Agitation: Causes, Treatment, Cost and Side Effects

Agitation, or agitated depression, is a fairly serious medical condition pertaining to mental health. Its main symptoms include restlessness and anger, as opposed to the lethargy that is such as well-known characteristic of depression. This condition also occurs commonly in people suffering from bipolar disorder and schizophrenia.

Therapy is largely recommended in most mental health scenarios. Through therapy, patients can learn to recognize and counter their triggers, which can help prevent the onset of agitation. Cognitive behavioural therapy is often used to work through behaviours and feelings in order to change the way the patient behaves at a given moment, which also helps reduce the severity of the agitation. Finally, electroshock therapy can also be used as a treatment for agitation, though this is only meant for extreme cases and not all patients.

Common signs of Agitation include:

• Little patience.
• An urge to move, maybe with no purpose.
• An uneasy feeling.
• Nervousness.
• Crankiness.
• Too much excitement.
• Stubborn behavior (often toward caregivers).

Aggression can also be seen when an individual is agitated, but it is not the same. Generally, a person feels agitated in some cases, but it becomes a mental disorder when the Agitation is frequent and can be seen in almost every scenario.

Agitation can be verbal (such as shouting at others) or physical (such as getting into a fight, hitting someone, breaking things).Intervening early during the onset of an episode can help prevent it from escalating.

There are three main ways of treating agitation: medication, therapy, and electroshock treatment.

• Medication:

  Doctors may prescribe a combination of mood stabilizers, antidepressants, and antianxiety medications to help counter the agitation felt by the patient. More often than not, in cases where mental health is concerned, you will be required to visit your doctor every week or every two weeks, depending on the severity of the problem.

  As the treatment itself is gradual (often, it takes almost a week just for the medications to begin taking effect!), this helps your doctor gauge your progress and whether any adjustments are needed.

  He or she will also continually ask you about side effects and your emotional state to confirm whether the medication is a right fit for you. Don’t be alarmed if you face mild side effects initially as these medications are meant to stabilize a lot of the symptoms of agitation and it takes a while for your body to adjust to them.

• Therapy:

  Therapy, as a treatment, usually just involves a lot of talking and self-analyses, which can help you not only understand yourself better but also control your emotions in a more effective manner. When it comes to therapy, it also starts as soon as you are diagnosed.

  Your therapist and psychiatrist may not be the same doctor, and that is all right. The goal with therapy is to gain a deeper understanding of the environmental elements that can trigger your agitation and bring an episode on so it is important to be honest during your sessions.

• Electroshock treatment:

  Electroshock therapy takes place in a hospital or any other safe medical environment. Unlike what is shown in the movies, electroshock treatment is not violent and patients are often sedated to prevent them from feeling pain.

  A bite is inserted into the mouth so that the tongue isn’t bitten off and the shock is administered to the temples in the desired amount. The patient wakes up in his or her own bed and does not recall the procedure due to the sedation. The procedure helps stabilize electrical synapses in the brain, which can control your agitation.

As is the case with most medicines, there are certain side effects that one needs to be vary of. Lorazepam is a drug that is commonly used to treat agitated depression, however its side effects can lead to the development of respiratory depression. Haloperidol has a few side effects as well such as akathisia, acute dystonic reaction, and a decrease in the seizure threshold.

Olazapine can lead to some weight gain over time. There are no specific side effects of therapy. Electroshock therapy can lead to confusion and problems with the memory (though memory problems do go away a few months after the treatment is over), headache, jaw pain, nausea, and muscle aches. These can be treated with the help of medicines.

The main guideline for treating agitation is to follow the routine of taking the medicines as strictly as possible. Maintaining a specific time to take the medicines can help habituate it, leading to a lesser likelihood of forgetting and tampering with the progress of the treatment. With therapy, post treatment guidelines include patient specific guidelines that pertain to the therapy session.

These are normally behavioural guidelines for both, the patient, and the people around him/her. Minimizing the exposure to triggers is also an important part of the post treatment process. Since the treatment and recovery is one that takes a while, the guidelines are usually meant to alter the lifestyle of the patient while the treatment is occurring, so that it can be sped up. With most variants of depression, including agitated depression, patients are advised to monitor and control their outlook once the medication period is over.

With most problems related to mental health, the recovery time really depends on the patient. With the constant use of medication, therapy, and other behavioural and lifestyle guidelines that are meant to help the patients, the frequency of the episodes can be largely reduced, and, if possible, eliminated entirely over a period of time.

Patients suffering from the same disorder and taking the same medication can have varying recovery periods. In the case of mental health, it can be harmful to expect to get better by a specific time as it leads to undue pressure on the patient, leading to more stress and further problems.

Most medications that your doctor may prescribe to you can range from Rs 150 – 300 for a single leaf. Medications that are designed for mental health are often more expensive than the ones designed for physical health and it’s a cost that one should be prepared for.

The cost of therapy in India ranges from doctor to doctor however, it can fall anywhere from Rs 1,500 – 5,000 per hour, depending on who you are seeing. The cost of electro convulsive therapy ranges from Rs 500 – Rs 1000 per dosage and many private psychiatrists also administer this procedure in India.

The treatment of agitation is not permanent. There are many factors that can trigger agitation, even after being treated, which is why most doctors will advise you that it is extremely important to maintain a positive outlook.

By continually questioning yourself, adding stress, and dwelling on negative thoughts and emotions, you can cause your agitation to come back in varying levels of severity. Agitation can also be caused by external events such as grieving over death, a stressful time period, or a traumatic event in life, which is why it’s important to always monitor and control your emotions.

If medication is not your cup of tea, you can opt for certain herbal remedies to counter the effects of agitation in your life. Certain essential oils such as the oils of clary sage, lavender, and myrrh are known for their antidepressant properties and can be used to stabilize your mood.

Using these oils during a massage, or adding them to a diffuser and allowing their fragrance to spread through your room can help you combat depression and agitation.

Practising yoga, meditation, and breathing exercises can also help you stabilize your mood. However, it is important to note that with most medical problems, it is extremely important to speak to a health care professional so that you are not putting yourself in any jeopardy.

Summary: Agitation can be described as a sudden state of aggressive behavior that can harm oneself and others in terms of physical and psychological aspects. While Agitation is just a minor reaction, it can easily be controlled with the help of emotional and environmental changes.