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June 14, 2022 — 1:04 AM
Anger is a normal human emotion. In prehistoric times, it was said that the behaviors linked to anger helped with survival: helping us hunt, fight off predators, and protect ourselves. Anger still serves us today in situations of perceived danger or injustice, but it becomes a problem if it is not a proportionate response to the situation at hand. If uncontrolled, anger issues can lead to physical or emotional harm to ourselves and others.
If anger is ill-affecting our family, friendships, or work relationships, we need to take a step back and assess. Anger can be both a cause and a symptom of emotional instability, mental health challenges, and even a hormone imbalance. No matter the trigger, it is important to determine if the severity or frequency of angry outbursts is truly damaging.
Below, we asked mental health experts to help demystify anger from the medical perspective and explain the signs, symptoms, causes, and coping mechanisms needed to tackle this emotion.
What are anger issues?
“There are two types of anger: functional/healthy anger and dysfunctional/unhealthy anger,” says clinical psychologist and cognitive-behavioral therapist Houyuan Luo, Ph.D.
Functional and healthy anger occurs when an individual’s personal boundaries are violated, he explains. The other kind of anger, which is dysfunctional or unhealthy, masks other feelings related to painful experiences. “Anger can cover sadness and vulnerability, and those feelings are too painful to feel, but anger is much easier,” he says.
According to board-certified psychiatrist Nereida Gonzalez-Berrios, M.D., anger becomes an issue when problems related to controlling anger in various social situations provoke sudden outbursts that are socially unacceptable. “You may feel irritable, frustrated, and suffer from physical symptoms as well,” she says of people who experience unhealthy levels of anger. Not only can people prone to anger experience physical symptoms, like chronic pain or aches, they also might find themselves in harm’s way, often. Verbal fights or physical violence are natural progressions, which can lead to even more physical harm.
There is no definitive anger issues test, but there are many self-assessments. Over the years, clinicians have developed different tools to help assess a patient’s anger level or reactions. “Anger issues are usually diagnosed by a therapist or psychologist by doing a thorough mental status examination of the patient, along with a detailed record of the various instances of anger responses in various daily life situations,” Gonzalez-Berrios explains.
While anger by itself is not a psychological disorder, it can be a symptom of various mental health conditions such as depression, dementia, ADHD, intermittent disorder, oppositional defiant disorder, disruptive mood dysregulation disorder, borderline personality disorder, and bipolar disorder.
Types of anger issues.
This is the most noticeable form of anger. It can manifest itself in verbal or physical expressions, like shouting, hitting, breaking things, or attacking others.
This type of anger is internalized. Instead of directing the anger outward, it is directed inwards and can manifest itself in feelings of self-hatred, shame, or low self-worth. It can lead to depression, withdrawal, and self-harm.
Passive anger is a way of not expressing anger directly but instead exhibiting it indirectly through behaviors like sulking, procrastinating, being uncommunicative, ignoring people, or refusing to respond to requests or participate in activities. All these behaviors could be problematic because they do not align with clear verbal cues. So, a person may be outwardly polite and agreeable, but unreliable or non-committal when it matters. This is the most difficult form of anger to recognize because it can be so asynchronous.
Common signs of anger issues.
Luo categorizes common signs into four categories: feelings, thoughts, physical reactions, and actions. Below are some examples of signs in each category:
You feel angry often.
Feeling angry on occasion is normal, but it should not be a constant. If you feel like you’re very frequently finding yourself angry in your day-to-day life, that could be a sign of anger issues. Luo also notes that anger can come in many forms, such as feeling:
You experience sharp or frequent mood swings.
If your mood can swing so sharply that they are frightening–even for you–then this is a sign that anger is getting the best of you. Unpredictable moods and reactions can damage social bonds and diminish trust.
You’re very critical of others, or yourself.
Anger is usually based on feelings of disrespect or dissatisfaction. When those feelings are not properly focused on the confluence of issues that might arise in a situation and are, instead, placed on a single person, the emotional damage can be devastating. Whether you blame yourself or others, anger can create a vicious cycle of disappointment and unmet needs.
You find yourself holding onto grudges or resentment.
If you have trouble letting arguments go, then you’re likely holding onto negative emotions beyond their shelf life. For example, being upset with a stranger who steps on the back of your favorite shoes is a normal and natural reaction in the moment. But, if you find yourself welling up with anger days and weeks later, or going into a fit of rage every time you see those shoes, then you’re holding an unresolved grudge. Holding grudges can cause stress in the body and deplete emotional resilience overall.
You have physical symptoms of anger.
As Gonzalez-Berrios points out, anger can manifest as physical symptoms, such as chronic shoulder or back pain, or teeth grinding that wears at the enamel. Other examples include heart racing, shortness of breath, shaking, sweating, hot flashes, increased blood pressure, or muscle tension, according to Luo.
You yell, curse, or get physical when you’re angry.
Raising your voice or becoming violent are clear signs that you’re angry. In these bouts of unfiltered emotion, there’s a lack of self-control. A pattern of these symptoms are a strong sign of anger issues, and when this aggression is directed at another person, it can be considered as abuse or harassment.
You’ve hurt your loved ones while angry.
Impulsive and unexplained responses, like hitting, kicking, breaking things, yelling, screaming, and cursing, are all signs of anger issues–and they can cause irreparable harm, even if it’s unintentional. Emotional, physical, sexual, and verbal abuse is tied to anger in the aggressor.
You find indirect ways to communicate your frustration toward others.
Passive aggression is a way of communicating anger and frustration indirectly, and constant passive aggressive behavior may be a sign of anger issues. Passive-aggressive reactions can also include acting like nothing ever happened and masking grudges for a very long time. While the aggrieved person might be trying to suppress their anger or convince themselves that they have no right to be mad, they still may subtly communicate frustrations by becoming evasive, avoidant, or unreliable.
Where the problems come from.
There are many different causes and triggers that can lead to anger issues, and they will not be the same for everyone. Generally, someone usually feels angry when they are:
neglected,emotionally or physically
abused or manipulated
in disagreement with others
unfairly treated (or perceive that they are)
disrespected (or perceived as such)
These immediate situations are usually triggers for underlying issues, like:
If you were hurt, bullied, or abused in the past, situations that make you relive those moments can trigger an anger response. In such moments, it may be hard to discern why anger boils over. A disproportionate reaction to a seemingly benign or minimally problematic event can then be an indication that past traumas have not yet been resolved. In this case, minimizing angry outbursts might mean working on healing those deeper wounds.
Masking other emotions
“Anger is often a way we express our distress related to other painful emotions, like being hurt or scared,” explains Kamran Eshtehardi, Ph.D., a clinical psychologist focused on families. The anger iceberg theory treats anger in that way, as just the tip of a much deeper iceberg of emotional distress. Masked below the calm watery surface are other buried feelings of sadness, fear, anxiety, jealousy, or grief. Anger is the only part that is visible, so that is what gets attention, but addressing the underlying concerns and feelings will be key to healing the anger issues.
Some people were taught to suppress feelings of anger or frustration, so they never learned how to properly deal with this emotion. In such cases, parents and teachers may have ingrained the notion that anger is “bad” or, worse yet, that children who express anger should be punished, ignored, or scolded. That suppression could lead to normalizing passive aggressive responses that just do not serve us in adulthood.
And the reverse is also true. Some children learned that tantrums and shouting matches were effective tools to get what they want. Carrying those behaviors into adulthood are not sustainable.
“Children also imitate their parents’ behaviors,” Gonzalez-Berrios adds, and so learn to respond in similar ways. In cases of prolonged exposure to violent or abusive tendencies, some children will normalize and mimic these troublesome examples.
The stress of everyday life.
Life is hard! Prolonged stress can make anyone more irritable than normal. Whether it is the grief of losing a loved one, the constant fear of the coronavirus, or outrage at global injustice, anger is a logical reaction to months and years of exposure to trauma triggers. Big and small worries can pile up to make us feel weak and powerless. Anger can be totally justified, though if people don’t know how to respond and deal with that anger in healthy ways, it can become self-harming.
Identifying anger issues in yourself or a loved one.
“Although anger is a normal emotion for people to experience, it’s when it leads to regular impairments in functioning that we need to start paying attention,” says Eshtehardi. Look for destructive behaviors, such as hitting oneself, punching walls, throwing objects, or yelling. These are obvious signs that anger is problematic. More subtle clues are negative thoughts, feelings of being wronged or disrespected, and aggressive attitudes. Also, avoidance is another common reaction that might go undetected for a long time.
When you notice anger rising in yourself, take note of what that feels like in your body. For example, do you feel heat in your gut or are your teeth clenched? For some people, it is easier to recognize the bodily reactions first rather than the feeling of anger itself.
The same is true when trying to identify if a person you love is angry. If they are screaming, well, then you know. But if they are passive aggressive, then they may become more distant or unavailable. In such cases, a calm and non-accusatory approach to expressing concern and the hope for repair is more effective than direct confrontation in the moment.
Resolving the issues & healing.
To resolve anger issues, it often helps to work with a professional. Cognitive behavioral therapy (CBT) or anger management classes can help get to the heart of the problem. Also, working with groups or therapists can offer a long-term support system, which promotes constructive ways to respond to tough situations and offers a safe space to unpack hurtful incidents.
“Aside from mental health treatment, it is important that we maintain tools for regulating ourselves during periods of emotional distress. This includes meditation, mindfulness, breathing, etc.,” Eshtehardi advises. “Mindful breathing has a huge impact on stress levels and can be a very productive coping skill.” Luo also recommends learning calming techniques and breathing exercises for muscle relaxation. Additionally, you may consider taking one of these 15 science-backed stress-relieving supplements.
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With the benefit of calm, Gonzalez-Berrios says it is easier to mind your words so that you communicate concerns without escalating tensions. “Express your point of view to others only after you have calmed down. Learn to pacify yourself when under the grip of the anger trigger. You can do this using humor and laughter. Move away from heated discussions whenever you could feel anger building up within you. This is known as time-out,” she advises. Forgiveness is not easy, but she also says that it can be incredibly helpful for healing.
Eshtehardi adds that “reflecting on how one’s anger could be masking other painful internal experiences can also lead to insight and growth.” To that end, Luo suggests documenting every time you are angry. He says that writing down what happened, what you felt, and why, can make it easier to detect early warning signs faster in the future. (Here’s tips for journaling your way to better mental health, if you’re curious).
Whether you are dealing with your anger issues or someone else’s, you must draw a hard line at abuse-whether verbal, physical, or emotional. If you find that anger is causing domestic or family violence, seek help immediately. You can call the National Domestic Violence Hotline at 800-799-7233 (or your local support group) for free support from a trained advocate, who can help you plan next steps.
“All human beings have anger; anger is a normal human emotion. However, anger becomes an issue when it is excessive and destructive,” Luo reminds. “In clinical practice, I assess anger issues by looking at the context in which anger occurs, how long it lasts, and the impact of anger on that person’s life. For example, if your wallet is stolen and you feel angry for a day, I do not think it is a problem. But if that anger lasts for a month and everyone around you does not like that, I would be very concerned.”
If anger is getting the best of you or someone you love, seek professional help to resolve underlying trauma and to channel those feelings into constructive behaviors in the future. If you’re worried about finding a therapist you’ll connect with, these tips may help.
If you are in immediate danger, call 9-1-1. For anonymous and confidential help, you can call the National Domestic Violence Hotline (1-800-799-7233 or TTY 1-800-787-3224) and speak with a trained advocate for free as many times as you need. They’re available 24 hours a day, seven days a week. You can also speak to them through a live private chat on their website.