Anger is a common feeling. Blood boiling. Muscle tightening. Clenched jaw. Want to scream. Pent up energy. These are the common internal experiences of anger. Most people, if not everyone, have felt angry at some point of their lives. We can feel angry when we perceive that an injustice has been done. We can feel angry when something doesn’t go our way. Rumour has it that some can feel anger simply from being hungry, leading to the popular culture term “hangry.”  

Anger is a natural adaptive response to threat, that is coupled with physiological and biological responses, such as increased heart rate, and the release of adrenaline and noradrenaline. These responses can be helpful in overcoming threats, such as fighting off attackers or solving problems. 

While a common feeling, anger is also unusual in that it can be destructive. The feeling of anger can manifest in aggressive behavior, impacting our environment and people around us. When we feel angry, we may want to punch, kick, and destroy something, resulting in damages to our physical environment or causing physical harm to people around you. For those who are able to inhibit physical aggression, we may be less capable of holding back verbal aggression or passive aggressive behaviors, both can cause emotional harm to those on the receiving end of the non-physical aggression. 

While there is no specific diagnosis for anger either in the DSM-5 (Diagnostic and Statistical Manual) or the ICD-10 (International Classification of Diseases) manual, anger and aggression are commonly found as symptoms of more than 30 disorders listed in the manuals. Some disorders in the manuals also reflect enduring and dysfunctional anger. Intermittent explosive disorder is one such disorder. This behavioral disorder is characterized by a pattern of sudden, impulsive, aggressive, and violent behavior, or explosive outbursts of anger and/or violence that are disproportionate to the situation. Intermittent explosive disorder often co-occur with other emotional/mood disorders like depression and anxiety disorder, and can often be linked to substance abuse. This disorder is also observed to lack ability in controlling impulses. 

People with intermittent explosive disorder can demonstrate a pattern of road rage, temper tantrums, and other impulsive aggressive behaviors. Before we get carried away labeling our friends and family with intermittent explosive disorder because of that one temper tantrum, we have to remember that anger and aggression are within the normal spectrum of feelings.  It’s only when this anger or aggression is disproportionate and occurs in high frequency that it becomes problematic. 

Some of the negative impacts of a pattern of angry and aggressive behavior include: 

Impairing interpersonal relationship. Being perceived as always angry can be an obstacle to building strong relationship with others. Aggressive behavior can lead to deterioration of interpersonal relationships. 

Causing trouble. Job loss, legal trouble, impulsive behaviors, financial problems

Substance abuse. Self soothing behavior through overuse of alcohol and/or drugs.

Physical health problems. Being regularly angry can lead to muscle tension, heart disease, stroke, high blood pressure, ulcers, chronic pain, etc.

Self-harm. A person with aggressive behaviors can direct the aggression toward the self instead of inflicting harm on others. 

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How to cope with anger 

In therapy, different techniques and methods can be used to help an individual cope with patterns of anger and aggression. Here are some of the simplified ways to cope in everyday situations: 

Take a breather – Breath in and out deeply. Breathe in for four to five seconds. Breathe out for six to seven seconds. Repeat this for five to 8 times. This slow and deep breathing helps to calm down the agitated physiological arousal, slowing down heart rate, lowering blood pressure, and cooling down the body. This “time-out” reduces the likelihood of impulsive aggression.

Be a problem solver (or else let it go) – We usually feel angry when there is a problem. Learn to identify the problem that is causing you to feel angry. Are you “hangry” because you haven’t eaten since morning? Solve that problem. If it is a problem that is out of your control, learn to let it go.  

Redirect constructively – When feeling angry, we can feel a lot of energy waiting to be released. Instead of manifesting this energy in aggressive behaviors, redirect that energy to something that is constructive (or at least, not destructive). Exercise is a good way to redirect this energy. Not only does the pent up energy gets released, exercising also releases endorphins, which helps make us feel good.

You don’t have to do this alone 

Anger and Intermittent explosive disorder can be hard to cope, as it is often coupled with impulsivity and a feeling of being “overtaken” by a highly charged emotion. When in need, seek help from professionals who will be able to guide you safely and effectively to adopt healthier coping strategies. 

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