Monday, October 3, 2011

Antidepressants and anger

About a month or six weeks ago, I had the opportunity to join a DBT (Dialectical Behavioral Therapy) session at a nearby hospital.  I went in for the initial assessment, but ultimately decided not to do it.

There were a few reasons why I decided not to participate, not the least of which is that I'm lazy and have commitment issues and couldn't see myself hauling across town every single Tuesday for the next six months.  There was another, more specific reason, though, that doesn't have anything to do with my personal shortcomings.

During the assessment, the therapist was asking about anger, and what happened when I got angry, and how I coped.  One of the most significant and consistent benefits I've noticed about antidepressants and mood stabilizers, essentially since I started taking them almost ten years ago, is that my anger episodes have all but disappeared.  I still get angry, but it's more mild irritation than blinding rage (except when we're talking about the people putting the new roof on my house, but that's another story).

I used to get so mad, it would be hard to see; I'd stammer and get all shaky.  I'd throw things (shoes were my favorite thing to throw, I don't know why) and slam doors.  It was ugly.  And, seriously, when I started on medication, those episodes sort of floated away.

This brings me back to the DBT assessment.  The therapist asked what happened when I got really angry, and I told her I used to have serious anger problems, but since I started antidepressants and mood stabalizers, those episodes went away.  She looked at me in a kind of condescending manner and said, "Well, I can tell you, medication rarely helps manage anger.  But therapy can."  She then moved on to the next part of the interview.

Now, I'm sure she's much more well-versed in all this kind of stuff than I am, but I know for a fact that my anger has lessened a lot since I started my meds. I guess it could be a coincidence, or maybe just mellowing out with age, but it seems awful odd that the two would coincide so completely and not be related. 

That's about the point I lost a lot of confidence in the DBT program.  I got the feeling it was going to be a "meds are bad, therapy is good" kind of situation, which isn't totally a bad thing; but what's more, I got the impression that I was going to be told my perceptions of my situations were "wrong," and that the therapists and facilitators are "right."  And let's be honest; if I wasn't wrong about a lot of my perceptions, I probably wouldn't need DBT.  But I'd like the facilitators to at least listen to me and not dismiss my ideas out of hand because they didn't fit with their notions of therapy or treatment.

In retrospect, maybe I was too quick to judge the situation.  I have learned, however, if I get a certain "vibe" or feeling about something, it's often right -- no matter how quickly I get that feeling. 

I think I made the right decision.

Or maybe I am just really lazy and didn't want to haul all the way across town every week.  Whatever.  At least I'm not going to get mad about it.

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