After sleep, food and water, safety is everything in life. You can’t experience love, learn new skills, give of yourself, or live up to your potential while you’re using your energy watching for threats and avoiding blows.
Threats, breaking things, invading personal space, or assault are results of the irritable aggression symptom of HD. They do not reflect the character of the person. Once irritable aggression happens, it’s likely to continue and may get worse if nothing is done to change the situation.
Fortunately, treatment can make a big difference! There are two main strategies to use:
If someone you know is showing signs of irritable aggression, speak to your physician as soon as possible. Often antidepressants such as the selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) are prescribed. Another common medical treatment is mood stabilizers or long-acting benzodiazepines. If those options aren’t helpful, then Neuroleptics or antipsychotic medications can be prescribed. Work with your physician to find the treatment that best meets your goals.
Strategies to Calm Irritability
Pay attention to signals from the person with HD about they want or why they are upset. Sometimes they’ll tell you what’s wrong. You may have to look for cues such as their voice getting louder, speaking faster, or becoming suddenly quiet.
Allow the person with HD as much control and independence as possible knowing that there might be some minor accidents.
Recognize your own frustration with the changes that are happening to someone with HD. Are you frustrated by their new limitations?
Try to slowly reduce the demands and expectations on the person with HD.
Having responsibilities around the house that are within their ability helps maintain calm.
A person with HD may not be able to make the same kinds of decisions they used to but will feel calmer if they are still part of decision making.
Identify what leads to outbursts by thinking about what was happening just before someone acted irritable. Then, come up with ways to avoid those types of situations. You will have more control over some situations than others. If you need help thinking of solutions, call HD Reach or another healthcare professional.
Distract someone away from the source of the frustration. As they are starting to get angry, can you redirect them to something they enjoy? Remember, people with HD can’t quickly or easily change what they are thinking or doing. So, it’s important to stay calm and avoid confrontations and ultimatums. Showing signs of anger, finger pointing, and yelling can make the situation worse.
Remove weapons and dangerous objects from the home because HD can cause a person to lose their ability to control aggressive impulses.
Safety first. If you feel unsafe like the person with HD may hurt you or hurt themselves, leave the situation and go somewhere safe. Then call a trusted friend, family member, or neighbor for help or call the police.
When someone is yelling and making you feel unsafe, it’s hard to figure out what to do. Taking a moment when everything is calm to create a safety plan helps when you find yourself in a difficult situation. Work with an HD Reach social worker or another healthcare professional to develop a safety plan so you avoid having to make all the decisions while trying to calm a loved one.
As part of your safety planning, reach out to your area police department and ask to speak to a Crisis Intervention Team (CIT) officer. Explain to the police that you are living with someone who has a disease that can cause aggressive actions. If you need to call the police during a crisis, ask for CIT officer. They will be able to respond better if they understand they are helping control a situation caused by a mental health issue.