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Bipolar disorder & anger control

A bipolar man talks about hs struggle with anger control at work and in daily life.

Charles, 39, was at work, in the middle of yet another long, super-stressful watch. He was responsible for making sure that a supply chain of personnel, fuel, and equipment kept moving to its intended location. Vehicles were breaking down and had to be replaced, personnel had to be kept out of harm's way, demanding superior offices had to be kept happy.

It all became too much for Charles. "I felt my brain short-circuiting," he says. "I knew if I didn't do something there and then I would harm myself and put lives in danger."

Question: Charles, you work in national security. Where?

Charles: I do not wish to divulge that. Let's keep locations and names out of the discussion.

Question: OK, but you were in a potentially dangerous place responsible for the supply of personnel and equipment along a difficult route?

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Charles: I was one person in a chain of command responsible for that task, yes. I was at the business end, if you like, making sure that it actually happened. Let's say a vehicle breaks down, suddenly you have people on the ground who are exposed, you have valuable equipment at risk, you have disturbances to the planned flow. The problem has to be solved quickly and effectively.

Question: Presumably this is all computerized now?

Charles: Yes and no. For sure, you're staring at monitors, but then you're getting reports from the ground. The radio is busy, the phones are always ringing. Superior officers are always showing their faces to ask what the heck is going on. It's information coming at you all the time and you have to think on your feet.

Question: And you are trained specifically for this kind of work?

Charles: There's training, which is good because it prepares you for real-life events, and then there's the actual real events. There's a difference between flunking a test and getting it wrong in real life or in a combat situation where lives can be lost. These are very different situations. The stress levels are thousands of times higher in a real-life crisis.

Question: What happened on the day that it all became too much?

Charles: I want to leave a lot of the details out, but I can say that we had a driver who died after suffering horrendous wounds to his neck, we had some trucks knocked out, we had a number of personnel at risk, and we had equipment and fuel exposed out there.

On the ground, they were dealing with it as best they could, but I had the overview, the bigger picture. I had to sort out the mess, keep people safe, keep things moving. Hundreds of things were happening all at once. I'd worked for 12 hours that day, 16 the day before, 14 the day before that, and it had gone on for months, the same pressure, constant demands all the time, problems and issues every second of the time.

Then a superior officer came in and wanted to talk to me in the middle of this mess. He wanted me to speculate on what his commanding office would think of the situation. I kept telling him I was too busy just then to speculate about anything. He persisted, "I would just like you to speculate ..."

I could almost feel my blood boiling, I was sweating, my head was about to explode, I could feel a meltdown coming on. I was holding a pen and I thought to myself, "If this guy keeps talking, I am going to stab him in the neck with this f---ing thing".

Instead, I grabbed a chair and hurled it across the room. I told my buddies to cover for me and I walked out. I feel awful about that but it's what I did. I went and sat in a corner for a few minutes to cool off. I was sure I was having a mental breakdown.

Question: Did you return to your post?

Charles: I tried, but I was told to get the hell out of there. They didn't need me in there if I was going to throw things around, go crazy. I was having a total brain meltdown.

Question: What happened next?

Charles: I could see my entire career disappearing before my eyes, everything I had worked so hard for, you know, abandoning my post at a time when people were in danger. I went straight to the company shrink, I wanted to talk to the guy immediately. I guess I was protecting myself and my men, but I also wanted to know what was going on with me. I could not control what was going on in my head.

A rage had taken over, I was about to lose control totally, I was on the verge of doing something very, very stupid that would have impacted my life forever. I mean, I was just thinking "I'm going to stab this guy", I was about to do it. If I had stayed in that room, I would have done it. That's the frightening thing. I took myself out of it to protect myself and those around me.

Question: What did the psychiatrist say?

Charles: From his medical point of view, I did exactly the right thing. In normal life, if something like that happens, the right thing is always to remove yourself so you can calm down. If you're in an office and you're about to hit your boss, you walk away right?

Question: Unfortunately, you were not in an office. What happened to you?

Charles: I don't wish to talk about those first days. I thought we were just going to talk about my treatment, ok?

Question: Of course, I'm sorry. So, then, your treatment?

Charles: Let's just say I was relieved of all duties and I was put out of harm's way for a month. I had talks with the shrink, but talks weren't found to be helpful in my case because I just kept reliving the stress and getting worked up about it. I got pretty angry with all the doctors trying to help. I kept thinking, "You have no idea, you have absolutely no idea what this is like". Of course, they have an idea, that's their training but I mean they don't know what it's like to live through it.

Question: Talking did not help. I'm guessing you rested and were put on medication?

Charles: Of course, a drug called Venlafaxine, also Effexor. It's an anti-depressant, serotonin-norepinephrine reuptake inhibitor of you want the full info.

Venlafaxine is used against major depressive disorder, bipolar disorder and anxiety disorders. I think it's one of the top five or six prescribed anti-depressants in the U.S. It's been good for me, it works for serious, major depression. It has reduced my anxiety levels, it's taken the deep bottom out of my depressions. It took about two or three weeks to kick in for me. I was on 500 mg per day, which I think is a pretty heavy dose. I'm told a lot of people get relief for 300 mg a day or less.

Question: Have you suffered any side-effects from Venlafaxine?

Charles: Nothing major. I've had some trouble sleeping, and I seem to sweat much more than I usually do. I get some pretty bad headaches once in a while. That's about it.

Question: You mention anxiety disorder. Has anxiety been a feature of your life, even before your "meltdown".

Charles: I've had the opportunity to do a lot of thinking. Something that is commented on a lot is my desire to do a perfect job. If I have to write a report, I can spend all night doing it. I want every word to be just right. I'll submit the report then I'll worry the paragraphs should have been in a different order. I won't be able to sleep because I keep running those worries through my mind.

As a younger man and even as a kid, I would get very nervous, not just normally nervous but extremely so about meeting new people, interviews, social gatherings. I would do what I could to avoid them. As a kid I was worried that people were staring at me all the time, laughing at me. To answer your question, anxiety has been a big part of my life for as long as I can remember.

Question: Have you had periods of extreme interest in things, feelings of heightened mood?

Charles: You mean the bipolar manic thing? I have what you might call minor obsessions. I can get way too focused on specific subjects. I'll give you an example. A few years ago, I really wanted to own a motorbike. I researched bikes in minute detail: did I want a 125, a 250, a 500, or bigger? Did I want a Harley, an Italian, old British, German, or Japanese bike? What was the performance of each, what was the fuel consumption? I was drowning in information, way too much information to handle.

My wife actually said I was getting obsessed, but doing that work really gave me pleasure. And when I bought the bike, it was the one I really wanted. I drove it everyday all winter, in rain and snow. I loved that bike. Then, one morning, the interest, the love of bikes, disappeared. I haven't ridden it since. I can't even look at it anymore.

I've been the same about computers, cell phones, cars, clothes. I obsess, the thing becomes my whole life for a while, then I lose interest very quickly.

Question: When you suffered from burnout, you mentioned anger. Has this featured in your life before?

Charles: Absolutely. As a boy I got into trouble for not being able to control my temper. If a boy at school laughed at me or made fun of me, I'd attack him. I'd want to cause him serious damage. I wasn't big enough to cause injury to anyone in a fist fight, but I got into a lot of trouble for fighting, using bad language, shouting at other pupils and teachers.

It got milder when I met my wife-to-be at 19, but I have always struggled to control my anger. I have a very short fuse. If someone bugs me, I can really get the urge to smash them. I feel it building inside my head, a desire to smash them over the head with a chair or bottle, just shut them up. I haven't acted on it, but it's a powerful feeling when it happens. I've verbally abused a lot of people who didn't deserve it. I defend myself verbally. When I'm angry I often go too far, say things I soon regret. I've caused some major rifts in my family.

Question: Has anger been an issue in your family, your parents I mean?

Charles: It's interesting you should ask because I have given it a lot of thought. My father was a physically violent man, not big but violent. He shouted a lot at us when we were kids.

If we were noisy, he shout at the top of his lungs. Or if we were within reach, he's lash out and slap or punch us. He didn't injure us, but he hit hard like he meant to hurt us. Something I remember about him, he's dead now, is that he had no friends. He didn't drink, didn't go out for a beer with his buddies, he had no buddies, not one that I can remember. He stayed around the house and was moody, bad tempered. He was kind to my mom, but I think he hated us kids.

Question: These are a lot of issues to deal with. How are you handling them?

Charles: The time away from work, well, I don't have work anymore, has saved me. The stress was eating me up. I am probably the wrong guy to have in a very high stress environment. My outlet is anger. I know you're supposed to face your fears, but you shouldn't do stuff that fuels your fears and your rage.

Talking to the psychiatrist and therapist has not helped me. In fact, as I said, talking makes it worse for me. I get anxious and annoyed. I can get very angry with therapists.

The anti-depressants have helped. The Venlafaxine has taken that horrible edge off things. I'm calmer, I'm certainly not as depressed. I'm not that anxious anymore. I feel calmer, no angry outbursts.

Question: How do you view the future? What are your plans?

Charles: My wife and I would like to have a kid. With a child around, I would have to have a much better handle on my anger and depression. The prospect of being a father is a golden opportunity to overcome these issues, deal with them properly once and for all.

It is painful to live in anger, to have that rage burning away all the time. Too much stress is destructive. And depression, those feelings of worthlessness and low self-esteem, they have to be overcome if you are going to enjoy life and enjoy being a parent.

I'm very hopeful. I have a patient, loving wife. I am getting good treatment. I think my employment prospects are pretty good all things considered. I am very sorry about the hurt and damage I have caused, but I must look forward and press on.

Question: Thank for your time and openness. We wish you all the very best.

Charles: Thank you. I enjoyed this hour even though it was difficult.

By Giles Devos

Your questions answered: How often do married couples have sex?; Can sex ever be fun again?; How can I help my husband enjoy sex more?

By Giles Devos