The Link Between PTSD, Anger, and Irritability

Trauma can trigger many complex emotions, including feelings of anger. In fact, research shows that anger, irritability, and post-traumatic stress disorder (PTSD) often co-occur. Typically in this condition, anger is one of the hyperarousal symptoms of PTSD, and it can affect relationships with those around you.

It is important to know that the anger of people with PTSD can be so intense that it gets out of control. When this happens, you may become aggressive towards others or harm yourself. However, this is not always the case, and not everyone with PTSD becomes angry.

Below, learn more about the connection between anger and PTSD and some of its effects. It also discusses treatments and coping strategies that can help.

How anger and PTSD are connected.

After trauma, people may experience symptoms such as intrusive thoughts, hypervigilance, irritability, hostility, avoidance, anxiety, and depression. Disturbing memories, sleep problems, and unhealthy coping strategies can make anger worse and harder to manage.

Anger is just one symptom of PTSD. Although people with PTSD may experience anger, it is not a requirement to receive a PTSD diagnosis.

These feelings are complex and multifaceted. People with PTSD also experience anger in different ways. Sometimes this anger is directed outward and can manifest as aggression or violence towards others. But that doesn’t have to be the case.

Anger and irritability symptoms in PTSD

Anger and irritability are hyperarousal symptoms of PTSD. Hyperarousal means being in a constant state of “fight or flight” which can cause:

• Difficulty sleeping
• Irritability
• Hypervigilance

Although anger is a common response to these symptoms, there are ways to deal with each. Anger can sometimes be constructive, helping to motivate and fuel change. But it can also be a destructive force that can harm individuals and others.

Types of anger in PTSD

Many people view anger as negative or harmful. While anger can lead to unhealthy behaviors such as substance abuse or emotional outbursts, it is not always harmful.

You may have heard that anger is divided into two types: constructive anger and destructive anger. Constructive anger can help heal, move forward, and restore, while destructive anger can cause harm. It’s a good idea to understand the difference and find ways to manage both in your life.

Anger and the impact of PTSD

The anger associated with PTSD can have several harmful effects. For veterans, this can complicate the transition back to civilian life. This can strain relationships, contribute to ongoing stress, and lead to unhealthy coping habits.

Anger and PTSD in combat veterans

Military service is associated with an increased risk of PTSD. It has become clear that veterans are at risk for a number of mental health problems, including PTSD and severe anger.

While frustrating and disruptive, help is available. The more we learn about PTSD in veterans, the more we’re learning about effective treatments, and the more service members are getting help.

PTSD and relationship violence

Unfortunately, research has found a link between PTSD and relationship violence. Research has found that having both depression and PTSD increases the likelihood of aggression in a relationship.

Self-destructive behaviors in PTSD

Although intense anger can cause people with PTSD to be aggressive toward others, more often than not, they will try to minimize or hide their anger. This may work in the short term, but in the long term, it can fuel anger until it gets out of control.

When this happens, some people turn their anger on themselves in the form of self-destructive behaviors. This may include substance abuse or deliberate self-harm.

Anger and PTSD Treatment

Treatment of anger and irritability in PTSD focuses on helping people improve their sense of control over their emotions. These symptoms can be severe and disruptive, but fortunately there are a number of evidence-based treatment options that can reduce emotional reactivity and promote overall emotional regulation.

Treatment

Antidepressants are often prescribed to treat PTSD symptoms, including mood and sleep-related symptoms. Four types of selective serotonin reuptake inhibitors are recommended for the treatment of PTSD.

Psychotherapy

Therapy can also help people process trauma and manage PTSD symptoms, including feelings of anger.

Other types of therapy may also be helpful, including cognitive processing therapy (CPT), exposure therapy, and eye movement sensitization and reprocessing (EMDR).

Coping with anger and PTSD

Anger can be a very difficult emotion to manage, especially if it feels intense and out of control. Rather than turning to unhealthy behaviors to try to cope, it’s a good idea to learn useful anger management techniques.

Take time out from anger.

Among these helpful anger management skills is the suggestion to take a “time out” when you find yourself getting angry.

You can do this:

• Develop a plan for how you will deal with anger before it happens.
• Be aware of signs that you are getting angry, such as rapid breathing, increased heart rate, and muscle tension.
• Telling the people you are with that you need to take time to deal with your feelings.
• Go to a quiet place where you can practice your anger management skills.
• Give yourself time to cool down

When you create a time-out plan, you give yourself specific steps to take when you feel angry. Many people with PTSD have found it to be a great source of relief and a great strategy for their relationships.

Use self-soothing skills for anger.

Self-soothing skills can be helpful when you feel angry. They are easy to learn and use because they are designed to make you feel better, and you do them yourself.

Self-soothing skills use your five senses—touch, taste, smell, sight, and sound. The key is to focus on the activity. By focusing on something other than your anger, your mind and body naturally calm down.

Find social support.

Talking with others as a way to “get your feelings out” can be effective in preventing anger from building up inside. For one thing, it can help you see the other person’s perspective. It also gives you an opportunity to express your frustrations in a constructive way.

Support groups for PTSD are widely available and many people have found them to be a great help in their challenges. Anger management courses can also be helpful.

Learn anger management skills.

Believe it or not, anxiety management skills can also help you manage your anger more effectively. Why? Because intense anger and anxiety are similar emotions in that both trigger a “fight or flight” response.

Helpful strategies that can help you better manage angry feelings include:

• Becoming aware of your anger and identifying the emotions that are contributing to the anger.
• Assessing whether your anger is constructive or destructive
• Removing yourself from the situation when it becomes too much.
• Engaging in brisk exercise to reduce stress and cope with your frustrations
• Finding distractions to take your mind off your anger
• Deep breathing
• Practicing mindfulness and meditation
• Finding someone you can trust to talk to.
• Writing in a journal
• Doing yoga.

When you learn coping skills for intense anxiety, you’re also learning ways to keep your anger at a less intense level. Remember that your PTSD triggers can trigger either, so it’s worth your while to learn coping skills for both.

Takeaways

Anger can also sometimes occur as a hyperarousal symptom of PTSD. It can be difficult to manage and can have a devastating effect on relationships and well-being. Fortunately, there are treatments that can help you cope with PTSD and learn more about dealing with your anger more effectively.