[18F] Experiencing intense anger and physical symptoms

Patient Description

An 18-year-old female reports experiencing intense anger, often triggered by feelings of betrayal, which leads to saying hurtful things without remorse. These episodes occur 2-3 times a week and persist until she engages in risky behavior. Accompanying symptoms include a pit feeling in the stomach, urges to harm, a stabbing sensation in the chest, and lightheadedness. She has a history of binge eating disorder diagnosed at age 12. No current medications are reported. The patient has acted on thoughts of self-harm and harming others in the past.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing the following conditions:

  • Intermittent Explosive Disorder (IED): This is a disorder characterized by repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation. The intense anger and physical symptoms you've described could be indicative of this condition.

    • Treatment typically involves cognitive behavioral therapy (CBT) to help manage anger and control impulsive behaviors. In some cases, medications may also be prescribed.
  • Depression and Anxiety: You have a history of these conditions, and some of your symptoms such as feelings of hopelessness, insecurity, and thoughts of self-harm are common in these disorders.

    • Treatment usually involves a combination of psychotherapy (talk therapy) and medications. Lifestyle changes, such as regular physical activity, a healthy diet, and adequate sleep can also help manage symptoms.
  • Binge Eating Disorder: You've mentioned a history of this disorder. If you're still experiencing episodes of binge eating, this could be contributing to your feelings of loss of control and insecurity.

    • Treatment often involves psychotherapy, medications, and nutrition counseling.

What you can do

  1. Seek immediate help if you're having thoughts of hurting yourself or others. Reach out to a trusted friend or family member, contact a mental health professional, or call a crisis hotline. In the U.S., the National Suicide Prevention Lifeline is 1-800-273-TALK (1-800-273-8255) or use the Crisis Text Line by texting HOME to 741741.

  2. Schedule an appointment with a mental health professional. They can provide a formal diagnosis and develop a treatment plan tailored to your needs.

  3. Try to identify triggers for your anger and develop strategies for managing it. This could involve taking a few moments to breathe deeply and calm down, walking away from the situation, or finding a healthy outlet for your anger such as exercise.

  4. Practice self-care. This includes eating a balanced diet, getting regular exercise, ensuring you get enough sleep, and taking time each day to relax and do things you enjoy.

What you should look out for

  • Increased frequency or intensity of anger episodes
  • Increased feelings of hopelessness or thoughts of self-harm
  • Any new or worsening symptoms

Remember, it's important to seek help from a healthcare professional who can provide a formal diagnosis and appropriate treatment. This information is intended to be educational and should not be used as a substitute for professional medical advice.

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6 mo ago


People Also Ask


What is Intermittent Explosive Disorder (IED) and how is it treated?

Intermittent Explosive Disorder (IED) is characterized by sudden episodes of impulsive, aggressive, or violent behavior that are disproportionate to the situation. Treatment typically involves cognitive behavioral therapy (CBT) to help manage anger and control impulsive behaviors, and sometimes medications are prescribed.


How can depression and anxiety contribute to feelings of anger and impulsivity?

Depression and anxiety can contribute to feelings of anger and impulsivity by causing emotional distress, feelings of hopelessness, and insecurity. These emotions can lead to difficulty managing anger and impulsive reactions. Treatment usually involves psychotherapy and medications, along with lifestyle changes.


What are the treatment options for binge eating disorder?

Treatment for binge eating disorder often involves psychotherapy, such as cognitive behavioral therapy, medications to help control urges, and nutrition counseling to develop healthy eating habits.


What should I do if I have thoughts of self-harm or harming others?

If you have thoughts of self-harm or harming others, it is crucial to seek immediate help. Reach out to a trusted friend or family member, contact a mental health professional, or call a crisis hotline. In the U.S., you can contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the Crisis Text Line by texting HOME to 741741.

1 Comments


Anonymous#19741

6 mo ago

My girlfriend suffers from this as well, and it's taking a toll on our relationship because therapy is too expensive at the moment, and she doesn't have any strategies for managing flare-ups. Her go-to response is throwing objects and screaming loudly.

The last time it was really bad, we were putting together a bookshelf, and she kept getting frustrated with the screws. She ended up throwing one of the shelf brackets, which hit my foot and resulted in me needing stitches.

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