Anger is a natural human emotion, often triggered by perceived threats or frustrations. While occasional anger can serve as a protective mechanism, chronic or uncontrolled anger can wreak havoc on nearly every aspect of life. The inability to manage anger effectively is a worthy concern, with significant implications for personal relationships, career success, and physical and mental health. Studies reveal that unchecked anger is a leading cause of interpersonal conflict, workplace disruptions, and poor health outcomes (Scott et al., 2013; Laitano et al., 2021; Saini, 2009).
In my own psychotherapy practice, I have seen anger cause more damage in the lives of individuals, their families, and their friends than just about anything else. In consideration of the devastating effects of anger on relationships and general well-being, there are few more worthy causes in life than confronting and resolving your own anger and the ways you express it in your life.
This article is intended to discuss the nature of anger, its consequences, and evidence-based strategies for managing it effectively.
Impact on Relationships
Chronic anger is detrimental to every kind of interpersonal relationship. Studies show that excessive anger can erode trust and intimacy, often resulting in estrangement or divorce. For parents, poorly managed anger can negatively influence children, leading to behavioral problems and emotional distress (Del Vecchio & O’Leary, 2004).
Anger is a major source of strain in personal relationships, often leading to misunderstandings, resentment, and emotional distance. Partners may struggle to communicate effectively, and recurring episodes of anger in any relationship erodes trust and intimacy. Research highlights that anger is a frequent contributor to divorce, with unresolved conflicts and hostile communication patterns cited as common reasons. According to studies, approximately 61% of divorced individuals cited "too much conflict or arguing," as the primary factor in their separation (Scott et al., 2013).
Anger also has a profound impact on children. Exposure to parental anger and conflict can have long-term effects on a child’s emotional and psychological development. The Adverse Childhood Experiences (ACE) study demonstrates that children who grow up in environments with frequent displays of anger and hostility are more likely to develop behavioral problems, anxiety, depression, and difficulties in forming healthy relationships as adults (Del Vecchio & O’Leary, 2004). Additionally, these children often experience issues with emotional regulation and social competence. Such findings emphasize the importance of addressing anger to foster healthier family dynamics and prevent intergenerational transmission of emotional challenges.The medical literature is unambiguous in this message: As a parent, if you’re angry and volatile around your kids, unless you want them to grow up with the emotional deck stacked against them in terms of their ability to be happy in relationships and life in general, the time to stop was yesterday! Parents of angry adult children often face a challenging situation where their grown child expresses significant anger, potentially stemming from past experiences in the family dynamic, unresolved conflicts, or underlying mental health issues, leaving the parents feeling distressed and unsure how to best respond. Adult children who frequently express angry outburst, create crises in families. Parents of struggling adult children who behave this way often feel like they are on call to fend off “the next crisis” (Berstein, 2013).
Career Consequences
The workplace is another environment where uncontrolled anger has serious repercussions. Workplace anger contributes to conflict, reduced productivity, and even job loss. Individuals struggling with anger often report difficulty maintaining professional relationships, further hindering career progression (Lee & Digiuseppe, 2018).
Employees who struggle with anger may find it difficult to collaborate, resolve conflicts, or maintain professional relationships. Workplace anger is associated with higher rates of absenteeism, reduced productivity, and even job termination. Chronic anger can also hinder career progression, essentially creating a “glass ceiling” for advancement, as it undermines leadership potential and damages reputations (Lee & Digiuseppe, 2018).
Health Outcomes
Anger’s impact on physical health is well-documented. Frequent anger episodes are linked to elevated blood pressure, increased risk of cardiovascular disease, and weakened immune responses (Saini, 2009). Prolonged physiological arousal caused by anger can accelerate aging and exacerbate chronic illnesses. Studies have also shown that individuals with high levels of anger are more likely to experience headaches, gastrointestinal issues, and insomnia (Beck & Fernandez, 2004). Addressing anger is crucial not only for emotional well-being but also for maintaining physical health and longevity.
This expanded understanding of anger’s far-reaching consequences underscores the importance of effective anger management techniques. While I frequently caution my own clients against turning “life problems” into “medical problems” (i.e., avoiding thinking about everything as a medical problem to be treated), when it comes to anger management, if you feel that you can’t slay this beast on your own, seeking help can be a source of self-respect and admiration from those around you. In other words, there are few more worthy causes in life than confronting and resolving angers dark tendrils in your life.
Life Satisfaction
High levels of anger correlate with reduced life satisfaction and poor overall mental health. Addressing anger not only improves relationships but also enhances personal fulfillment and happiness (Saini, 2009).
Understanding Types of Anger
Anger manifests in various forms:
State anger refers to short-term emotional responses to specific events.
Trait anger represents a personality disposition to experience anger frequently and intensely.
Driving anger involves anger elicited specifically in driving scenarios, often leading to dangerous behaviors on the road.
Understanding these distinctions is vital for addressing the underlying causes of anger and tailoring interventions accordingly. For instance, people with high trait anger may require more intensive therapies, whereas those experiencing driving anger might benefit from targeted coping strategies for specific triggers.
Anger and Substance Use
Research demonstrates a significant association between anger and substance use disorders.
A systematic review by Laitano et al. (2021) highlights that individuals with heightened anger are more likely to engage in substance use as a maladaptive coping mechanism. This includes:
Increased alcohol consumption.
Abuse of stimulants or sedatives.
Substance use, in turn, exacerbates anger issues, creating a vicious cycle. Addressing both anger and substance use concurrently is critical for successful intervention.
Again, the overlap of substance use, including alcohol, and anger is so frequent in my own psychotherapy practice that I would strongly suggest that if someone has told you, or if you have ever though that, it may be time to cut-back or stop drinking, and you have looked back on moments, especially in relationships or family life that you hadn’t got so angry (even if you felt justified at the time), there is a very good chance that your life will dramatically improve by seeking help for both the substance use and anger issues.
When is Anger a Medical Issue?
If you’re the type of person who feels that too often, normal life experiences are unnecessarily turned into “medical problems”, that makes two of us! There is no doubt that in my own practice I see some clients who “medicalize” challenging life experiences like stress, fear, uncertainty, sadness, and frustration. That said, sometimes anger, irritability, and temper can be symptoms of actual medical and psychological conditions. While I am by no means suggesting that anger is a medical condition, I have included some of these for the sake of being complete in this discussion:
1. Intermittent Explosive Disorder (IED)
IED is characterized by recurrent episodes of impulsive aggression and anger outbursts disproportionate to the situation. Individuals may experience significant distress and impairment in social or occupational functioning (Coccaro et al., 2016).
2. Bipolar Disorder
In the manic or hypomanic phases of bipolar disorder, individuals may exhibit increased irritability, aggression, and intense anger. This can lead to interpersonal conflict and problems in relationships (Berk et al., 2017).
Post-Traumatic Stress Disorder (PTSD)
PTSD can manifest through irritability and anger, particularly following traumatic experiences. Individuals may have difficulty regulating emotions, which can lead to aggressive behavior (Foa et al., 2016).
Attention-Deficit/Hyperactivity Disorder (ADHD)
Individuals with ADHD often struggle with emotional regulation, leading to irritability and angry outbursts. This is particularly common in children but can persist into adulthood (Barkley, 2015).
5. Major Depressive Disorder
Irritability and anger can be prominent features in some individuals with major depressive disorder, particularly in younger populations. This emotional dysregulation can complicate the clinical picture of depression (Kessler et al., 2015).
Thyroid Disorders
Hyperthyroidism, in particular, can lead to symptoms of irritability and anger due to increased metabolism and altered hormone levels. Individuals may exhibit mood swings and increased emotional reactivity (Kahaly et al., 2019).
Neurological Disorders
Conditions such as traumatic brain injury (TBI) and neurodegenerative diseases (e.g., Alzheimer's disease) can affect emotional regulation and lead to increased irritability and anger (Fann et al., 2017).
Effective Anger Management Strategies
Fortunately, the medical literature is quite encouraging in terms of offering evidence of benefit of structured psychotherapeutic approaches and programs for managing and even recovering from anger. Some evidence-based interventions for anger management include:
Cognitive-Behavioral Therapy (CBT)
CBT is one of the most effective treatments for anger. A meta-analysis by Beck and Fernandez (2004) found that CBT significantly reduces anger across diverse populations by:
Helping individuals identify and challenge irrational thoughts.
Teaching relaxation and coping techniques.
Mindfulness and Relaxation Techniques
Practices like deep breathing, meditation, and progressive muscle relaxation are supported by research as effective ways to reduce physiological arousal during anger episodes (Short, 2016).
Anger Management Programs
Structured programs can offer targeted interventions for specific anger problems. These programs often combine psychoeducation, skill-building, and group therapy (Del Vecchio & O’Leary 2004). The quality of evidence supporting anger management techniques is robust.
The effectiveness of psychological treatments for producing substantial improvements in anger control and reduction of aggression, especially in personally tailored interventions, is well supported (Lee & Digiuseppe, 2018; Saini, 2009).
Pharmacological Interventions
In more challenging instances, medications like selective serotonin reuptake inhibitors (SSRIs) may help regulate mood and reduce anger intensity, particularly in individuals with underlying conditions like depression or anxiety. While medication may not be an ideal, long-term strategy, when anger is causing significant impact and there is urgency in putting an end to it, an encouraging body of evidence does support the potential benefit of prescription medications.
Seeking Help: Finding the Right Resources
For individuals struggling with anger issues, professional help can make a significant difference. Anger management therapy and evidence-based programs offer tools to regain control and improve overall quality of life. Addressing anger is not only a step toward personal growth but also an investment in better relationships, health, and happiness.Speaking from the perspective of a psychotherapist, I always respect someone recognizing that they have an issue with anger, valuing their own health and the health and happiness of those around them, by asking for help.
While nobody is respected or admired for their legendary, explosive temper, for those who are brave and persistent enough to overcome their anger and its various expression in life, the rewards of their effort can positively benefit not only their life, but the lives of the people around them.
About the author: Dr. David George maintains a psychotherapy practice in Scottsdale, AZ at Neuregen, an integrative psychiatry and neurologic health clinic offering a range of mental health therapies, including integrative psychiatry, ketamine therapy, regenerative therapies, and interventional mental health procedures like stellate ganglion block.
References
Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.
Beck, R., & Fernandez, E. (2004). Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis. Cognitive Therapy and Research, 22, 63-74.
Berk, M., Dodd, S., & Callaly, T. (2017). Bipolar disorder and irritability: A neglected area. Bipolar Disorders, 19(3), 183-190. https://doi.org/10.1111/bdi.12530
Bernstein, J. (2023, January 18). 3 ways to defuse an angry adult child. Psychology Today. https://www.psychologytoday.com/us/blog/liking-the-child-you-love/202301/3-ways-to-diffuse-an-angry-adult-child
Coccaro, E. F., Cavell, T. A., & Trestman, R. L. (2016). Intermittent explosive disorder: An update on the evidence. Current Psychiatry Reports, 18(9), 89. https://doi.org/10.1007/s11920-016-0735-3
Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. https://doi.org/10.1001/archpsyc.62.6.593
Del Vecchio, T., & O’Leary, K. (2004). Effectiveness of anger treatments for specific anger problems: A meta-analytic review. Clinical Psychology Review, 24(1), 15-34.
Fann, J. R., Uomoto, J., & Katon, W. J. (2017). Psychiatric disorders and quality of life following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 88(3), 173-179. https://doi.org/10.1016/j.apmr.2006.01.008
Foa, E. B., Keane, T. M., & Friedman, M. J. (2016). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies (2nd ed.). Guilford Press.
Kahaly, G. J., Bartalena, L., & Duntas, L. H. (2019). Thyroid dysfunction and psychiatric disorders. The Journal of Clinical Endocrinology & Metabolism, 104(8), 3729-3743. https://doi.org/10.1210/jc.2019-00315
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2015). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National
Laitano, H., et al. (2021). Anger and substance abuse: A systematic review and meta-analysis. Brazilian Journal of Psychiatry, 44, 103-110.
Lee, A., & Digiuseppe, R. (2018). Anger and aggression treatments: A review of meta-analyses. Current Opinion in Psychology, 19, 65-74.
Saini, M. (2009). A meta-analysis of the psychological treatment of anger: Developing guidelines for evidence-based practice. *Journal of the American Academy of Psychiatry
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