The Link Between Anger and Other Mental Health Conditions

According to MIND approximately 1 in 4 people in the UK will experience a mental health problem each year, and in England 1 in 6 people report experiencing a common mental health problem, such as anxiety and depression, in any given week. 

Mental health is a state of mental wellbeing that enables people to cope with the stresses of everyday life, make the most of their abilities, and contribute to their family and wider community. Many mental health conditions can be effectively treated; however, too often health systems are significantly under-resourced and there are treatment gaps. People with mental health conditions often also experience stigma and discrimination due to a lack of education and empathy within society.

Understanding anger

Anger is a natural human emotion which is characterised by feelings of displeasure, hostility, or frustration. It typically arises in response to perceived threats, injustices or conflicts. Anger can manifest in various ways, ranging from mild irritation to intense rage, and it can be triggered by both internal and external factors. 

Physically, anger is accompanied by changes in the body, such as an increased heart rate, elevated blood pressure, and the release of stress hormones like adrenaline and cortisol. These bodily changes prepare you for a fight-or-flight response, which is the body’s instinctual reaction to perceived threats.

Anger itself is not inherently negative as it is a normal human emotion; however, it is essential to learn how to manage it constructively. Uncontrolled anger can lead to destructive behaviours, strained relationships, and even physical and mental health problems.

Often within society we are taught that anger is a bad emotion; even small children are taught to suppress their anger and often are not taught how to express anger appropriately. People can have trouble managing anger appropriately for a variety of reasons, including:

• A lack of emotional regulation skills – some individuals may lack adequate emotional regulation skills, making it challenging for them to control their anger when faced with triggering situations.
• Unresolved issues – past experiences, trauma or unresolved emotional issues can contribute to difficulties in managing anger. If someone has not addressed underlying issues, they may be more prone to explosive or inappropriate outbursts of anger.
• Learned behaviour – people may have learned unhealthy ways of expressing anger from their family, peers or cultural influences. If they grew up in an environment where anger was not managed effectively, they might replicate those behaviours.
• Stress and pressure – stressful situations, pressure at work or in personal relationships, financial difficulties or health problems can all contribute to heightened feelings of anger. When people are overwhelmed by stress, they may struggle to manage their emotions effectively.
• Personality traits – certain personality traits, such as impulsivity or having a tendency towards aggression, can make it more challenging for people to manage their anger appropriately. Additionally, some people may have a lower threshold for frustration, leading to quicker outbursts of anger.
• Communication skills – difficulties in communicating their emotions and needs in a constructive manner can lead to frustration and anger. If someone lacks effective communication skills, they may resort to anger as a way to express themselves, even if it is not the most appropriate or productive approach.
• Substance abuse – substance abuse can impair judgement and exacerbate anger management issues. Drugs and alcohol can lower inhibitions and make it more difficult for people to control their emotions.
• Lack of coping mechanisms – some people may not have developed healthy coping mechanisms for dealing with anger. Instead of addressing the root causes of their anger or finding constructive ways to manage it, they may resort to destructive behaviours or avoidance tactics.

Anger as a symptom

Anger can in some cases be a symptom of a mental health condition. While it is a normal human emotion and can be healthy when expressed appropriately, excessive or uncontrollable anger can be indicative of an underlying mental health issue. 

Some examples of mental health conditions where anger may manifest as a symptom include:

• Depression – in some cases, depression can manifest as irritability or anger rather than sadness. People experiencing depression may have a low threshold for frustration and find themselves easily angered by minor issues.
• Bipolar disorder – this condition involves episodes of both depression and mania. During manic episodes, individuals may experience heightened emotions, including intense irritability or anger.
• Intermittent explosive disorder (IED) – this disorder involves recurrent, impulsive and uncontrollable episodes of aggression or violent outbursts. People with IED may have difficulty controlling their anger, which may lead to verbal or physical aggression.
• Post-traumatic stress disorder (PTSD) – anger and irritability are common symptoms of PTSD, especially if the individual experienced trauma involving betrayal, injustice or violence. Anger can serve as a coping mechanism or defence mechanism in response to a perceived threat.
• Borderline personality disorder (BPD) – people with BPD may struggle with intense and unstable emotions, including anger. They may have difficulty regulating their emotions, leading to outbursts of anger or aggression.
• Substance use disorders – substance abuse can exacerbate anger issues or contribute to the development of anger-related problems. Some substances can directly affect mood and impulse control, leading to increased irritability and aggression.
• Generalised anxiety disorder (GAD) – while anxiety is typically associated with feelings of worry and fear, it can also manifest as irritability or anger, especially if people feel overwhelmed or unable to control their anxious thoughts.

Contributing factors

There are several factors that can contribute to anger as a mental health symptom, which include:

• Biological factors – imbalances in neurotransmitters such as serotonin and dopamine can influence mood regulation, potentially leading to heightened irritability and anger.
• A genetic predisposition – genetic factors play a role in determining someone’s susceptibility to anger-related issues. A family history of mood disorders or aggressive behaviour can increase the likelihood of experiencing anger as a symptom.
• Experiencing trauma – past traumatic experiences, such as abuse, neglect or witnessing violence, can contribute to anger-related issues. Trauma can alter brain function and lead to difficulties in regulating emotions, including anger.
• Environmental factors – growing up in a chaotic or dysfunctional family environment where anger is frequently expressed or where emotions are not appropriately addressed can contribute to the development of anger problems.
• Personality traits – certain personality traits, such as impulsivity, low frustration tolerance, or a tendency to internalise emotions, may predispose people to experience anger-related difficulties.
• Lack of coping skills – inadequate coping skills for managing stress and regulating emotions can make people more prone to experiencing anger as an automatic response to challenging situations.

Impact on relationships

Anger can have a significant impact on relationships, both in personal relationships and professional relationships in the workplace. Not managing anger effectively can lead to communication breakdown, as when someone is angry, they may struggle to communicate effectively. Anger can hinder healthy communication and understanding between people and lead to emotional distance. The person who is angry may withdraw or shut down emotionally, making it difficult for their partner or friend to connect with them on an emotional level. Anger being expressed in unhealthy ways can also lead to:

• Resentment and bitterness – if anger is not addressed and resolved, it can lead to feelings of resentment and bitterness over time. Resentment can erode the foundation of a relationship and make it challenging to rebuild trust and intimacy.
• Damage to trust – anger, especially if expressed through hurtful words or actions, can damage trust in a relationship. Trust is essential for the health and stability of any relationship, and repeated expressions of anger can undermine that.
• Difficulty in resolving conflicts – anger can make it challenging to resolve conflicts constructively. Instead of working together to find solutions, people may become entrenched in their positions and become unwilling to compromise.
• Physical and emotional harm – in extreme cases, anger can lead to physical or emotional harm. This can include verbal or physical abuse, which can have long-lasting consequences for all involved. This can be particularly damaging for any children who witness conflict between family members. Domestic abuse is any type of controlling, coercive, bullying, threatening or violent behaviour between people who are or have been in a relationship. It can also happen between family members. It can be very harmful for children and young people. Experiencing domestic abuse is child abuse. REFUGE is the largest domestic abuse organisation in the UK and they can provide help and support to anyone experiencing or affected by domestic abuse. You can also contact them on their free phone 24-hour National Domestic Abuse Helpline 0808 2000247.
• Stress and health issues – living with someone who frequently expresses anger can create a stressful environment. Chronic stress has been linked to a range of health issues, including high blood pressure, heart disease and depression.

Anger management and treatment

Treating anger as a symptom of mental health involves various approaches depending on the underlying cause and severity of the anger. In some cases, medication may be used in order to address the specific symptoms of the mental health condition and therapy may also be recommended. Other things that may be considered include:

• Stress management.
• Anger management techniques.
• Support groups.
• Communication skills training.

You may also be offered an anger management programme, which is a structured intervention designed to help individuals understand and regulate their anger more effectively. These programmes typically involve a combination of educational components, therapeutic techniques and skill-building exercises aimed at teaching participants how to recognise their triggers, cope with anger in healthier ways, and develop constructive communication and conflict resolution skills. You can usually access these locally by speaking to your GP or mental health professional.

Substance abuse and anger

Substance abuse and anger often have a complex and interconnected relationship. Substance abuse can both trigger and exacerbate anger-related problems. Some things to consider include:

• Biological factors – substance abuse can affect brain chemistry, leading to alterations in mood regulation and impulse control. Certain substances, such as alcohol and stimulants like cocaine, can exacerbate feelings of anger and aggression.
• Psychological factors – people may turn to substance abuse as a way to cope with underlying psychological issues, including anger. Substances may appear to temporarily alleviate feelings of anger or frustration, but they can ultimately exacerbate these emotions over time.
• Cyclical nature – substance abuse and anger can feed into each other in a cyclical pattern. For example, a person may use drugs or alcohol to cope with anger, which can lead to reckless behaviour or impaired judgement.
• Environmental factors – stressful environments, dysfunctional relationships or traumatic experiences can contribute to both substance abuse and anger. People may use substances as a coping mechanism, which may lead to increased feelings of anger and frustration.
• Underlying issues – anger issues often coexist with other mental health conditions such as depression, anxiety or PTSD, which can also be risk factors for substance abuse. Addressing underlying mental health concerns is essential for managing both anger and substance abuse effectively.
• Treatment implications – effective treatment for people struggling with both substance abuse and anger usually involves addressing both issues simultaneously. This may include therapy, such as cognitive behavioural therapy (CBT), anger management techniques, substance abuse counselling, and potentially medication for underlying mental health conditions.
• Recovery process – sobriety and anger management often go hand in hand in the recovery process. Learning healthy coping mechanisms, developing emotional regulation skills, and addressing underlying issues are crucial for long-term recovery from both substance abuse and anger problems.

Healthy coping mechanisms

• Deep breathing – practising deep breathing exercises, also known as breath work, can help to calm your body and mind. Inhale deeply through your nose, hold for a few seconds, and then exhale slowly through your mouth. Both feet should be touching the floor when you do this. You should repeat several times until you feel more relaxed.
• Mindfulness and meditation – engaging in mindfulness meditation can increase self-awareness and help you to learn to observe your emotions without reacting impulsively.
• Physical activity – engaging in regular physical exercise such as walking, jogging, yoga or swimming can reduce stress levels. Exercise also releases endorphins, which are natural mood lifters.
• Finding healthy outlets – find healthy outlets for your anger, such as journaling, painting, playing a musical instrument, or engaging in a hobby that you enjoy. Expressing your feelings creatively can help you to process and release anger in a constructive and healthy way.
• Assertive communication – you should practise assertive communication skills in order to learn to express your needs and concerns calmly and respectfully to other people. Avoid aggressive or passive-aggressive behaviour, as this can escalate conflicts and exacerbate anger.
• Take some time out – if you feel overwhelmed by anger, take a break from the situation.
• Positive self-talk – challenge negative thoughts and beliefs that contribute to your anger. Try doing some positive affirmations.
• Seek support – talk to a trusted friend, family member or therapist about your feelings of anger. Sharing your experiences with someone who understands can provide some perspective and coping strategies.
• Practice gratitude – practising gratitude by focusing on the positive aspects of your life can help to reduce the negative feelings as they begin to creep in. Reflect on things you are thankful for, even in challenging situations. Gratitude can help shift your perspective and reduce feelings of anger and resentment.
• Seek professional help – if you are struggling to manage your anger on your own, consider seeking professional help from a therapist or counsellor or accessing an anger management course. A typical anger management programme may involve 1-to-1 counselling and working in a small group and most involve cognitive behavioural therapy. Many NHS Trusts run free local anger management services; you can ask your GP what’s available near you. You can also contact your local MIND directly to check whether they offer anger management services.