed mood" in the diagnostic criteria for depression. In the context of depression, "mood-reactivity" refers to the ability to be cheered up on by pleasant events (but usually, the person has lost interest in former interests and will not actively seek out pleasure). The "mood reactivity" associated with borderline personality includes excessive, "out-of-control" anger that is out of proportion to whatever the person claims to be angry about. N.P.'s description of her husband's behaviour does sound somewhat like BPD -- inappropriate or out-of-proportion anger attacks that are intense but brief, stormy or unstable relationships and home life, the appearance of manipulativeness, the belief that his behaviour is "normal" or "acceptable," etc. -- but I think that personality disorder diagnoses are red herrings. (To say that BPD is the result of a lousy home life ignores the question of why only some of the many people who had lousy childhoods grew up to become "borderlines," and why some "borderlines" had extremely difficult childhoods (sexual and physical abuse, etc.) while others had only moderately difficult ones.)
>
> Irritability is sometimes a prominent feature in depression -- some people express their depressed mood in this way -- but it seldom dominates the picture. Brief anger episodes in the context of an otherwise normal mood are not characteristic of depression; a depressed/dysthymic person with anger attacks would be gloomy, pessimistic, perhaps sarcastic. Also, irritability or anger by itself is not sufficient for a diagnosis of depressive disorder. Although I agree with loosmrbls that there isn't enough information, depression isn't what comes to mind based on the description given.
>
> To me, this sounds like something that I've heard referred to as "ADHD spectrum disorder" -- see the writings of Akiskal for a discussion of spectrum theory of mental disorders. Basically what I mean is that the problems described don't fit into any of the current pigeonholes described in DSM-IV, but ADHD looks like the closest match based on the available information. (There are also some features associated with borderline personality disorder, which appears to be related to ADHD in many cases.)
>
> Although they do often have difficulty with concentration and attention, people with ADHD are known to focus intensely on certain activities; what particularly caught my eye was the suggestion of "computer addiction." This seems to be very common among people with ADHD (in my experience). Angry outbursts are also common among adults (as well as children) with ADHD. These outbursts are thought to be due to impatience or poor frustration tolerance.
>
> As loosmrbls points out, ADHD is a life-long, temperamental disorder. N.P., could you tell us anything about what your husband was like as a child? That would be very helpful. A chaotic home life, as you described, is especially harmful to a child who is sensitive, impulsive, and inattentive. I can easily imagine that such a child would not "grow out" of these traits if he grew up in a chaotic environment.
>
> It would also be helpful to know more about what your husband's personality is like when he is not having anger attacks -- what do you see as his strengths and weaknesses?
>
> Medically, the most effective treatments for the ADHD-borderline spectrum of disorders are probably antidepressants (e.g., SSRIs, Effexor, MAOIs -- but *not* tricyclics), psychostimulants (Ritalin, Dexedrine, Adderall, Cylert), and anticonvulsants (Depakote, Tegretol, Lamictal). There are also cognitive-behavioural psychotherapies that can be effective, but I think they are probably less effective if the mood aspects of the disorder (in this case, the anger attacks) are not treated first.
>
> I hope that this makes sense and can help lead you to a solution. I know your husband seems like the "bad guy" when he's having these episodes of anger, but my guess is that they are a source of shame and pain for him as well as for you and your children.
>
> Best wishes,
> -elizabeth

 

Re: is anger a sign of depression or.....? SLS

Posted by Elizabeth on May 29, 2001, at 18:09:40

In reply to Re: is anger a sign of depression or.....? Elizabeth, posted by SLS on May 27, 2001, at 20:00:31

> > Medically, the most effective treatments for the ADHD-borderline spectrum of disorders are probably antidepressants (e.g., SSRIs, Effexor, MAOIs -- but *not* tricyclics),
>
> Why not tricyclics? Are they counterproductive when there are BPD symptoms?

Yes, that's exactly right. "Borderline-spectrum" patients (i.e., those identified today as having BPD) seldom respond to TCAs and frequently do worse on them. One possible explanation I've heard is that there is some relationship between BPD and bipolar disorder: TCAs are the most likely of all the ADs to induce rapid-cycling and mania, in particular dysphoric mania.

> In the past, tricyclics were considered effective for treating the behavioral aspects of ADHD in adults.

Behvaioural aspects, but not the affective aspects? I have a hard time imagining that, unless it's just because people with ADHD are often hyperactive and tricyclics tend to be sedating.

ADHD and depression do overlap a great deal, so I'm sure that some people diagnosed with "adult ADHD" would respond to TCAs. This particular case didn't sound like "typical" major depression or dysthymia to me, though.

Does that make sense?

-elizabeth


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