ANGER DISORDERS

Anger is a normal and very powerful emotion, but when not processed it can manifest in the body in many ways including chest and headaches. When it gets out of control, it can cause long-lasting physical and psychological problems, as well as conflicts in interpersonal relationships with family, work or school peers.
 

What Are Anger Disorders?
 

Anger disorders are aggressive, violent or self-destructive behaviors that are both symptoms of and driven by an underlying, chronically repressed anger or rage. It is thought that anger disorders result from long-term mismanagement of anger. Over time, normal anger grows into bitterness, resentment, hatred, and destructive rage.
 

Anger disorders can be exacerbated or caused by neurological impairment and substance abuse. Both inhibit a person’s ability to resist angry, aggressive, or violent impulses.
 

The most commonly used psychiatric diagnoses for angry, violent, and aggressive behavior are: Disruptive Mood Dysregulation Disorder (DMDD), Borderline Personality Disorder, Oppositional Defiant Disorder (ODD), Attention-Deficit/Hyperactivity Disorder (ADHD), and Conduct Disorder (in children and adolescents), Psychotic Disorder, Bipolar Disorder, Antisocial, Paranoid and Narcissistic Personality Disorder, Adjustment Disorder with Disturbance of Conduct, and Intermittent Explosive Disorder (IED). 

Intermittent explosive disorder (IED) involves repeated incidents of explosive, aggressive, violent behavior or angry outbursts that are grossly out of proportion to the situation, during less than 3 months. These behaviors are the result of impulsive behavior and not premeditated. The National Institute of Mental Health (NIMH) estimates that more than 16 million Americans may suffer from IED. Women and men with IED may attack others, causing bodily harm and property damage or harm themselves during an outburst. Later, they may express feelings of regret, remorse, and embarrassment. 

Symptoms of Anger Problems
 

People with anger problems may experience a variety of symptoms, including:  

• Intense memory-related anger 
• Getting angry about past events or people from the past
• Disproportionate anger 
• Reacting to certain circumstances with more anger than most other people would in similar situations
• Anger without cause 
• Feeling angry without a particular reason 
• Guarded interactions with others 
• Being cautious and guarded when interacting with others
• Others notice and comment 
• Several other people give feedback that you have difficulty managing your anger
   

For those with IED, explosive reactions usually last less than 30 minutes and occur in clusters or are separated by weeks and months. In between IED episodes, the person may be irritable, impulsive, aggressive, or angry.
 

Prior to or Following an IED Episode, Man or Woman May Show:  

• Feeling of pressure in the head
• Chest tightness
• Increased energy
• Irritability
• Heart palpitations
• Racing thoughts
• Rage
• Tingling
• Tremors
• After the episode, fatigue, relief, or depression may occur.
  
   

Women who exhibit anger problems may have been abused by an intimate partner (domestic abuse), or the victim of violent behavior. A woman with suicidal thoughts may be filled with anger and contemplate self-harm as a way out. Women’s anger or hostility may also be related to their use of alcohol and drugs.

Aggressive behaviors may be displayed in people with other forms of anxiety, personality disorders, or mood disorders, along with some medical conditions such as Parkinson’s disease or traumatic brain injury.  In the case of IED, although the exact cause remains unknown, suspected causes include environmental factors as well as genetics and brain chemistry.
 

Who’s at Risk?
 

There are a number of factors that increase the risk of developing anger problems, including:
 

• History of substance abuse   
• Drug and alcohol abuse increases the risk of IED
• History of physical abuse 
• Those who were physically abused as children or experienced multiple traumatic events are at increased risk for IED.
• Age – IED most commonly begins during the teens and 20s.
• Gender – Men are more likely to     experience IED than women.
   

Treatment for Anger Problems
 

While there is no single treatment that works for everyone with anger problems, treatment generally includes psychotherapy, hypnotherapy Brainspotting Therapy and medication as the last resource.

With Erick Sandstad, women and men with anger problems participate in individual Cognitive behavioral therapy (CBT) sessions, and Brainspotting Therapy. This helps clients identify situations or behaviors that may trigger a hostile, aggressive response. Clients also learn how to manage their anger and control inappropriate responses using techniques such as relaxation therapy, cognitive restructuring (thinking differently about situations), and learning coping skills.    

Disruptive Mood Dysregulation Disorder (DMDD) is characterized by aggressive outbursts of verbally and behaviors  that are out of proportion in intensity to the provocation accompanied by a persistently negative mood state (i.e., irritability, anger) lasting most of the day, nearly every day for more than 12 months. This condition usually begins by age 10.

Oppositional Defiant Disorder (ODD) is characterized by aggression typically taking the form of temper tantrums and verbal arguments with authority figures. These aggressions are less intense than DMDD since they are normally accompanied by more intense mood swings.   

Conduct Disorder is characterized by a repetitive and persistent pattern of behaviors in which the basic rights of others or age appropriate society norms are violated on purpose. This behavior tends to be severe and includes aggression towards animals, individuals, destruction of property or theft and is premeditated.