Concussion and Anger
 

My son suffered a concussion and stroke 8 weeks ago. I am looking for help from anyone who has suffered the post concussive symptoms that he has. Along with headaches, he has periods of severe anger and rage, screaming fits and hysteria. Sometimes he is so silly and loopy and acts like a toddler (he is 11). All doctors call this pcs but it is so severe, it is hard to handle. I need advice.

Severe mood swings are quite a common facet of brain injury.

If you look at this link there is a PDF at the bottom of the page under "related resources" that may help

https://www.headway.org.uk/Effects-of-brain-injury.aspx

amj,

Welcome to NeuroTalk. Sorry to hear of your son's injury and struggles.

If he had a stroke, I would think his doctors would take his anger more seriously. His anger is not good for his brain. It is a part of his blood pressure rising. High blood pressure is not safe for his brain, especially if he is recovering from a stroke.

There are meds that can stabilize him. Some anti-seizure meds can be helpful. He needs help because these events are not helping his brain heal.

If his pediatrician does not help, maybe a neurologist or a pediatric psychiatrist can help you both.

My best to you.

Thanks Mark. He is actually on anti-seizure meds to try to stabilize his moods. He is also on Depakote for his headaches. Just increased that because I think he is in constant pain and can't relax or be still because of his head. But this is more than a mood swing or a quick temper. He can't get out of it for a long while. He is still mad at me because of something I did 3 days ago. Neurologist is in loop and is helping. Just wish he could calm himself down.

amj,

What is his blood pressure like? A common problem from a head injury is a malfunctioning adrenal system. In some, it is called adrenal-cortical hyperfunction. A beta blocker may help.

Get a home blood pressure kit to check his BP when he is exploding.

When he gets angry, he is likely as scare inside him mind as you are. The feeling of loss of control only make it worse.

My best to you.

I'm so sorry to hear of your son's challenges (and yours as well).

Anger and rage are common problems with TBI. The areas of the brain that control primitive emotions are located more to the periphery and to the front. As such they are more liable to be damaged by physical trauma. The more primitive drives are towards the center of the brain, which are hence more cushioned. Do a search on "traumatic brain injury" and anger, a lot will come up.

This very likely explains why your son is struggling with anger issues. As for what to do about it, of course this is the tricky part. I have this problem, and find the only thing that works is go for a "time-out" and let the feelings subside. I mean no contact with other people at all. It does take time. Sometimes a few hours, sometimes days. Not easy.

Best of luck and well-wishes to you.

I'm sorry to hear about your son's anger issues as well.

You mention he acts like a toddler... you know, that's a good description, that's exactly how I feel when the anger hits me too. Words escape me, feels like no one understands, like I have no control over my life and emotions... very similar.

I've had my own challenges with anger since my fall in February and they've not been pretty and I'm 40 years old!! They are scary to me, since previous, I always felt very in control of my emotions and it would take a lot to make me feel angry and way more for me to act on it. And acting on it then would maybe mean raising my voice.

Now, it seems like there's little rhyme or reason to things that make me angry. Something that made me angry yesterday, might not phase me a bit today and vice versa.

Definitely removal from the situation or person that is triggering the anger is important. But for me, I have a really hard time sitting alone and waiting it out. It seems to take a very long time to work its way out if I just try to sit in a dark quiet room and wait.

My personal strategy is to go somewhere alone and I usually go outside (just works best for my situation) and I have a collection of empty cardboard boxes that are all taped shut and I kick the crap out of them until I'm no longer angry or I'm too exhausted to care that I'm angry. Sometimes I yell, scream, swear (we live rurally so our neighbours are quite far away ;) ) but I just kick them over and over, usually they require quite a bit of repair later when I'm feeling better.

It seems to help work the adrenaline out of my system and no one gets hurt and I can move forward sooner with my day. Often I head upstairs for a nap afterwards and all is good when I wake up.

I did have to set a rule with my family that when I'm out kicking my boxes, no one is to disturb me, no matter what. No one is to come outside where I can see them, nothing. That just sets me off again.

Originally, I was probably using the boxes 3-5 times a week... now its often once every 2-3 weeks and usually only on days that I've overdone it or the day after I over did it, combined with something that might have originally irked me a bit.

There has been progress, even if its slow.

Not sure if this might be helpful to you and your son... set up the rules beforehand... only these boxes may be beaten on, nothing else and let him at it.

I know I sure need an outlet for it when it strikes... and falling down on the floor and having an all out temper tantrum really isn't becoming when you're a middle aged woman!!

Best of luck.
Starr

I used to kick boxes and graduated to kicking cooler chests into smithereens. When I finally realized that this was my brain misbehaving rather that my 'right to be angry,' I started learning skills to temper this behavior. It takes a lot of work. Probably not something a young mind can do easily.

I don't see it as my "right to be angry" or my brain misbehaving. I see it as a way to dissipate the adrenaline in a way that no one gets hurt and you don't have to try to swallow it down. A reasonably healthy way to release... not unlike some people that run when they are angry or punch a punching bag or that sort of thing.

Obviously trying to intervene and prevent before you get to this point is ideal, but when you are still learning what triggers you, and in my case that changes, making learning difficult, its a way of coping with that adrenaline surge that comes with the anger.

Having a reliable, safe outlet has been useful for me... I've not graduated to anything bigger... in fact, I've been using the system less and less.

I would think for a child who already hasn't mastered their emotions before a tbi, something similar might be useful, whether it be beating a pillow with their fists or whatever.

Starr

For me, the box was not an exercise to release the adrenaline. It usually happened to be on the floor in my messy garage or such and the only inanimate object for me to lash out at. Once I took the first kick, I would go ahead and finish the exercise.

I can see how a punching bag could be helpful for a youngster.

I did learn that I needed to learn to recognize when I was starting to get triggered. Often, it was that sense of "I am right and thus justified in getting angry." I realize that even if I was right about the situation, it did not justify my reaction to the conflict so I had to stop the behavior before it got rolling downhill.

Thank you Starr for your reply and sorry I have not posted in a while. I was curious to know how long your "fits" last. I just ended a 3 hour one with my son that involved throwing pillows at me, screaming that he hates me and wishing I would leave. He is now going to therapy but I really don't think anyone can understand the degree of rage he feels. I am also curious to know if you have found any medicine helpful for you to control the anger. He has a "freak out" pill (Risperdal) but it always seems to be too late when he takes it. Going to find out with neurologist if he should take it everyday.
Thanks again for your reply.
Anne

Anne,

I was put on phenobarbital when I was young. It was very good at smoothing out my attitude. It is a barbiturate but is effective at small doses.

If the meds he is on are not helping, the doctor should be willing to try something else. Meds are not a science. Different brains respond differently. Trying all the latest and greatest often means old tried and true meds get overlooked.

A beta-blocker may be a better and quicker acting med to try for his rages.

To me, anti-psychotics like Resperdol sound extreme at such a young age. The brand name drugs tend to get pushed by the makers.

Keep asking questions of the doctors. Don't let them pass you off. Your son needs help. Have you tried to find a pediatric psychiatrist for a consult?

Please know we are here for you. I remember how I struggled at 10 years old as I could not control my thoughts and rages. As I said before, my mom lost her sweet little boy.

My best to you.

Dear Anne,
I would recommend when your son is calm to get him to try and draw or write what makes him angry. This will be an insight for you both. Maybe put a structure in place that he knows will happen when he loses his temper.
You need to make sure no one gets hurt. So maybe tell him that when his anger comes he will be put in a certain room(that is safe), for a set time, then mum will come in and remind him he is loved. If he is still angry he will be left again, then mum will come in again.
I just wonder if this programming of his mind will help because it involves set boundaries.

He may also feel misunderstood and hate who he has become. Try and draw this out of him so you are on the same page. Get him to keep a progress diary too. Make it fun with stickers and a chart so he can start to feel proud of himself and not a failure as an angry son.

I do not talk about myself in other peoples threads but in this instance, you may like to know that in my brain my anger is always triggered from others not understanding me. It becomes violent and unreasonable but is always triggered by the same thing.

Good luck to you and your family.