NEPHRINE—the stress hormones. This cascade
causes BLOODvessels throughout the body to con-
strict, raising BLOOD PRESSURE. It also causes HEART
RATEto go up and BREATHINGrate to increase. These
changes can take place within seconds, though the
body takes much longer to return to normal.
Anger can become a personal health issue or a
social problem when its expression is inappropri-
ate or when it is a persistent state of being. On the
health front, prolonged elevations of the stress
hormones can cause permanent changes in the
cardiovascular system. Numerous research studies
linking prolonged anger in particular with CORO-
NARY ARTERY DISEASE (CAD). The suppression of
anger can also result in physical manifestations
such as chronic HEADACHE, chronic gastrointestinal
symptoms such as NAUSEAor DIARRHEA, or clinical
DEPRESSION.
The inappropriate expression of anger that
involves aggressive or violent words or actions
may also risk the well-being of others. Such
expressions may include prolonged yelling, throw-
ing things, physically fighting with others, acts of
road rage, acts of VIOLENCE, and in other ways lash-
ing out. ALCOHOLabuse and substance abuse often
contribute to inappropriate anger or anger expres-
sion.
INAPPROPRIATE EXPRESSIONS OF ANGER
getting into fights hitting
passive–aggressive behavior persistent yelling or tirades
placing blame pretending nothing is wrong
reckless or erratic driving swearing and abusive
tantrums (at any age) language
throwing or breaking things
Anger management is the structured effort to
express anger in appropriate, constructive ways
through learned responses and behaviors. Thera-
pists and psychologists can teach methods to iden-
tify circumstances that trigger anger and appropri-
ate ways of expression through approaches that
may include- COGNITIVE THERAPYto change the way a person
thinks about anger - BEHAVIOR MODIFICATION THERAPYto change a per-
son’s actions and behaviors - discussion of underlying worries, fears, and
issues that may contribute to feeling angry - problem-solving and communication skills
People who are unable to control anger and
their behavior responses through therapy may
have a psychiatric disorder called intermittent
explosive disorder, which often improves with
selective serotonin reuptake inhibitor (SSRI) med-
ication treatment. The SSRIs are ANTIDEPRESSANT
MEDICATIONSthat extend the presence of serotonin,
a NEUROTRANSMITTER, in the BRAIN. Serotonin is key
in the movement of electrical impulses among
brain neurons responsible for mood and emotion.
Some people also benefit from alternative and
complementary approaches such as HYPNOSISand
BIOFEEDBACKand from relaxation methods includ-
ing MEDITATIONand YOGA. Regular physical exercise
reduces stress, provides an outlet for physical ten-
sion, and induces the release of endorphins and
enkephalins, biochemicals in the brain that cause
feelings of pleasure. Health conditions that can
cause changes, sometimes sudden, in a person’s
anger response and anger management ability
include serious illness or injury, STROKE, BRAIN
TUMOR, degenerative neurologic conditions such as
ALZHEIMER’S DISEASE, and TRAUMATIC BRAIN INJURY
(TBI).
See also CHILD ABUSE; DOMESTIC VIOLENCE; ELDER
ABUSE; EXERCISE AND HEALTH; PROBLEM-SOLVING AND
CONFLICT RESOLUTION; STRESS AND STRESS MANAGEMENT.anger and anger management 241