Dr. Hitesh Kumar
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 15 year old son is showing a lot of anger and aggressiveness. Please see his attached files for the details. I want your second opinion. I need your opinion on the possible treatment of my son to reduce his extreme angriness, lack of patience, and restlessness. His exams are around the corner, and I want treatment done before his exams. Or else, the medicines will make him sleepy during his exams. He is very sincere about his studies, and his behavior is normal, but I want him to work with a cool head and take precautions in life. I have also attached his prescription. Are these medicines correct for him or do you suggest any other mild treatment? Please guide me. Thanks.
Hello,
Welcome to icliniq.com. I have seen all the attached reports (attachment removed to protect patient identity). I would like to know a more detailed history of your son: 1. Since when is he having such behavior? 2. You also mentioned that he is very sincere about his study, and his behavior is normal, so the aggressive behavior of your son is situational or persistent? 3. How is his behavior when he is not under any mental stress or work or study performance pressure? 4. How is his behavior with his peer, friends, and siblings while playing? 5. How is his sleep routine? 6. Does he have any symptoms of hallucinations or delusions? If he is performing well in class and plays well, I can assume that he is not having any memory or cognitive problem. Possibly, he has performance anxiety, which is getting aggravated by parental pressure. I suggest you do not put extra pressure on a good performance in exams and let him give his best in exams. If he feels nervous and anxious, you can try giving him anti-anxiety medications and psychotherapy. That has to be done only after consultation with a psychiatrist or neurologist in-person with a detailed history.
Patient's Query
Hi doctor,
Thank you for replying. My son has many friends, and he is very sportive. He does not like to read newspapers, magazines, and books on general subjects. He somehow behaves normally in public but expresses his unpleasantness at home if any adverse situation occurs. He has been aggressive since his childhood. His performance in class is not bad. His exams will start soon, and he cannot constantly study for a long time. He feels the pressure after studying for three to four hours, and he needs the company of his friends to study. He cannot study properly alone. His sleep is normal. We do not put any pressure on him, and we have no problem with him even scoring less in exams. I feel that living in a society with various types of people, and He should tackle situations with patience and a calm mind. When he was three years old, he suffered from brain fever. His doctor at that time told us to consult a child psychologist. But at that time, there was no such type of specialist in our city. My son has good knowledge of computers and mobile. He wants to become a scientist and wants to earn a lot of money. I am afraid that he does not think with a genuine attitude. His expectations about life are high, and he cannot satisfy them. Do I need to consult a psychiatrist now? Please tell me if the medicines prescribed to him are essential. Thanks.
Hello,
Welcome back to icliniq.com. I feel his unpleasantness is situational. He might be having expectations from himself. Or his exams are giving him anxiety and stress. But, if his behavior with others is pleasant, and he is doing good in his studies, it is good. Studying at a stretch for 3 to 4 hours is sufficient. He can study in breaks. I feel that you only need to show a supportive attitude toward him. If you think his anger persists after exams, you may consult a psychiatrist or a psychologist. I do not feel like starting him on antipsychotic medications. Psychological counseling should be tried first.
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