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Suggest Treatment For Mood Swings, Uncontrollable Anger And Chronic Pain
Question: May I ask a hypothetical (only such because it is too unbelievable) question. Into my fifth year after MVA; four surgeries (one necessary, repair of it, MVA, unnecessary and disastrous sigmoid resection, infection, hernia, treated for chronic pain and surgeries not addressed) I wonder, with being so lost in the cracks; pain that is indescribable and fear of being so complicated, I'll never get the puzzle solved, how can I not feel anger: How can I fear visitors because I can't sit still or let things go and then, visitors gone, pain builds up and anger is toward my husband. To this day I wonder why and how anyone could be so dismissed; so lost; and have so much pain yet specialists are so specialized they can't think outside of the box. But, how can I possibly show pain when grandchildren, whom I love, are here? I can't. They leave and I'm in so much pain; I tend to rehash the past and my anger towards my husband, patient man that he is, is uncontrollable. If I do not budge from couch, pain is controlled - this is a person who was so very active. My question is, until the right doctor checks every area; symptom, how do I control the person I've become - a stranger to me.
Brief Answer:
Please try to remain calm and see a pain specialist
Detailed Answer:
Hello, thanks for asking from HCM for your health related queries
I have read the query and I can understand your concern. You are 67 years old female who used to be a different person prior to all these surgeries and onset of pain. You have undergone four surgeries in past few years, are being treated for chronic pain and have underwent unnecessary sigmoid resection. Even with medicines pain is persistent and if you don't move much from couch then the pain doesn't occur in severity. Due to all these surgeries over short period of time and then non relieving pain you have probably developed mood disturbances which have resulted in episodes of uncontrollable anger. Repetitive and persistent stress results in symptoms of adjustment disorder which can result in anger, mood swings etc.
Relief of pain would result in improvement of your mood. So you have to consult a pain specialist as well as a psychiatrist for help. Even some medicines like SNRIs as Venlafexine or Duloxetine etc help a lot in chronic pain when other conventional pain medications fail. These will also help to reduce your mood swings and irritability.
Don't be distressed due to pain. Remain hopeful the pain will decrease in some time. For some time you can increase the dose of Percocet to reduce the pain till you see a specialist. For very severe intolerable pain Buprenorphine patches are available. These patches provide sustained drug delivery of drug and thus provide continuous pain relief. Consult your doctor for these patches.
Try to read a good book or listen light music to remain calm. Make a list of events which result in anger outbursts especially on your husband. Then start from most anger provoking to least and deal these symptoms one by one. Try to delay the outbursts progressively. Take a glass of cold water and drink it sip by sip during irritable episodes. This will help you to calm down.
See a doctor and a psychiatrist for management.
Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts.
Take care
Please try to remain calm and see a pain specialist
Detailed Answer:
Hello, thanks for asking from HCM for your health related queries
I have read the query and I can understand your concern. You are 67 years old female who used to be a different person prior to all these surgeries and onset of pain. You have undergone four surgeries in past few years, are being treated for chronic pain and have underwent unnecessary sigmoid resection. Even with medicines pain is persistent and if you don't move much from couch then the pain doesn't occur in severity. Due to all these surgeries over short period of time and then non relieving pain you have probably developed mood disturbances which have resulted in episodes of uncontrollable anger. Repetitive and persistent stress results in symptoms of adjustment disorder which can result in anger, mood swings etc.
Relief of pain would result in improvement of your mood. So you have to consult a pain specialist as well as a psychiatrist for help. Even some medicines like SNRIs as Venlafexine or Duloxetine etc help a lot in chronic pain when other conventional pain medications fail. These will also help to reduce your mood swings and irritability.
Don't be distressed due to pain. Remain hopeful the pain will decrease in some time. For some time you can increase the dose of Percocet to reduce the pain till you see a specialist. For very severe intolerable pain Buprenorphine patches are available. These patches provide sustained drug delivery of drug and thus provide continuous pain relief. Consult your doctor for these patches.
Try to read a good book or listen light music to remain calm. Make a list of events which result in anger outbursts especially on your husband. Then start from most anger provoking to least and deal these symptoms one by one. Try to delay the outbursts progressively. Take a glass of cold water and drink it sip by sip during irritable episodes. This will help you to calm down.
See a doctor and a psychiatrist for management.
Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
After surgeries because of MVA and chronic pain I was on 50 mg fentynol and up to 8 percocet. I asked for safe withdrawal and was successful until I passed such huge amounts I feel like I tore something.
I see a Psychiatrist; he was brought in (Army) to help me withdraw from xanax. I wanted off of everything as I had never been on this stuff until surgeon's got the best of me so going back to more meds is not good. My goodness, my insides are screaming; finally I have a radiologist who listened to surgeries, symptoms, had appropriate tests and will combine them with the other experts, but 2 1/2 years and I had to request that he compare the old with the new - who wouldn't be angry? No life. What good does it do to see a doctor when symptoms are so obvious? And, do I not have a right to get angry once in awhile. Opiate mess with the mind therefore I get angry but I get relief. I think it's selfish of my husband to be so timid that he'd rather I not be angry from Percocet (I think i told you I was off of all opiates until matters worsened due to neglect) I limit it to 4/day which means inactivity. This is 2015. Seems that a probable ilias should concern someone. My psychiatrist is the one who has stood by me - he acknowledges the awful journey but he's leaving (military) I can't take anti depressants; pain management here is a joke - I kept getting injections because, MVA and CHRONIC PAIN, were treated. I believe I'm stuck and every day seems like a waste. Sorry to ramble. I want to shake a doctor and say "Look at me" I was fine until two surgeons violated me and provider drugged me. I care not to have anyone around because pain rules. Thank you. It's easier said than done because it's gone on too long and my guess is I'll end up with a colostomy. All because of a careless surgeon who won't answer my calls. I should not even write on this site because I'm too upset to make sense. One thing I do know, it has done no good to tell symptoms because of ignorance. Best to you and I am angry. Anger brings on more pain so it's said, but, I don't get angry until the pain peaks. Catch 22.
I see a Psychiatrist; he was brought in (Army) to help me withdraw from xanax. I wanted off of everything as I had never been on this stuff until surgeon's got the best of me so going back to more meds is not good. My goodness, my insides are screaming; finally I have a radiologist who listened to surgeries, symptoms, had appropriate tests and will combine them with the other experts, but 2 1/2 years and I had to request that he compare the old with the new - who wouldn't be angry? No life. What good does it do to see a doctor when symptoms are so obvious? And, do I not have a right to get angry once in awhile. Opiate mess with the mind therefore I get angry but I get relief. I think it's selfish of my husband to be so timid that he'd rather I not be angry from Percocet (I think i told you I was off of all opiates until matters worsened due to neglect) I limit it to 4/day which means inactivity. This is 2015. Seems that a probable ilias should concern someone. My psychiatrist is the one who has stood by me - he acknowledges the awful journey but he's leaving (military) I can't take anti depressants; pain management here is a joke - I kept getting injections because, MVA and CHRONIC PAIN, were treated. I believe I'm stuck and every day seems like a waste. Sorry to ramble. I want to shake a doctor and say "Look at me" I was fine until two surgeons violated me and provider drugged me. I care not to have anyone around because pain rules. Thank you. It's easier said than done because it's gone on too long and my guess is I'll end up with a colostomy. All because of a careless surgeon who won't answer my calls. I should not even write on this site because I'm too upset to make sense. One thing I do know, it has done no good to tell symptoms because of ignorance. Best to you and I am angry. Anger brings on more pain so it's said, but, I don't get angry until the pain peaks. Catch 22.
Brief Answer:
Please try to relax yourself.
Detailed Answer:
Hello again,
I am able to understand your problems. Due to negligence of surgeons and then medicines providers you developed intractable, non remitting pain. All these things are worsening your mood and have resulted in anger outbursts. Continuous debility results in significant blow to day to day functioning. You have anger because of persistent pain, because of useless and negligent surgeries and because they made you dependent on medicines. But I am afraid but you have to accept this.
The relationship between pain and anger, stress symptoms is bidirectional considering your history. Persistent pain is worsening stress and anger. But in the same time anger and stress symptoms are also worsening the pain. A cycle of pain-anger-pain has been formed. So to come out of all this mess you have to break this cycle. As it is really difficult to control pain because of non-response so in such situation best is to address the issues of anger and stress.
I known you don't want to take antidepressants but believe me they will help you. The drugs of SNRI class as I have mentioned like Venlafaxine or Duloxetine both are very helpful in chronic pain conditions and will help to reduce your anger also. I have used both of these medicines in a lot of patients of mine and these medicines proved useful. Please I know its difficult for you to go on antidepressants but these medicines are different. You can call your psychiatrist also and can take opinion regarding these medicines.
Thanks, Please write again if you want to discuss more. Don't be depressed, you will surely come out of this mess, just believe in yourself.
Take care
Please try to relax yourself.
Detailed Answer:
Hello again,
I am able to understand your problems. Due to negligence of surgeons and then medicines providers you developed intractable, non remitting pain. All these things are worsening your mood and have resulted in anger outbursts. Continuous debility results in significant blow to day to day functioning. You have anger because of persistent pain, because of useless and negligent surgeries and because they made you dependent on medicines. But I am afraid but you have to accept this.
The relationship between pain and anger, stress symptoms is bidirectional considering your history. Persistent pain is worsening stress and anger. But in the same time anger and stress symptoms are also worsening the pain. A cycle of pain-anger-pain has been formed. So to come out of all this mess you have to break this cycle. As it is really difficult to control pain because of non-response so in such situation best is to address the issues of anger and stress.
I known you don't want to take antidepressants but believe me they will help you. The drugs of SNRI class as I have mentioned like Venlafaxine or Duloxetine both are very helpful in chronic pain conditions and will help to reduce your anger also. I have used both of these medicines in a lot of patients of mine and these medicines proved useful. Please I know its difficult for you to go on antidepressants but these medicines are different. You can call your psychiatrist also and can take opinion regarding these medicines.
Thanks, Please write again if you want to discuss more. Don't be depressed, you will surely come out of this mess, just believe in yourself.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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