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Ask the Mental Health Expert Archives 2001-2004

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Easily Angered

Q. Lately I've been getting very angry at little things. If something won't work right, I get a very bad temper and get hot flashes. Is there an over-the-counter drug I can take to calm me down?????

A. There are over-the-counter agents you can try, but they all have potential risks. I think it would be wiser to begin looking at why, lately, you have been feeling angry and irritable, as well as why you are having hot flashes.

Ruling out some underlying, physical or psychiatric problem is an important first step, and I would recommend beginning with a general medical assessment. Explain to your doctor that these symptoms are not usual for you, and discuss with him or her whether appropriate laboratory and physical tests would be useful; for example, people with over-active thyroid glands may become anxious, irritable, or intolerant of heat.

If you are female and approaching menopause, an evaluation of your hormonal status may be appropriate. Irritability may sometimes be a sign of a clinically serious mood disorder, such as depression or mania--though I can't tell this from the limited information contained in your question. But, asking your family doctor about this possibility would be prudent. If he or she thinks that you may be depressed or have a bipolar disorder, you may be referred to a mental health professional for further evaluation and treatment. Or, your doctor may try to treat the problem, perhaps using a mental health professional (psychiatrist, psychologist) as a consultant.

All of this is another way of saying, "Hold off on the over-the-counter drugs." First, get the evaluation. Some herbal or over-the-counter agents for anxiety or depression could make things worse, if you have an underlying medical or psychiatric disorder. However, you can almost never go wrong with learning some relaxation techniques, such as deep-breathing, muscle relaxation, yoga, etc. (This is in addition to, not instead of, the medical evaluation). Herbert Benson's "The Relaxation Response" is a classic in this area. A stress reduction work-shop or an anger management class, if it is conducted by a mental health professional, may be useful.

Prescribed medication may be very helpful for you, if it turns out that you do have an underlying anxiety or mood disorder. I don't mean to evade your question. But five question marks at the end of a query letter usually says to me, "don't try self-treating this problem"!

December 2002

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