Someone close to me has been having the following problem for a few years now. He has seen several psychologists, but he do not feel that his problem is being addressed properly. He tried anti-anxiety meds, but they seemed to make the problem worse.
He normally feels fine, but from time to time has episodes where he feels a pain and pressure toward the front of his brain. He describes it as a symmetric and centered pain/pressure that extends laterally. He has had an MRI that was clear except for evidence of some bruising that occurred when he hit his head against a door frame during one of these episodes several months ago. He also had a sebaceous cyst further back on his scalp that has since been excised.
During these episodes he become extremely depressed and desperate. He feels completely hopeless, sometimes suicidal, and sometimes filled with rage. He basically becomes a loose cannon and says that he could not think straight when talking about it later. Personality-wise, he becomes a completely different person and does not act logically. Sometimes he is able to make the pain go away with sleep and sometimes it remains. When the pain goes away, he is able to be mentally in control as well.
Any suggestions on what this could be? I wonder if it could be a type of migraine. It might also be related to his sleep apnea. He has been diagnosed with it but has been unable to sleep well with a CPAP, so he doesn't use it. Yesterday when he had an episode, he was laying on the couch and felt a draining in his neck and thought it might have helped him feel better; is it possible that there was some sort of fluid buildup? He doesn't have the best sleep pattern or diet, but is resistant to change as he asserts that simple changes along those lines won't help him.
Is there any way to know (or reasonably deduce) if is is of physiological or psychological origin? Any help or suggestions at all are greatly appreciated.