What is Anger?
Anger is a completely normal, usually healthy, human emotion which allows us to respond and take action against danger or injustice.  It varies in intensity from mild irritation to fury and rage and is accompanied by physical changes in the body and energy hormones.   We get angry at other people, situations and ourselves.  Anger is something that everyone in life will experience.  However, when it gets out of control it can lead to problems, for example, problems at work, in our personal lives, relationships and overall, to the quality of our lives.

When an angry episode occurs all of the following are involved:

• cognition – our present thoughts
• emotion – the physiological arousal our anger produces
• communication – the way we display our anger to others
• the effect of anger on others – fear, hostility
• behaviour – the way we act when we are angry

We also (if we are aware of it) feel the results of anger in our own bodies.  It seems that some people are angrier than others.  They usually become angry more easily and more intensely than the average person.  There are also some people that do not show their anger in loud spectacular ways but are chronically irritable and grumpy.  These people sometimes withdraw socially and/or become physically ill.

What are the Symptoms of Anger Problems?

• tension or stress begins to build, e.g. we are easily frustrated, clenched posture
• breathing and heart rate increases
• blood pressure rises, e.g. flushed face and neck, veins standing out
• increases in hormones such as adrenaline and noradrenaline
• the person may express their anger verbally, either directly or through emotions such as disgust, sarcasm, put-downs, blaming, criticism, resentment, argumentativeness, sullenness, insults and contempt
• violence, threats, temper tantrums

What are the Effects on Our Health?
In the case of chronic anger, long-term hyper-arousal of the autonomic nervous system can cause the following symptoms:

• headaches
• stomach ache
• skin rash
• arthritis – anger produces uric acid in the bloodstream which may contribute to the onset of arthritis
• circulatory disorders
• aggravation of existing physical symptoms
• emotional disturbances such as depression
• the physical effects of violence towards the self and others

What Are the Causes of Anger Problems?
There are a number of reasons why some people tend towards anger more than others. One cause might be genetic or physiological. There is evidence that suggests that some children are born with irritable, sensitive and easily angered natures and these signs are present from a very early age. Another cause might be our fast paced, and increasingly pressured, way of life.  Because anger is often regarded as negative, we are taught that it is all right to express anxiety or depression and other emotions but not anger. This can result in outbursts from a build up of tension. It may also be a result of frustration from our experiences in life, a disturbed background and/or our lifestyle.  People often learn to react with anger from seeing how their parents dealt with conflict.

Is There a Link Between Anger and Mental illness?

The prevalence of anger attacks (defined as irritability, inappropriate anger and rage, frequent outbursts and overreaction to minor annoyances) in patients with depression can be as high as 44%. (http://www.psychiatrist.com/supplenet)  Also, people with bipolar disorder can have episodes or periods of irritability when hypomanic or manic.

What Help is Available?
It is potentially dangerous to ‘let it rip’ with anger as it escalates the anger and aggression and does nothing to help us or the person we are angry with.  There are solutions available to deal with anger.  Some options are listed below:

• one strategy is to find out what it is that triggers our anger then develop strategies to keep those triggers from tipping you over the edge
• another strategy is relaxation, which is very important in helping our body to remain calm.  Picture your breath coming up from your gut and breathe slowly and deeply
• slowly repeat a calm word or phrase, for example, ‘take it easy’ or ‘relax’ and repeat it to yourself while breathing deeply
• non-strenuous, slow yoga-like exercises can also relax muscles and bring feelings of calmness
• cognitive reframing (changing the way we think) can work.  Try to replace exaggerated and overly dramatic angry thoughts with more rational ones.  For example, telling yourself ‘I know it’s frustrating and it’s understandable that I’m upset but it’s not the end of the world and anger is not going to fix anything’
• Develop better communication skills.  Sometimes angry people tend to jump to and act on conclusions; these are not always very accurate.  It is important to have slower discussions with others.  Also, think through your responses.  Do not say the first thing that comes into your head and think carefully about what you want to say and, at the same time, listen to what the other person is saying.
• Changing your environment, for example, sometimes our immediate surroundings give cause for anger.  Give yourself a break making sure that you have some ‘personal time’ scheduled for times in the day that you know are particularly stressful.
• Counselling may be needed if you think that your anger is out of control.  Psychologists or other licensed mental health professionals can help work with anger by developing a range of techniques for changing thinking and behaviour.  This can be surprisingly effective.  Even by just admitting to a problem and being willing to change is a big step in the right direction – as frightening as that may be.
• Assertiveness training - this means learning how to express your needs clearly and respectfully, without infringing on the rights of other people.  Using “I” statements is often useful.  For example, ‘I feel upset when you don’t return my calls’ as opposed to ‘you never return my calls’) as this tends to reduce blaming and defensiveness.

Goals of Anger Management

• developing better communication skills with the aim of improving relationships
• developing an understanding of what triggers anger
• developing strategies to deal with anger
• developing listening skills
• developing skills like ‘reframing’ negative thoughts about life situations
• getting help to change your life circumstances, if necessary
• stress management

Where to Get Help

• Therapeutic Axis provides counselling in Sydney and psychotherapy in Sydney for persons seeking assistance with Anger Management.

Further Reading

Beyond Anger: A Guide for Men: how to free yourself from the grip of anger and get more out of life, by Thomas J. Harbin ISBN: 1569246211 published by Marlow & Co 2000
The Angry Self; a comprehensive approach to anger management by Miriam M. Gottlieb
Publisher Zeig, Tucker and Theisen, 1999, ISBN 189194407X
Dealing with Anger, by Carol Rogne, Discovery Counseling & Educational Center, 2002, ISBN: 1881565025

References:
Mental Health Association of NSW Inc
www.mentalhealth.asn.au