Violent Behavior : Treatment, Procedure, Cost And Side Effects

Violent and aggressive behaviour is one of the most common psychological disorders faced by the children, teens and young adults these days. It may range from verbal abuse to physical abuse. In some case the harm can be very violent in nature. It can lead to breakdowns in one’s relationships. The person suffering from this disorder may feel restless, irritable, and impulsive and thus is unable to control the behaviour which may not be socially acceptable. Some may become very aggressive and thus may harm themselves or others.

Aggressive or violent behaviour are classified as namely predator aggression, social aggression and defensive aggression. During any kind of these violent behaviours the person affected will have a strong outburst to cause physical or emotional harm to either himself or others. Therefore it is very important to address this problem to a psychiatrist or a psychologist. There are many associated diseases that may contribute to this kind of behaviour like autism spectrum disorder or schizophrenia or post- traumatic stress disorder. Some incidences happened in past may also affect the patient behaviour. The main cause for the behaviour may be due to the following factors:

1. The physical and mental health of the person
2. The family lifestyle and structure
3. Social and working environment
4. Delusions, hallucinations
5. Life experiences and lifestyle
6. Any existing trauma or accidents
7. Diseases like : bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD) etc.

The treatment for the violent behaviour will vary, depending on the underlying causes of the aggressive behaviour. The main modes of treatment are changes in the lifestyle and behaviour control through self-management, medication support, Cognitive behavioural therapies( CBT)

Violent behaviour is a common reason for psychiatric admission and prolonged hospital stays. The violent behaviour may be acute or psychotic in nature. The treatment is undertaken with the basic objective of easing the mental health issues faced by the patient. The treatment aims to bring the patient back to social life and this requires the consultation with the psychiatric. The specialist shall first examine the pattern of violence of the patient i.e., what is the frequency of the outburst, for how long does it stay and on what factors does it get invoked. A proper case history of the patient is studied about all the past experiences of his life. After a complete analysis then first the parent management training is started if the patient is a child. This aims at improving the patterns of family interaction of the child during violence. Also, the parents are guided about how to stabilize their child during the violent outburst. For adults with mild violent behaviour the treatment may include talk therapies, counselling and medication to control mood swings. Thus the treatment are as follows:

1. Cognitive Behavioural therapies : Cognitive Behavioural therapies are behavioural therapies that can help the patient to learn how to control one’s behaviour and it is a long term process that has to be given again and again in short intervals. These include behaviour therapy, talk therapy, parental management therapy. These are executed on the patient through specialist psychiatrist who follow the psychological principles and methods which are used to calm down a violent mind.
2. Medication: Medications given in this treatment are mostly the antipsychotic drugs classified as first generation drugs and second generation drugs depending on the severity of the violence shown. Some patients shall be prescribed with antiepileptic drugs (AEDs) like phenytoin and carbamazepine. Sometimes if extreme mood swings take place then the patient is also administered mood stabilizers. Intake of omega-3 fatty acid supplements is also promoted. Patient experiencing an acute violent episode is treated with an oral first- or second-generation antipsychotic. In case of patients with acute agitation, intramuscular (IM) delivery provides more rapid symptom resolution. For sedation of the patient antipsychotic medication can be used along with the lorazepam.
3. Changes in the lifestyle: some patients are asked to change their lifestyle pattern by stopping activities like smoking, drinking, late night sleeping etc.

Patients who suffer from the symptoms associated with the violent behaviour and who are facing difficulty in controlling their aggressive behaviour are eligible for this treatment. Patients who get violent very frequently even over petty matters should definitely consult the doctor. They must keep a check over their violent behaviour and if it turns out to be uncontrollable then they must go for some relieving therapies. If the parents observe an extreme violence in their children over simple things then they are definitely advised to consult a doctor. Patients, who have suffered some trauma, some brain injury, face hallucinations and delusions are also eligible for the treatment.

Extreme use of technology and social media by the teens and young adults is found to have added stress, irritation and frustration to their lives. This leads to aggression on minor issues and violence be it be verbal or physical. Peer Pressure and urge to be able to fulfil all the luxurious wants in life too add a lot of tension which comes out as an outburst. Such adults may not be suffering from any serious mental disorder but need to take a break from such a busy and tiring schedule. They need to control themselves and understand the need to enjoy in life. Also, rather than crushing themselves under societal pressure they should learn to live life on their terms.

Going for any psychological therapy or a session with a counsellor has no side effects at all. It is quite healthy to share your mental stress and tension with someone trustworthy. It relieves the patient and also makes him grateful to the one helping him. As for the antipsychotic and antiepileptic pills are concerned, they are a bit hard on the stomach. They may cause nausea and constipation. If taken frequently for a long time may affect the kidneys too.In case any patient reports any other complexity after undergoing the treatment the patient is advised to consult the doctor immediately.

The treatment duration may vary from patient to patient on the basis of the severity and the reason for such violence. It may range from six to eight months in very severe cases or may be very small upto a few weeks in simple stress based violence. Even after the treatment is over, the patients are advised to keep calm and practice the advises on controlling their behaviour. The lifestyle changes must be regularly practiced. They are advised to release their tension from time to time and need to take a break from a stressful life. They are also advised to reduce the time spent on social media websites because it adds more depression to life than happiness. A proper exercise atleast three times a week, a balanced diet and a proper intake of water is a must.

Every patient recovery time may vary and thus the treatment mode may be different. Every cause for the violent behaviour is different. There are several factors over which the recovery time may vary. Age is one of the biggest factors. A child will be able to change faster than any middle aged adult as child can be easily train and can adapt easily to the changes but for the adult the adaptation may be challenging. Case history of the patient matters too. If the patient has suffered any kind of mental trauma before in his life then, the patient is likely to take longer time to settle to the normal behaviour than the one with superficial causes. Also, the frequency of the therapy sessions improves the speed of recovery. Thus, this treatment requires a proper timeliness.

The cost of the treatment varies from place to place and on the availability of the specialist. An average session with a counsellor of about 45 minutes costs between Rs. 1000 to Rs. 5000. At least three to four sessions are required to be taken which will amount to about Rs. 4000 to Rs. 20000. For the cognitive behavioural therapy the cost for one seating is Rs. 2000 to Rs.6000. The therapy requires about four seating’s. As per the drugs are concerned they are quite expensive to about Rs. 150 for a single table. So, a better alternative would be to go for a long term effective treatment rather than going for short span instantaneous treatments.

For most cases if a patient is taking the antipsychotic or antiepileptic pills then the treatment does not last for long. It will be effective for only a few hours or maybe a day in case of a strong drug. Whereas when the psychological treatments are taken then the results of the treatment are quite positive in nature. If precautionary measures are taken after the treatment and the advices are properly executed by the patient then the results can be permanent in nature with positive outcomes.

Violent behvaiour is an psychological prolem and requires more social and moral support so as to overcome the emotional imbalances. The alternative to the treatment is to ensure a smooth and stressful life which can be executed if one is able to balance their lives like for example using technology in balanced way, avoid bad habits like drinking, drugs and smoking, etc. One can do this through proper planning in life and it is necessary to have close friends and family who are supportive and provide emotional support at rough times. A healthy communication with family and friends is the best cure to all the problems in life. Also, it is the high time to understand that everyone is unique and everyone has a different situation to face. Self- pampering is also a unique way to de-stress oneself. Practicing yoga, meditation and taking massage or a spa to relax the body and mind are other alternative options to ensure that stress is miles away from the person. Taking proper diets, nutrients and exercises shall help in ensuring an healthy mind and sound body.