Disorder strains reader’s self-control

Dear Dr. Roach: Recently, you wrote about intermittent explosive disorder. I have this condition and would like your help dealing with it. I can lose my self-control and get so upset that I swear. I get very angry and then feel guilty when I say things I don’t mean to ones I love.

E.M.C.

Answer: The first step in successful treatment is to recognize you have a problem, so I congratulate you taking it.

As with most conditions affecting the mind, treatment is with therapy, medication or both. The most well-studied treatment on the therapy side is called cognitive behavioral therapy, but it is expensive, can be hard to find and is not appropriate for everybody.

Medication therapy has also been demonstrated to be effective in treating intermittent explosive disorder. The best-studied medication is fluoxetine (Prozac), which was found to have a moderate or large improvement in 66% of subjects, compared with 29% of those taking placebo.

A combination of CBT and medication is considered the best treatment, when possible.

The Mayo Clinic has good information on this condition, at tinyurl.com/mayo -IED.

Dear Dr. Roach: I am a 41-year-old man. I used to do jiujitsu for three years until 6 months ago. Two weeks ago, in a stress echo (running on the machine) test, I was diagnosed with aortic root of 41 mm. Two years ago, my aortic root was 30 mm. Can I continue practicing jiujitsu? Is my condition dangerous? What kind of sports can I do?

U. J.

Answer: The aortic root is where the aorta starts, at the left ventricle. The normal size in men is up to 39.1 mm.

In general, regular, moderate exercise is safe even in people with dilations in their aortic root. Strenuous exercise should be avoided because blood pressure can increase. You should get specific advice from your own physician. If they say it is OK, talk with your jiujitsu coach about your need to avoid overly strenuous workouts.