Mental Health Diagnosis

MarkEsq said:

My specific questions, then, are:
1. What would be an appropriate MH condition/issue?
2. What would the medication be that my MC finds, and then helps the character appear normal?

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You might just want simple anxiety, if you're looking for not too severe. I think the actual term would be "General anxiety disorder." Your violent outbursts are rarer but possible and easily controlled by anti-anxiety medication such as Cymbalta, Effexor, Prozac, Zoloft and about a billion others. Benzodiazepines, such as Xanax or Valium, would be common if the patient had panic attacks, but those usually won't result in violent outburts. Your patient should also be under some type of therapy if violent outbursts are a characteristic.

There's also a diagnosis called Intermittent Explosive Disorder, where a patient randomly becomes violent or aggressive out of proportion to the situation they are in. Similar drug and therapy treatments, can be related to anxiety or bi-polar disease, but the latter may be more than you want for your character. Or it may fit perfectly. This is what is called a passive-aggressive behavior.

By the way, steroid use/abuse can cause a similar reaction, though you wouldn't normally find medication for that at someone's house. You could find steroids though and have that explain it. Though "roid rage" doesn't meet the criteria of being on/off medication, it may fit your story.

Jeff

Hi
I not in anyway an expert in mental health , but I believe mental health problems that can make people violent are relatively rare and difficult to treat .Do you need violence . Bipolar in comparison is more common and is treatable with a single drug , Lithium. Living with someone with bipolar can be difficult , but not dangerous.

This link might help: http://www.psychguides.com/guides/anger-symptoms-causes-and-effects/

stephenf said:

Hi
I not in anyway an expert in mental health , but I believe mental health problems that can make people violent are relatively rare and difficult to treat .Do you need violence . Bipolar in comparison is more common and is treatable with a single drug , Lithium. Living with someone with bipolar can be difficult , but not dangerous.

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I am bipolar and yes, if someone goes off their medication then they can become extremely angry and prone to outbursts. This of course would not be the only symptom, but would suit your needs, OP. However, I disagree on using Lithium as the drug. Lithium is rarely used these days to treat mild forms of bipolar disorder due to its severe side effects. It is still used some, but generally only after many other medications have been tried and failed and only if it is a severe case. I would recommend using Welbutrin. It is a well known and effective drug that acts as a mood stabilizer with far fewer adverse side effects than Lithium.

When I was diagnosed as having a psychotic episode, I was prone to fits of violence. Didn't get into many fights but easily could've. I remember once I flipped out in front of everyone at work and said "I didn't fucking say anyone had touched the accounts" in a really sinister way, everyone went quiet. Funny thing is it could've been the voices in my head that triggered it lol. Voices in the head may require a lot more work, though.

Edit, I had a lot of mini episodes where I didn't realise that something bigger was coming. All the mini one's led upto a massive one. Went on for about 2 years.

GAD doesn't tend to lead to violence ime. Maybe if you were cornered by people who insisted on helping you with your panic attack and just wouldn't go away and leave you alone. It's very much an internalising disorder.

Does your story need anything specific? No, anxiety disorders are not necessarily prone to violence, so that would be surprising. But, certainly psychosis, bipolar disorder, depression, various personality disorders can be (although PDs are not typically treated with meds.) And Jeff has a great point about steroids (assuming that 'roid rage was referring to steroids and not hemorrhoids!)

But yes, clients who are depressed can seem very nice (because they are!) but can become very irritable if they go off an effective antidepressant. Sometimes they could get violent (that would be very plausible -- many couples come in because one is having temper tantrums, is really irritable and it turns out the person is depressed) Women who have premenstrual dysphoric disorder could be very irritable (and are treated, typically with an SSRI) Of course, people with psychosis can be violent if they go off their antipsychotic for any lengthy of time (they don't necessarily but they could--and the difference when people are off vs on their meds is striking!) Tegretol is one med that is used for anger/explosive issues.

And yes, one would hope that if there were explosive issues that the client would be in therapy, but unfortunately, not always the case, particularly these days But certainly if the client would depressed, they might be.

Bipolar disorder might fit your bill. Yes, lithium is still used. As is valproic acid, Zyprexa, Lamictal and sometimes, depending on the presentation (some drugs are better for depression, some for mania), a combination may be used (or drugs like Abilify, Latuda or Geodon) But someone diagnosed with bipolar disorder I could certainly be violent/massive tantrums if off their meds. you would have a lot of flexibility here as far as meds, because there is a lot of variation in how it's treated!!

My only qualm with using bipolar disorder (speaking with someone who has it) is that it is the go-to trope for anyone with outbursts of any kind. The last three murder mystery shows I watched (different shows, I might add) all had someone who was bipolar go off their meds and commit some sort of violent act. ADD/ADHD can also be characterized by aggressive outbursts if medication is missed.

I will politely disagree that ADHD is associated with aggression in any way like bipolar disorder, in fact, that is one of the things that can sometimes distinguish impulsivity/inattention from bipolar symptoms. ADHD can be very frustrating but typically (yes, there are anecdotal exceptions) does not come with the explosive rage that can accompany BPD.

Sorry, I was thinking with my teacher hat for a moment. Aggression and inattentiveness are traits we associate with students who may need further evaluation at the elementary level. I apologize for any confusion/misinformation. It's been a long day lol.

Then again, (and I'm just theorizing here so take with a grain of salt) if an individual with ADHD/ADD happens to be prone to violent outbursts, the stress of withdrawal may make them lash out more than normal. At least for me, missing my medication exacerbates my anxiety and proclivity for yelling at strangers for minor offenses.

Again, in general, and for the purposes of this story--what would be a common disorder with the features described--a bipolar presentation is far more consistent with violent outbursts than ADHD. Can folks with ADHD be aggressive? Sure! Pretty much anyone can be. But if I was seeing a lot of aggression, explosive outbursts and so forth in an ADHD'er, I would definitely be looking at comorbidities (oppositional defiant disorder, conduct disorder, antisocial personality disorder, maybe a substance abuse disorder, and yes, bipolar disorder.) And again typically, withdrawal is not an issue, if one tapers off on a medically recommended schedule. Can it be unpleasant? yes, particularly if someone has been abusing the drug (Adderall, for example) but if people experience anything, they're usually lethargic, depressed, irritable and so on. Not prone to violent rages (unless they have a comorbid diagnosis)

Of course, a TBI (traumatic brain injury) can definitely dispose someone to violence as well,might not work for the story though!