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Does my husband need psychiatric help?

Q: I am a 48 year old working woman, married to a man of the same age for the past 23 years. We have two daughters who are 20 and 15 years old. My husband is highly short tempered. He used to get into quarrels and fights while travelling and otherwise right from the early years of marriage. But for the past ten years he is shouting at home for petty things. He verbally abuses me and my daughters and continues like this for two to three days. After this he expects us to move with him as before forgetting all his nasty comments. My daughter is unable to do this and their relationship is strained. Whenever she is at home from college even for a short stay of two or three days he will start a verbal fight with her, scold her and will tell her that he will not do anything for her. But at such times I feel sorry for her and try to defend her and in turn I also get his ire. I do my best to patch up things. Of late I found that this is happening once in a fortnight and just before new moon / full moon day. I had told him during such heated arguments that he needs to go to a counsellor but he says he is fine. For the outside world he is a very efficient executive. But life at home is hell for all the three of us as we are unable to predict his behaviour (when he will be angry). He blackmails me that he will make all the fights public to spoil my reputation in society and recently he has started telling that he would have been better if he had married another woman and started asking me whether he can separate. I feel he does not mean it. At other times he is normal and carries on with his work. He is very self centred and does not have any close friends or a close relationship with his kin. Is this a form of psychiatric disorder and is it possible to cure this through medication? If yes, please suggest me how to convince him to go for treatment. I am unable to discuss this with any of my friends and relatives and feel bottled up whenever there is a fight.

A:As you have rightly said your husband has been short tempered since a long time. This is an ingrained personality trait which is maladaptive and thus leads to frequent anger outbursts. There is a strong possibility that lack of friends and relationships may be indicative of the need to be in control and that people do as he wishes which leads to poor relationships which again points towards maladaptive traits. An individual may become more prone to reacting to stressful situations in the manner as described, to vulnerable family members who are taken for granted. The brief periods of continuous anger outbursts could be secondary to impulse dyscontrol or even possibility of a mood disorder. What is however important is that during the period of few days when there are continuous anger outbursts there may be association with increased talk, increased spending, inability to concentrate , disturbed sleep and appetite and other different behaviours which would all normalise generally with remission of anger. If the latter pattern exists it would be advisable to consult a psychiatrist to rule out a treatable cause. Otherwise I would consider it to be a personality issue and would advise anger management therapy since that would be the best course to go form here. A clinical psychologist would be the resource person.

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