Understanding PTSD Anger
PTSD, or posttraumatic stress disorder, is often associated with challenges like flashbacks and panic attacks. While these symptoms can be common, there are other possible symptoms of which to be aware. Anger is one example. It’s not uncommon for trauma survivors to experience intense anger due to PTSD. Strategies like identifying and addressing triggers, practicing mindfulness and breathwork, and attending regular therapy sessions can be helpful.
What is post-traumatic stress disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is a mental illness that can develop after exposure to a traumatic event. While it’s often associated with combat veterans, PTSD can happen to anyone.
Situations that trigger PTSD
A variety of situations can trigger PTSD, such as the following:
- War
- Natural disasters
- Serious accidents
- Physical or sexual abuse
- Relationship violence
PTSD can also develop in people who have witnessed others’ trauma. People who work closely with trauma survivors may develop a mental illness similar to PTSD called “secondary traumatic stress.”
PTSD symptoms
PTSD symptoms tend to start within a few weeks to months after a traumatic event. However, they can sometimes start later. According to the National Institute of Mental Health, people with PTSD may experience symptoms for as few as six months, but symptoms may also last a year or more.
Common symptoms of post-traumatic stress disorder (PTSD)
These symptoms can look different for different people, but some common examples include those listed below:
- Panic attacks
- Nightmares, intrusive memories, or flashbacks of the trauma
- Avoidance of reminders of the trauma
- Changes in eating or sleeping habits
- Mood swings
- Social isolation
- Trouble concentrating
- Trouble remembering aspects of the trauma
- A loss of motivation to do daily tasks
These symptoms and others can cause challenges at work, in relationships, and in daily life. People with PTSD may also experience other mental health challenges, like depression and anxiety.
Why PTSD anger can occur
Beyond the symptoms we’ve already discussed, there’s another possible PTSD symptom that may be worth exploring: anger. In addition to other intense emotions, like sadness, hopelessness, or panic, people with PTSD may also experience extreme anger.
Signs of extreme PTSD anger
This, too, can look different for different people, but it may manifest as:
- Increased aggression
- Sudden angry outbursts
- Reckless behavior
- Reliance on substances like alcohol
- Physical manifestations of emotion, such as muscle tension and a rapid heartbeat
- Agitation
- Frequent conflicts at home or work
People with PTSD may feel angry about the trauma
People with PTSD may feel angry about the trauma or the other symptoms they are experiencing. They may also develop negative beliefs about themselves, the world, or other people, which can contribute to emotions like anger. Anger may also be caused by the brain itself. To understand this process, it may help to understand the arousal-anger connection.
When you’re exposed to extreme stress
When you’re exposed to extreme stress—like the type that can cause PTSD—your brain may enter a state of heightened arousal. Also known as “fight-or-flight” mode, this reaction normally starts in the amygdala, an area of the brain that affects how you react to events.
Fight-or-flight mode can be seen as a natural physical response that’s designed to defend you from danger. However, when your body is unable to fully calm down from this stress response, you might experience tension or hyperarousal long after the danger has passed. This can lead to irritability and aggression, even in situations that don’t call for it.
Tips for managing post-traumatic stress disorder (PTSD) and anger
In the moment, anger might seem like a very difficult emotion to manage, but it’s not necessarily a bad thing. In dangerous situations, the anger you might feel in fight-or-flight mode may help you defend yourself and respond to threats.
However, with PTSD, anger can arise more often than is healthy. According to the Substance Abuse and Mental Health Services Administration, anger may contribute to negative health effects, depression, anxiety, and high-risk behaviors. That’s why, if you’re living with PTSD, you may benefit from taking steps to manage your anger, such as those discussed below.
Practice mindfulness and breathwork
Practicing mindfulness and deep breathing may calm your nervous system and help you view situations more objectively. Consider setting aside five minutes each day to focus on your breath and quietly observe your thoughts. This may better prepare you to respond to challenges in a healthy way.
Take a step back to manage anger
Sometimes, it can help to get some distance from situations that are contributing to anger. If you notice symptoms of anger, like a rapid heartbeat or an adrenaline rush, consider going somewhere quiet for a few minutes. You may find that your mind is clearer when you return.
Find coping strategies for rage
Consider making a game plan for the next time you sense that you’re getting angry. You may find it useful to have a set of go-to coping skills ready. Some examples include the following:
- Listening to music
- Reading a book you enjoy
- Journaling for a few minutes
- Getting a burst of exercise
- Taking a cold or hot shower
Identify your PTSD and anger triggers
If you have PTSD, you may notice that certain thoughts, situations, sights, sounds, or smells aggravate your symptoms. Anger may also have specific triggers. These could be anything from getting stuck in traffic to talking about politics. Consider keeping a list of things that trigger your anger. You can then try to address them proactively. For example, if you notice that you often get angry when you’re running late, you could try leaving the house five or 10 minutes early. The more triggers you can identify, the easier it may be to prevent them.
Seek professional treatment for mental health
A variety of professional treatments are also available that may make it easier to manage PTSD symptoms, including anger. Medications, like mood stabilizers or selective serotonin reuptake inhibitors (SSRIs), may be used. These medications must be prescribed by a licensed psychiatrist or doctor.
Evidence-based therapies are also recommended by the American Psychological Association (APA). Specifically, several types of cognitive behavioral treatment may be helpful for processing traumatic memories, changing unhelpful thought patterns, and learning healthy coping skills.
Online therapy for PTSD and related mental health issues
Therapy for PTSD can be a highly personal experience that may depend on having a therapist you trust. Finding a counselor with whom you connect can be a process, but online therapy may help. Platforms like BetterHelp may let you change therapists at any time, for any reason, at no additional cost. This may make it easier to find the right therapist for you.
Studies have found that online therapy may benefit people who struggle with anger. In a 2022 study, 234 participants received different types of internet-based anger management therapy. After four weeks of treatment, they usually experienced significantly lower levels of aggression and expression of anger.
Takeaway
Can PTSD cause anger outbursts?
Many trauma survivors experience elevated levels of anger, aggressive outbursts, and physical violence. These symptoms are especially prevalent in veterans, and these symptoms are thought to increase over time after the experience of traumatic event(s).
It’s thought that, because traumatic events often involve extreme threats, they can leave people in a heightened state of alertness and fear. Prolonged exposure to this stress can lead to destructive anger, self-blame, and other symptoms.
How do you calm down PTSD rage?
Some anger management techniques that can help when PTSD anger feels intense include:
- Take a few deep breaths
- Remove yourself from the triggering situation
- Find outlets to express anger in a healthy way, like working out, painting, or writing down your feelings
- Seek support from others
- Try calming strategies like meditation, yoga, or self-hypnosis
- Consider trying cognitive processing therapy or joining a class for managing anger
- Talk with your doctor about medications for treating PTSD, like selective serotonin reuptake inhibitors (SSRIs)
Researchers have identified three key aspects of posttraumatic anger, including hyperarousal, behavior, and thoughts/beliefs, such as “people are out to get me.” PTSD treatments, like cognitive behavioral therapy and medications, can effectively help people heal from traumatic experiences.
Why am I so angry after a traumatic event?
It’s common to feel extreme anger after surviving a traumatic event for several reasons, including:
- The flight or fight response
- Triggers
- Feeling victimized or treated unfairly
- Chronic stress
- Getting stuck in “survival mode” and reacting to daily stressors as if they were the traumatic event itself
Anger is a normal response to surviving an extreme threat, but it can lead to anger issues that disrupt daily life, harm relationships, and damage mental health. Processing the emotional and physical feelings that come with surviving a traumatic event is often necessary to effectively manage anger.
What stage is anger in trauma recovery?
The phases of trauma developed by Dr. Pierre Janet and later Dr. Judith Herman include:
- Safety and stabilization: During this phase, people often feel threatened, easily provoked, and unsafe. In addition to hyperarousal symptoms, many people experience intrusive thoughts, difficulty talking about trauma, self-harm, and maladaptive self-soothing.
- Remembrance and mourning: In this phase, people put words to their experiences, grieve, and hold more space for their emotional experience.
- Reconnection and integration: In the final phase, the survivor creates a new sense of themselves and their future, being fully aware of the impacts of trauma while regaining self-determination and improving well-being.
Anger may be most common during the first phase of trauma recovery, but it’s a common response during any phase and it’s not necessarily a “bad” thing. For example, constructive anger can help people work through trauma, define boundaries, and solve problems.
What happens when you yell at someone with PTSD?
People with PTSD often experience an elevated “normal state” of being, marked by heightened tension, arousal, and reactivity. Yelling at someone with PTSD may trigger certain reactions, like:
- Emotional withdrawal
- Flight-or-fight response
- Act physically aggressive
- Act inflexibly
- Panic attacks
- Physical feelings of stress, such as nausea, trembling, or muscle tension
Yelling is one of the common triggers for people with PTSD, as it can mimic the threatening situation that caused trauma in the first place. Rather than yelling at someone with PTSD—or anyone else—it’s a good idea to learn healthy, empathetic communication strategies.
Why do I lash out when angry?
People may act aggressively when they’re feeling angry for several reasons, such as feeling:
- Unheard
- Wronged or victimized
- Overwhelmed
- Threatened
- Frustrated
- Triggered by past experiences
Anger outbursts are closely linked to issues like experiencing trauma at a young age, poor emotional regulation skills, executive dysfunction, feeling disempowered, and issues with communication skills.
Some other responses you may want to try when you experience anger include journaling, removing yourself from the triggering situation, considering the other person’s point of view, or taking a deep breath before responding.
What is dissociative rage?
Dissociative rage refers to a type of anger rooted in repeated emotional repression. The chronic repression of anger can lead people to become easily frustrated, aggravated, or angry. People with dissociative rage may find it difficult to express their anger healthily, leading to destructive patterns like self-injury, substance use, negative self-talk, or acting aggressively toward others. Survivors of traumas that involve exploitation or betrayal may be at a greater risk of experiencing dissociative rage and anger.
Joining support groups for anger management and/or dissociation can help people work toward healthily expressing feelings.
Can people with PTSD be stuck in a fight-or-flight response?
Yes, people who’ve experienced frightening or life-threatening situations often find themselves “stuck” in flight-or-fight responses even after the danger has passed. This heightened state of arousal can lead to issues like impulsivity, difficulty concentrating, increased heart rate, muscle tension, sleep changes, and poor job performance.
Why do I have no patience and get angry easily?
If you find yourself getting angry easily or like you have a “short fuse,” it may indicate underlying challenges like:
- Poor sleep quality
- Chronic stress
- Lack of boundaries
- Burnout
- Mental health challenges
- Emotional regulation challenges
Relaxation strategies, prioritizing healthy lifestyle habits, recognizing and validating emotions, and working on communication skills can help people regulate their emotions more effectively.
What is PTSD hyperarousal?
PTSD hyperarousal refers to a state of increased anxiety, feeling “on edge,” and reactivity. Hyperarousal is one of the key aspects of trauma responses, and it can interfere with daily functioning, sleep quality, and mental health. Prolonged hyperarousal can lead to physical health problems, such as hypertension, back pain, or migraines.
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