Dr Adrian Winbow sees many patients for whom anger is a problem. We asked him to tell us more.
Anger is a natural emotion and it is normal to lose your temper sometimes. However, if you often feel angry – whether you express your anger through aggression towards others or suppress it – you have a problem.
Stress, anxiety, fear and anger are all mediated by adrenaline and physiologically they generate the same responses: tension headaches, sweating, rapid heartbeat, hyperventilation, knots in the stomach.
If you feel full of rage, shout, throw things and hit people, it is easy for you and others to see that you are angry. It’s clearly a problem for them and you.
If you internalise your anger, it is just as damaging. You may appear miserable or negative. But it may not be obvious that you are feeling anger, even though you are damaging your relationships and potentially your health.
Often someone’s spouse or relatives will say they need to get help. For example, a wife may to threaten to leave her husband unless he sorts his anger out.
If someone gets into a fight and the police are involved, the police may suggest they seek help before they get into serious trouble.
Sometimes they do and sometimes they don’t.
The most common cause of anger problems is stress. If you are under pressure at work and at home, have financial problems, and your relationships are not healthy, you can begin to feel angry at the life you lead. People often tell me, ‘all I do is work and sleep.’ They are deeply frustrated.
Alcohol and drugs are a big issue. Alcohol precipitates anger because it releases inhibitions. Drugs too – prescription or illegal – are a potential catalyst, in particular ecstasy, LSD and amphetamines because they can lead to paranoid thoughts and suspicions.
Not at all. People with mental illness are rarely violent. They’re actually much more likely to be the victims of violence themselves.
Personality disorders, though, are a significant factor in people’s problems with anger. For example, someone with explosive personality disorder or sociopathic personality disorder is more likely to have problems with anger. You may be able to see a pattern of violence and aggression in the family.
If someone comes to me with anger problems that are clearly a result of stress, we look at your lifestyle. What can you do to improve your work-life balance, for example?
We may look at techniques such as relaxation and stress management. Breathing exercises, meditation and yoga can help. Anger management techniques such as counting to ten or walking away are simple but can be extremely useful.
If your anger is deep rooted we may explore talking therapies such as Cognitive Behavioural Therapy or psychodynamic psychotherapy. We can use these therapies to explore issues such as unconscious conflicts from childhood.
Occasionally, if we see a definite cause for the anger problem, we use medication such as short courses of tranquilisers, betablockers, antidepressants, or pregabalin.
The NHS has some simple tips on their website.
Mental Health Foundation has a free booklet, Cool Down: Anger and How to Deal with It.
Mind has a useful guide to dealing with anger.
