How Is Anger Related To PTSD?

Anger and irritability are common symptoms of PTSD. Anger is sometimes, but not always, associated with aggression and can have a severe negative impact on relationships with loved ones or even on yourself.

It is important to remember that anger is not always outwardly expressed. It is often repressed by sufferers, which can cause problems of its own and commonly leads to self-destructive behaviors.

Anger and PTSD

PTSD is a complex disorder with many symptoms. Just because you suffer from PTSD does not mean you have anger issues, and vice versa. Anger can present itself in different ways and be triggered by different things.

Your expression of anger may be due to your personal history, trauma, or genetics. While these things are beyond your control, it is useful to understand what might be causing your mood swings and learn how to manage them more effectively. You can do this by introducing anger-management techniques into your daily life.

What is hyperarousal, and how does it relate to anger?

There are two subtypes of PTSD:

• Hyperarousal subtype

• Dissociative subtype

The hyperarousal subtype, otherwise known as the non-dissociative subtype, makes up around 70% of PTSD cases and is especially relevant to the discussion around anger and PTSD. Hyperarousal is related to hypervigilance — think of it as extreme alertness in response to a threat or danger.

In the case of PTSD, this happens even when the threat is no longer present. This causes alertness and hyperactivity in parts of the brain that also correlate to anger, so the threat response is more likely to cause angry outbursts.

As you can imagine, feeling anxious and stressed often leads to worsening symptoms and can cause people to view the world around them in a more negative light.

PTSD, anger, and violence

Anger is not always associated with violence, but it is a possibility. It is more common to find anger and aggressive behaviors in veterans, perhaps because of the nature of their service.

If you recognize signs of aggression in yourself or a loved one, it is important to seek help managing this. Studies have shown that providing PTSD survivors with good social support can greatly reduce the likelihood of aggressive behavior. There is a list of useful resources on the National Coalition Against Domestic Violence (NCADV) website.¹

Anger and self-destructive behaviors

Anger suppressed and internalized, rather than outwardly expressed, can also cause difficulties. Studies have shown that the link between anger and suicidal thoughts is the strongest of all PTSD symptoms.

This means that people who experience anger and aggressive tendencies are more likely to have suicidal thoughts than those who don’t.

Anger and aggression are also strongly linked to reckless or self-destructive behaviors, including:

• Substance abuse

• Dangerous driving

• Excessive sexual activity

• Risky sexual activity (e.g., lack of contraception)

• Weapon possession or weapon-related aggression

• Interpersonal violence

• Self-harm

• Thrill-seeking

Anger management techniques

Studies² show that, apart from cognitive behavior therapy (CBT), PTSD treatments currently available do not significantly reduce experiences of anger and aggression, although they do have a small positive effect. For CBT to be effective, it must be targeted toward anger management.

Targeted therapy, focusing on anger, has been successful in groups of veterans. With the help of a psychologist or therapist, you can also take steps to implement anger management techniques in your everyday life.

Techniques could include:

• Exercise

• Mindfulness

• Meditation

• Yoga

• Learning to recognize anger as it begins to form so you can take a ‘time-out’

Opening up to friends and family members is also a great way to work through feelings before they come to a head.

Frequently asked questions

What is PTSD?

PTSD is a mental health condition that results from experiencing a traumatic event. Experiencing trauma does not mean you will develop PTSD — it is a complex disorder that depends on the individual.

It has many symptoms that vary from person to person, including:

• Intrusive flashbacks

• Nightmares related to the traumatic event

• Avoidance of triggers that remind you of the event

• Increased negative perspective or mood after the trauma

• Inability to remember parts, or all, of the traumatic event

• Feelings of isolation from others

• Anger and irritability

• Recklessness

• Easily distracted

• Hypervigilance

• Trouble falling and remaining asleep

How is PTSD treated?

There are multiple treatment options available, including medication and therapy-based techniques. Cognitive behavior therapy is the most recommended, but different treatments can work for different people.

In some cases, medication is prescribed as well as talk-therapy options to increase the likelihood of treatment being successful.

Where can I get help for my PTSD and anger?

Contacting your local health professional is a great place to start. This could be a doctor to get a referral, a psychologist, or a therapist.

Opening up to your family and friends about starting this process has also been shown to improve the results of treatment, so choose a trusted loved one to help you.

The lowdown

Overall, feeling anger from time to time is completely normal. However, if you are experiencing detrimental effects from anger or are feeling excessive anger every day, it is important to seek help. It is important to recognize that anger presents itself in multiple ways, not just sudden outbursts or apparent mood swings.

Seeking advice from a mental health professional and support from your family and friends are the first steps you should take. The road to recovery may be long and not always easy, but it is worth taking to improve the quality of life for you and your loved ones.