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Query

In my childhood, I had many bouts of explosive rage, which led me to throw things, misbehave with friends and family and even cut my arms. As I grew up, I started developing depressive symptoms. I had problems concentrating in my studies and work. It's been some years since I started working and I don’t enjoy it. The issue with me is that I give up too easily. I am 30 now and I still feel angry at myself thinking about my past. I recently smashed my phone and tore my driving license. Family conflicts are also fairly common with me. I feel unloved, uncared for, and ignored. I often get demotivated. What should I do? Please help! —M.J.

Answered by Dristi Moktan, Counsellor, Happy Minds  

Given all that you have experienced since childhood and that things have only become worse with time, it would be preferable to consult a mental health expert. Anger issues in early stages can be somewhat self-managed, but as they intensify, you must be aware of your own limits. They are often too much to handle on your own. It is advisable to get professional help as anger issues are often symptoms of an underlying cause. 

But here are a few strategies you can use to manage your anger. It's important to first think about what makes you angry, what you actually feel when you're angry, what are the consequences that follow, is it hurting you, or are you merely expressing your sentiments? You might want to keep track of your anger. Being more emotionally aware of yourself can enable you to see things clearly. The more you express your feelings, the more they'll help. You can also try writing down your feelings when you get angry. 

Another thing you can do is to delay your response: if you feel angry, try to hold back your response and then reflect on the situation. We can't control our emotions, but we can control our responses. If you ever get a feeling of anger rising inside you, take a deep breath, hold it and exhale slowly. If that still doesn't work, consider leaving the situation that is triggering your anger. You can also imagine a pleasant scenario to help you calm down.  

Practicing meditation can also be beneficial to regulate your emotions. Given enough time and practice, all of these approaches can help you develop a robust coping mechanism for anger.

Query

I am a 52-year-old banker who was diagnosed with breast cancer six months ago. At my doctor's suggestion, I will have to undergo chemotherapy, as well as remove one of my breasts to stop the cancer from spreading. My doctor tells me that I will survive, but I feel sad and hopeless. Somehow, I have no enthusiasm to undergo treatment and get better. Lately, I have been avoiding my friends, family and well-wishers. Is this normal? -A confused patient

Answer by Rishav Koirala, Psychiatrist and Researcher

For most cancer patients, it is very difficult to accept the fact that they have cancer. It is normal to feel frustrated in a situation like yours. The reluctance to undergo treatment is also fairly common, as the news of cancer can make patients emotionally vulnerable. 

Chemotherapy has many kinds of mental and physical effects on the human body. It can result in loss of hair and weight, which is directly connected to the individual’s appearance. For most cancer patients, the thought of this can be very stressful. They are unable to come to terms with the fact that they will undergo physical changes. After all, our appearance is part of our identity.  

I want to assure you that feeling this way is normal. But letting this escalate will worsen your stress. As a cancer patient, you need enough rest and a positive outlook, which is not possible if you focus on the negative and keep imagining bad scenarios for yourself. 

One thing you can do to stop overthinking negative thoughts is give them a positive spin. For instance, if you are worried about losing your hair, focus on the long-term outcome and not the temporary effects of therapy. The hair will grow back once the treatment is over. More importantly, you will be cancer-free and healthy again.

Yes, it is difficult to stay positive when you have been diagnosed with cancer. But positivity is something you practice and it is a gradual process.

You should also remember that you cannot tackle this situation on your own. You need people to talk to. So, rather than avoiding interactions, I suggest you find someone whom you are comfortable sharing your thoughts, someone who will listen to you and give you the right suggestion. Doing this can improve your depressive symptoms. 

If these suggestions do not work, you can always consult a psychiatrist or a psychologist, who can help you navigate this difficult process. 

I am a 26-year-old student with anger issues. I have no control whatsoever over my anger. Minor inconveniences irritate me and on a bad day, this irritation morphs into a full-blown violent episode: I bang doors and throw stuff. Sometimes, I don’t remember what I did in a fit of rage. I feel extremely guilty after my outburst, but I cannot help myself. How can I prevent something like this from happening in the future when I cannot even remember what I did? My behavior is pushing my friends and well-wishers away. Please help. —An annoyed fellow

Answered by Alisha Humagain, Psychological Counselor, Happy Minds 

Anger is a built-in part of the body’s “fight, flight, or freeze” system, which helps protect us from threats or dangers. Everyone occasionally feels angry, which is common. But if you are unable to control your anger, it can create issues in your relationship with family and peers.

It is important to know that anger and aggression are different things. Anger is an emotion but aggression is related to how a person behaves. Not everyone with anger will show aggression, and not everyone who acts aggressively is angry.

Everyone experiences anger, but there are ways to control it so that it doesn’t spiral out of control. Being aware of the changes in your body, emotions, and behaviors caused by anger can help you decide how you want to react to a situation before you act. Walking away or even pausing for a minute before saying something or reacting can help you get a hold of yourself. 

When you feel like you’re starting to get mad, start counting to 10 slowly. It will help you reduce the intensity of the anger. Releasing tension from your body also helps you calm down. To release tension, drop your shoulders, unclench your jaws, and stretch your body. 

When you are angry it is also common to jump to conclusions. If you find yourself in an argument with someone, take some time to listen and pause before responding. You also have to remember that sometimes when our emotions are running high a situation might seem much worse than it really is. Writing down all your negative thoughts and feelings in a journal can also help you release the anger you might be holding inside. You can also look for other distractions such as listening to music, taking a walk, or even just taking a shower. Diverting your negative thoughts will help you realize that the thing making you angry is not a big deal. 

You can also try using relaxation techniques, such as deep breathing and progressive muscle relaxation to mitigate anger. If you are unable to control your aggressive tendencies even after trying these strategies, it is best to seek professional help. And remember, addressing the problem is the first step towards healing. 

I am a 21-year-old student with a terrible case of insomnia. I have tried everything possible to get a good night’s sleep, from exercising till exhaustion to using sleeping pills–all to no avail. I feel tired and sleepy but I can barely get myself to sleep for two hours. Some days, I am up all night and asleep all day. This has been going on for six months now. I started having this problem in my teenage and it's only gotten worse. What should I do? —An insomniac

Answered by Rishav Koirala, Psychiatrist and Researcher

Most of the time when a patient claims to have a sleeping disorder or insomnia, it is usually a secondary problem. Mostly, it is a symptom of other mental health issues like anxiety and depression. My professional experience tells me that it is only about 10 percent of the time when sleeping disorder is a primary issue. So, to figure this out, you will have to go through a proper assessment with a professional to identify the root cause of your sleeping disorder. Only then can we move towards treatment. 

You also mentioned the activities you have tried to sleep better. You should know that some of those activities do more harm than good. For instance, tiring yourself out through exercise is not good, for excessive workout has a bad effect on your sleep, causing distress and sleep disorder. On the sleeping pills, did you take them after professional consultation? If not, I suggest you get off those pills immediately. If a professional prescribed it, then chances are those pills do not suit you. If that medication does not work, another might. 

Concerning your sleep pattern, sleeping all day and being awake at night is the worst enemy of your mental health. I suggest you look up ‘sleep hygiene’ on the internet and try some of the tips to improve your sleep schedule. Some things included with ‘sleep hygiene’ are: going to bed and waking up at the same time every day, including weekends; ensuring your bedroom is quiet, dark, relaxing and at a comfortable temperature; and avoiding large meals, caffeine and alcohol before bed.

Further, there are times when we feel like we have not fallen asleep, while our body is actually getting enough sleep. We wake up thinking we got minimal rest but in reality, our body will have had an adequate amount of sleep to support us throughout the day. You getting only two hours of sleep a night for the past six months also suggests this. If a human body gets only two hours of sleep a day, it will not function after a week or even less. So your body might be getting adequate sleep but you feel sleep-deprived because of stress. 

My first suggestion for you would be to go through some techniques to maintain sleep hygiene, which you will find on the internet. Second, it is good to seek professional help, if you haven’t, to identify the root cause of your sleep disorder. Only then can you proceed to the solution.