Mental Health Conditions Associated With Extreme Anger

Updated November 13, 2024by BetterHelp Editorial Team

Sometimes, it can be easy to understand why you are feeling angry. You might be frustrated because slow traffic is making you late for an appointment, or maybe you are upset that your friend canceled plans at the last minute. However, extreme anger tends to be different from the natural, common type of anger that most people experience. It may seem to arise unprovoked or appear to be out of your control. 

If you frequently experience intense anger that results in outbursts, relationship problems, and behavior you feel ashamed of later, your anger may be related to a mental health condition. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) includes anger as a criterion for diagnosing five conditions, and anger can appear as a symptom in other mental health conditions as well. Often, excessive anger can be treated through therapy. 

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Does your anger seem out of control?

Intermittent explosive disorder

Of all the diagnosable conditions listed in the DSM-V, intermittent explosive disorder (IED) may be most closely associated with extreme anger. In the US, IED has a lifetime prevalence of approximately 4%, although for adolescents, this may be closer to 8%. 

The main symptom of IED is a pattern of explosive outbursts that are disproportionate to the situation at hand. The outbursts tend to be impulsive, unplanned, and last no longer than 30 minutes. Behaviors during an outburst may include the following:

  • Damaging property or objects
  • Physically assaulting people
  • Acting on aggressive impulses, potentially including violent behavior
  • Engaging in heated verbal arguments
  • Threatening others
  • Getting into physical fights

After the outburst, the person may experience regret and shame, as well as a sense of relief or exhaustion. 

IED can lead to interpersonal issues, such as conflict with a partner, family members, or friends. Outbursts may lead to problems at work, legal trouble, road rage, or money problems. Someone with IED may struggle with alcohol or substance misuse (formerly referred to as substance abuse). Risk factors for developing intermittent explosive disorder may include growing up in a home where this type of behavior was modeled or experiencing verbal or physical abuse. 

Intermittent explosive disorder in children

Intermittent explosive disorder can be diagnosed in children six years or older, but it’s more commonly diagnosed later in childhood or adolescence. Children with IED usually display many of the same symptoms as adults, such as frequent outbursts and a perceived inability to control their anger.

Borderline personality disorder 

Rage and aggression tend to be key symptoms of borderline personality disorder (BPD). People with the condition can have a hard time regulating their emotions, especially anger, and may experience intense mood swings. The condition usually involves an intense fear of abandonment, so when people sense that they’re being forgotten or neglected, they might experience extreme anger. BPD can contribute to extreme rage and rage blackouts that last anywhere from a few hours to a few days. Mood swings can also happen within hours or days. 

BPD is almost exclusively diagnosed in adults, and almost three-quarters of people diagnosed with the condition are women. The main treatment for BPD is therapy, and common treatment models include dialectical behavior therapy, schema-focused therapy, and transference-focused therapy.

Bipolar disorder

People with bipolar disorder usually experience unusual shifts in mood and energy. This condition typically involves periods of depression alternating with periods of mania. During manic episodes, individuals may have an irritable mood or be easily annoyed. Depending on the type of bipolar disorder someone has, their extreme anger and irritability may last a few weeks to a few months. 

Extreme anger in children

Tantrums and outbursts can be common behaviors for many children because they are still learning how to handle challenges and manage their emotions. However, if a child’s behavior doesn’t improve with time, or if it doesn’t seem in line with the typical development of their peers, they may have a mental health condition that is contributing to their anger issues. 

What causes anger issues in children?

Atypical or extreme anger in a child may indicate that there is something more than typical child development going on. Anger issues may be attributed to autism, sensory processing problems, or ADHD in some cases. Two conditions, oppositional defiant disorder and disruptive mood dysregulation disorder, can also be characterized by extreme anger and are primarily diagnosed in children. 

Caregiver stress can contribute to outbursts

Even if a caregiver doesn’t outwardly express their stress or anger, children may be able to pick up on those feelings due to changes in body expression, tone of voice, and overall demeanor. Staying calm may prevent your stress from compounding your child’s anger. In addition, children usually learn from modeled behavior. By keeping calm in the face of a child’s anger, you may be modeling a more effective approach to challenges and teaching the child how to regulate their own emotions and behaviors. 

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Oppositional defiant disorder

Oppositional defiant disorder (ODD) is a condition that typically occurs in children, although it can be diagnosed in adults as well. Children with this disorder usually display a pattern of uncooperative and hostile behavior toward their peers, parents, teachers, and others. ODD usually occurs more often in boys than girls, impacting approximately 2% to 11% of children.

The symptoms of ODD are different from typical childhood misbehavior because they occur more often and with greater severity. They can include the following:

  • Frequent temper tantrums
  • An angry and irritable mood
  • Questioning rules
  • Arguing with authority figures
  • Blaming others for their behavior
  • Seeking revenge
  • Trying to hurt other people’s feelings
  • Actively defying directions and rules
  • A tendency to inflict self-harm, such as banging their head or scratching themselves

A child with ODD may often lose their temper over mild inconveniences. They can be easily annoyed by others and say mean or hurtful things when someone has upset them. The extreme anger and defiance of children with ODD can be challenging for parents, so the American Academy of Child and Adolescent Psychiatry recommends that caregivers utilize respite care and find ways to minimize the stress on their own lives. 

Disruptive mood dysregulation disorder

Disruptive mood dysregulation disorder (DMDD) is a childhood condition that often involves constant irritation and anger, coupled with frequent and intense outbursts. Symptoms can include the following:

  • Severe verbal or behavioral outbursts three or more times a week
  • Ongoing tantrums for at least 12 months
  • Being constantly irritated or angry almost all day, every day

Diagnosis of DMDD usually occurs between the ages of six and 10. The condition can make it hard for children to successfully function at school and maintain friendships. Like ODD, DMDD is different from typical childhood behavior because of the frequency and intensity of outbursts. 

Many children voice their displeasure when a younger sibling interrupts their game or destroys something they built with blocks, for example. However, a child with DMDD might become extremely upset and have an outburst that lasts the next 30 minutes, yelling about how angry they are and hitting nearby furniture. 

DMDD was added to the DSM-V relatively recently, so research is ongoing as to the best treatment options. Many professionals recommend treatments similar to those for other disorders associated with extreme anger. Generally, therapy is the first approach, and prescription medication may be suggested later in the treatment process. 

Other mental health conditions whose symptoms include anger

Anger can be a symptom of other mental illnesses as well. Irritability is a possible symptom of generalized anxiety disorder, post-traumatic stress disorder, antisocial personality disorder, schizoaffective disorder, nicotine withdrawal, and pathological gambling. 

In one study, 81% of adults with major depressive disorder reported experiencing irritability, and half of those individuals said they were irritated during more than half of their waking hours. 

Physical health problems associated with anger issues

Over time, uncontrolled anger can impact physical health. When your body is constantly flooded with stress chemicals and experiences the associated metabolic changes, such as increased heart rate and blood pressure, it can begin to damage different body systems. 

Chronic anger has been linked to the following health concerns:

  • Headaches
  • Digestive troubles
  • Skin problems
  • High blood pressure
  • Heart attacks
  • Stroke

People who are constantly angry typically have a greater risk of developing coronary heart disease. 

In addition, researchers have found a twofold increase in heart attacks after angry outbursts, according to a 2014 study. 

Finally, in one study, researchers found that those with higher anger levels typically experienced more sleep disturbances, although updated evidence may be needed.

Tips to reduce stress-related anger and its impact on your health

You can take steps to more effectively manage your anger and limit its impact on your health and well-being. By working with a care team, you can improve both your mental and physical health. 

Reduce stress triggers

As you seek to better manage your anger, it may help to reduce or eliminate scenarios that often lead to extreme anger. For example, if you frequently experience road rage while driving, you may consider using public transportation or carpooling until you believe you are better equipped to manage your anger. 

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Does your anger seem out of control?

Seek treatment for mental health conditions

Because extreme anger is often associated with mental health conditions, treating these underlying conditions may reduce the anger you are experiencing. A mental health professional may suggest strategies to manage your emotions and better cope with life’s challenges. 

If you’re unsure of how to fit therapy into a busy schedule, consider opting for an online therapy platform, such as BetterHelp. With online therapy, you can schedule sessions at a time that’s convenient for you. You can also choose between video, audio, and online chat sessions to suit your preferences and comfort level.

Research suggests that online therapy is an effective treatment option for anger issues. In a 2022 study, researchers found that after four weeks of online therapy, participants typically saw a decrease in their anger and aggressiveness

Talk to your physician about physical health problems or symptoms

Because of the connection between physical and mental health, you may consider seeing your primary care physician about potential physical health issues. If you are frequently angry or experience intense anger, you may be at a higher risk of developing a variety of heart issues. Your doctor can run tests to screen for these issues and work with you to reduce your risk of heart attack or stroke. 

Takeaway

While anger can be a natural reaction to harmful or unjust situations, extreme, uncontrollable anger may be a sign of an underlying condition like bipolar disorder, depression, or borderline personality disorder. In children, intense anger can be a sign of conditions like oppositional defiant disorder or disruptive mood dysregulation disorder. You can take steps to calm your mind and reduce your anger, such as exercising regularly and practicing mindfulness. If your extreme anger seems impossible to control and is negatively impacting your life, you may benefit from working with a therapist in person or online to learn how to better manage your emotions.

Learn to separate anger from behavior
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
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