My husband was diagnosed in 2007 at 47 yrs old. In the last year, we have been dealing with increased anger issues directed at myself and other family members. He is taking sertraline and seroquel to help with these outbursts, but we still live in fear of the outbursts which have on occasion been physical and very scary. We're trying to limit the triggers, but it doesn't always help (and we discover more triggers). Any one have advice on dealing with this complex issue? Thx.

Those are certainly two good drugs to start with but not every drug works with every person with HD. There are different stages to the disease in which different things are going on in the brain, there are individual differences in the way people react to medicine, and the pattern of brain damage also varies from person to person.

My ex did better on Zyprexa than Seroquel. With Seroquel, it was like he was on nothing at all. The neurologist thought that might be because Seroquel has a shorter half life and it wasn't staying in his system long enough - he would wake up and get angry. He might also need a drug that handles mood swings. Her doctor tried a variety of meds for my MIL but the one that finally helped her was lithium.

We are not doctors here and can't make suggestions on a BB but if you've been reading here, you'll see that different combinations of drugs have helped different people.

Is your husband's doctor aware of the outbursts, that they can become physical and that they are very scary? Is he working with you to get the right combination of meds? If he is unfamiliar with HD, he could call a doctor at one of the Centers of Excellence. They are very willing to take calls from other doctors.

Has a stay in a psychiatric facility to get him stabilized on the right meds been considered? That can be very helpful as well as safer for you.

If you cannot get cooperation from the doctor and your husband, remember that safety comes first. You must protect yourself and if that means making other living arrangements for yours husband, then I would do that.

Keep us posted! I'll be thinking about you.

I appreciate the advice and suggestions. We've been seeing a counselor both together and separately in addition to being followed by a center of excellence for appointments every three months.

So, yes, our doctor & social worker & therapist are informed. We've had some improvement initially, then this winter experienced a very scary outburst where the police were called due to the outburst being in public. Thankfully, we've been able to cease his over-drinking problem which I feel (as do others) contributed.

We are still not immune to outbursts, however. And perhaps some of the most difficult times are 'daily living'. It is hard to have conversations when you aren't sure of what to say b/c of not knowing if he'll get upset (which tends to happen without warning.) Seems I can't say much of anything the 'right way'. I would say that 80-90% of the time my attempts at conversations are ignored or set him off. Most conversations consist of our schedule for the day/week, or other general items. Very little normal conversations take place.

Sometimes I wonder if I am just being paranoid, but our lives have changed drastically. We have children who are teens who have witnessed all of these outbursts and it is scary for them too.

I appreciate the support.

Hi there, i just want to mention the seroquel also makes an extended release pill, maybe that might be helpful? And maybe his dosages needed to be changed too, or maybe even like Marsha said, switched to something else.

Thank you so much for your support. This is my first post to the forum and I feel like I should have done so long before. I just 'watched' prior to today.

The last couple of years, since the diagnosis, has been very hard. Lots of life changes - loss of his job, the diagnosis, my going back to work full-time (after staying at home for many years)... Many adjustments have been made and the financial situation changed too. We were able to get him on disability, which has been very helpful.

I know we're not the only family who has experienced these challenges and it is nice to know there are many people out there who are willing to help.

Welcome.

There is really no substitute for the best medication combination. Taking three, four, or five medications is not uncommon. The COE has to understand your level of desperation in no uncertain terms and to start medicating more aggressively. Being aware of a problem by these people is not the same as feeling your pain. Tell them this combo is not working and he is gonna end up in jail if we don't get him stable and happier. They sound pretty conservative.. and while I can't tell what combo will work.. this one obviously isn't and they have loads of options. Include that this much anger in him is just plain suffering on his part and he deserves better. Being a little bit "druggy" is better than being angry all the time. They make all these medicines for a reason.. to get rid of as much of this as is possible. It's time to look at the full arsenal and deploy it. No one in your house is happy this way. This includes him. So spell it out.. this needs to be treated and treated right now. It's not like medications will steal anything away from him.. he already isn't being what was the natural him, so a little sedation isn't going to be an unfair trade off.

Just for the record.. therapy for anger like this in HD is not going to be any solution. You can't replace brain deterioration with talking. He is having anger with impulse control problems and lack of reasoning skills all combined to make talking it out not very productive. To reinforce not drinking that might help but for outbursts it's not going to help. There are just some chemical imbalances that need to be treated.



Edited 1 time(s). Last edit at 08/06/2009 09:37AM by Eric.

Welcome to the forum. I don't have any advice, but wanted you to know we'll be thinking of you.

Patty

dhanne,

I can see how difficult this is for you. It's very disconcerting to see your husband become so angry with no real "trigger".

The same situation was happening with my wife. And it's hard to manage it to a point where you believe you have control of it. I never did get to the point where it actually could be controlled. No amount of counseling will work, as the HD progresses his ability to be reasonable will continue to erode.

It's doubly difficult since you have to leave him alone most of the day and support your family. Plus, he has time to drink. I agree, alcohol doesn't help at all.

What I can suggest to help you out is that you must realize he will become tired more quickly. Not physically, but mentally. And when he has a lot of activity around him it will tire him out. At that time, he may become more prone to outbursts.

I suggest you do not schedule an activity that will subject him to a lot of "input" for more than 90 minutes. It will be helpful for you to keep his environment quiet, and somewhat dark if you can. That will help a lot. This will reduce his visual input and reduce the strain.

Make sure he has some comfort foods. Keeping him from any physical issues like pain or hunger is helpful. You may find that if is particularly upset a lot it may be that he is ill from a cold or flu. If he is uncomfortable, he will be more difficult.

Anything you can do to reduce his stress level would help. For instance, I assume you do the bills. Try not to share any concerns you have about them. Try not to get him to worry about any problem if you can. You will have to do the worry from now on.

Medication is something so important that you cannot trust just a doctor's decision based on a 5 minute consultation. YOu have to have a lot of information to give a doctor. To do that, you need to start taking some notes, and a log.

I found that my wife would become upset regularly at a certain time of day. Another poster here, Dave, also kept a detailed log. We both found (separately) that the timing of the medication is a key factor. Sharing information about his behavior and the time he takes his meds will go a long way in balancing his mood out. The doctor will have solid information to help you based on facts.

You also need to share your concerns about this with his doctor. If you can arrange a separate visit or consultation minus your husband, tell the doctor you need some "extra" help with these outburts. Maybe he can give you some optional doses, and at least some advice, to use when you run into these issues.

Another suggestion I have is that you need to reduce YOUR stress level also. In a big way you can control these situations by not provoking any confrontation without meaning too. And that's hard to do when you are drained. The way I did it was to hire a neighbor to help with the household chores like the laundry, some cooking for my wife while I was out, and some cleaning.

That helped a lot. I didn't have to sweat the small stuff. I could focus my efforts where I needed them instead of being rushed to clean the house and take care of the daily chores. That reduced my stress level, and in turn made me able to take the physical and emotional abuse that my wife would dish out.

I hope that helps.



Edited 3 time(s). Last edit at 08/06/2009 12:45PM by Fred.

Wow - I appreciate all the advice - especially about keeping a log of when meds are taken, timing of outbursts, etc.

I never thought about the darker room, quieter surroundings. I've noticed that he has started closing our blinds and moving away from distractions... never knew this could be a coping mechanism for him. He had made some comments about our kids' activities/music/tv loudness, etc exhibiting some stress. Thanks for the info about how removing the activity.

I was told by our social worker that therapy would not help him, but for right now he feel it does, so it is 'on outlet for him' at the moment. I don't like going together, b/c it turns into him picking on me with the counselor in attendance. And he (counselor) has difficulty calming him down or getting him to stop with the one-sidedness conversations/stuck on an issue, etc.

I will start to keep a log and see if I can see any patterns and show his doctor.

Thank you!

Welcome

Dhanne, you should also give your Doctor a heads up of problems before you get to the office. Whenever I have problems that is what I do and one way or the other the doctor addresses them without me having to be the bad guy.

When my husband had anger outburst he was prescribed trileptal and than later respirdal was added. We haven't had issues for a while until he went two days with no meds, spent a week or two with anger issues.

Safety first.

Wanted to say Hi . db

Dhanne.

I'm a year older than your husband, but am otherwise in the same boat. I've known I am positive for the past 16 years but it was these atypical episodes of white-hot anger over the simplest of things that indicated to me that I was exhibiting the "softer" signs of HD.

My Dr's put me on Lexapro 20MG and it made a new man out of me.

God bless.