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Dr. Steve
Dr. Steve, Psychologist
Category: Mental Health
Satisfied Customers: 370
Experience:  19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
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I have a history of uncontrolled and unpredicatbale anger attacks.

Resolved Question:

I have a history of uncontrolled and unpredicatbale anger attacks. They are directed toward my imtimate partner at the time. They are esplosive and often violent. They leave me with terrible guilt and emotional shock coupled witha sense of despair and loneliness. I am acutely anxious socially after one of these attacks. it seems as though all my relationships have this 'anger element' attached to them and I feel the ashamed of the level of anger and aggression that I show. I have very low self worth and an almost constant low mood. Although I get very very lonely I find social contact very stressful. Could I be bipolar?
Submitted: 6 years ago.
Category: Mental Health
Expert:  Dr. Steve replied 6 years ago.

Greetings:

 

Great question. And yes, you could be bipolar. Bi-polarity comes with emotional AND cognitive changes, often resulting in the type of outburst you describe. Typically, these outbursts are seen more prominently in bipolar children, but adults can have similar manifestations (more rare, but not unheard of). In other words, the emotions begin to leap out of control, but the cognitive processes that are typically employed to curb the behavioral episodes are also re-routed, thereby leaving the emotion to run unchecked.

 

Another possibility is a rarely-used diagnosis called Intermittent Explosive Disorder. There is some debate in our field as to whether this one exists or not, as it seems to fold nicely into the the broader "Bipolar" criteria. Still, it remains a diagnostic option for now.

 

Realistically, there is not much difference between the two as far as treatment goes. Mood stabilizers or atypical anti-psychotics will be employed (on occasion, anti-seizure medications can also be used). Talk therapy is recommended to deal with some of the self-talk that leads to the guilt and shame you feel after an outburst, and with the trauma that is possibly adding fuel to the fire.

 

If you are satisfied with the response, please hit "Accept." This is the only way I receive credit for my answer. Thanks-

Dr. Steve

Customer: replied 6 years ago.
Great response, just one more quick question.I have an irrational fear of abandonment that may have come from early psychological abuse form parents. I have heard of Borderline Personality Disorder. Could that be a possible diagnosis?
Expert:  Dr. Steve replied 6 years ago.

Hello Again:

 

No trouble at all. In fact, you bring up a good point that I overlooked in my original response. If the rages never get out of control outside of your intimate relationship, then borderline would be the place to look. A bipolar person would trip into the episodes in many different situations, not in a specific one all the time.

 

Borderlines tend to vacillate strongly between the intensity you described above (abandonment fears) which lead them into crazy, jealousy-fueled anger and attempts at controlling the partner - through physical force or emotional intimidation. Then, when the partner is close, they tend to feel uneasy because of prior traumas and abandonments, thereby creating craziness even when things seem to be going well.

 

The prognosis for full-fledged borderlines is not good unless you hook up with a therapist who has treated a lot of these character disorders. The traumas you described take a lot to get past, and inexperienced therapists may not know how to handle the energy and chaos in your life.

 

I do wish you well-

Dr. Steve

 

Please hit Accept if you are satisfied with the response. That is the only way I receive credit for my answer. Thanks!

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