Frequently Asked Questions about Anger

Q: What is anger?

A: Anger is a powerful emotion that is completely normal, and can be a healthy expression of strong feelings. When anger is felt too intensely, is felt too frequently, or is expressed inappropriately it can begin to destroy important relationships and leave you feeling at the mercy of the powerful emotion.

Anger is a strong feeling composed of three components:¹

1. Emotional: feelings ranging from mild annoyance to fury
2. Physiological: during the fight or flight response people can experience:
   • Increased heart rate or blood pressure
   • Heart palpitations
   • Muscle tension and clenching fists or jaw
   • Hot sensations
   • Flushes and reddening of the skin
   • Restlessness, agitation, or feeling jumpy
   • Short shallow breaths
3. Cognitive: thoughts that are related to anger such as:
   • "I've been treated unfairly"
   • "I'm a victim"
   • "An injustice has occurred"
   • "This was done on purpose to hurt me"
   • "They made me feel this way"
   • "This is the worst thing ever"
   • "I'm going to get even"
   • "I shouldn't have to deal with this"

Q: When does anger become a problem?

A: The expression of anger becomes a problem when it is felt too intensely, is felt too frequently, or is expressed inappropriately. More

Determine your Anger Profile by responding to hypothetical scenarios or take the Anger Quiz to determine if you should seek help for anger problems.

Q: Is anger a mental disorder?

A: Some people experiencing a psychiatric disorder may also experience anger that can become a problem. For instance, service members suffering from Posttraumatic Stress Disorder often struggle with anger and behave more aggressively than those without the disorder.² Individuals dealing with a substance abuse problem often have difficulty controlling emotions, including anger, while under the influence of drugs and alcohol.

Intermittent Explosive Disorder is characterized by explosive episodes that are extreme responses to situations that result in serious acts of assault or destruction of property. More

Q: Do men and women express anger differently?

A: Men and women may express anger differently. For instance, anger is more socially acceptable in males, and is often expressed physically through fighting. Outbursts by men are often laughed off as "boys being boys." Since overt expressions of anger are often punished when expressed by females, they tend to express anger in a more passive-aggressive way, like spreading hurtful rumors. Women are more likely to talk about their feelings of anger and problem-solve with others. Both men and women tend to have fewer problems with the expression of anger as they get older.³

Q: Is treatment helpful for problems with anger?

A: Anger management programs often utilize cognitive-behavioral techniques.^{1, 2}

The components include:

• Education about the nature of anger
• Cognitive strategies focused on changing unhelpful beliefs that trigger and maintain anger (e.g., "He tried to hurt me because he's out to get me" vs. "Even though he hurt me he did not do it on purpose.")
• Identifying triggers for anger
• Developing skills to cope with anger (e.g., relaxation techniques, assertiveness training and communication, and stress management)
• Homework assignments to practice strategies learned in treatment.

Anger management can be applied in individual or group formats. Psychosocial interventions have proven effective in reducing anger problems.⁴

Medications may be used to treat psychiatric disorders where anger is one of the symptoms. Since drug treatments vary depending upon the disorder and not all medications work the same for all people, it is recommended that you speak with your provider to find out what treatment is best for you.

Q: How do I locate professional help to deal with anger?

A: You can contact any of the following organizations, which have referral capabilities:

• Locate a TRICARE Provider
  For individuals enrolled in TRICARE or insured under TRICARE Reserve Select (TRS), find a provider online or call 1-888-TRIWEST for assistance.
• Association for the Advancement of Behavior Therapy or call 1-212-647-1890.
• American Psychological Association or call 1-800-964-2000.
• National Association of Social Workers—Search Clinical Register
• Locate a Psychiatrist or call 1-888-35-PSYCH. Outside the U.S. and Canada, call 1-703-907-7300.

Q: Do I have to see a specialist in order to get help?

A: If your PCM believes it is necessary to seek specialty care, he or she will be able to assist you in getting that next level of care. There are also a number of steps you can take on your own to address anger problems. Check out the self-help tools offered by this site. Sometimes family, friends, or clergy can be the best sources of support when facing a challenging behavioral change.

References:

¹Deffenbacher, J. L., & McKay, m. (2000).Overcoming Situational and General Anger - Client Manual. Oakland, CA: New Harbinger.

²National Center for PTSD & Walter Reed Medical Center (2004). The Iraq War Clinician Guide 2nd Edition. Accessed 3/6/06.

³Dittman, M. (2003). Anger across the gender divide. APA Monitor, 34, 52.

⁴Olatunji, B. O., & Lohr J. M. (2004). Nonspecific factors and the efficacy of psychosocial treatments for anger. The Scientific Review of Mental Health Practice, 3, 2. Accessed 3/6/06.

TRICARE policy for reimbursement requires that services must be medically necessary for a diagnosed psychological disorder. The disorder must be one referenced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and must be of a severity not only to cause the patient distress but also to interfere with the patient's usual activities.