PTSD and Anger: Untangling the Connection

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In the years following the wars in Iraq and Afghanistan, media reports of veteran violence began accumulating. Formerly social and kind people returned from war angry, and often violent. Rates of domestic violence among former combatants surged. Some veterans killed their partners or families. Many people were shocked, but the truth is that research has long linked PTSD to feelings of anger, and even violent aggression. People with PTSD may be angry about the trauma they survived or feel helpless or out of control.

In the popular imagination, posttraumatic stress (PTSD) is an anxiety disorder. Many envision people who cannot leave their homes, who are easily triggered into fear or panic attacks. Anger, though, is a common symptom of PTSD—so common, in fact, that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifically lists anger as a common emotional reaction among people with PTSD. Feelings of anger can make it difficult to get support from loved ones. A person who feels angry or out of control may feel guilty or ashamed, intensifying the isolation of experiencing trauma.

Even when loved ones want to be supportive, they may not fully understand the severity of the trauma, leaving trauma survivors feeling as if their suffering has been ignored or forgotten.

THE LINK BETWEEN ANGER AND PTSD
Trauma can be deeply isolating. Loved ones may not understand the trauma or may react inappropriately. For example, rape survivors frequently report being interrogated about their own behavior, while returning soldiers say that civilians are often eager to ask about violent combat experiences. Even when loved ones want to be supportive, they may not fully understand the severity of the trauma, leaving trauma survivors feeling as if their suffering has been ignored or forgotten. This can trigger anger, distrust of others, and related emotions.

Trauma itself may also cause feelings of anger. For example, a birthing person abused by a doctor may be angry both about the abuse and about losing a more positive birth experience. A child abuse survivor may have overwhelming feelings of anger directed at their abuser. coronavirus and its consequences for you

Sometimes a person’s feelings of anger are complicated. A returning solider might be angry about politicians who do not understand war, while also feeling proud about their service. An adult child abuse survivor may love their parents but be very angry about the abuse they suffered. These mixed emotions can make it difficult to manage feelings of anger and rage. In some cases, a person might feel like their anger is unacceptable or be unable to articulate why they feel angry or at whom.

HOW ANGER COMPLICATES PTSD SYMPTOMS
Spending time with an angry person can be difficult. The friends and family of people struggling with PTSD-related anger may eventually grow tired of dealing with mood swings or angry outbursts. They may experience compassion fatigue or even end their relationship with their loved one. This can intensify feelings of alienation and anger.

People with anger from PTSD may feel both ashamed of their emotions and entitled to them. This challenging cocktail makes it difficult to talk about how they feel or to try new coping strategies. For example, when a person feels righteously indignant about being abused, they may not want to try meditation or other coping skills. After all, the thinking goes, they shouldn’t have to have experienced trauma, and shouldn’t be the one stuck coping with the after-effects. While these feelings make perfect sense, they can also be quite self-defeating.

Research has also uncovered a correlation between PTSD, anger, and other mental health conditions. A 2014 analysis, for example, found that 30.3% of people with intermittent explosive disorder (IED) also have PTSD, compared to 14.3% in the general population. When a person presents with a secondary condition, such as depression or IED, their PTSD may go unnoticed and untreated. This prolongs their suffering and may cause them to drop out of treatment, especially when they do not see results.

OTHER SYMPTOMS THAT MAY CO-OCCUR WITH ANGER
The hallmarks of PTSD include persistently reliving memories or experiences associated with the trauma, such as in dreams, flashbacks, or emotions during the day. People with PTSD also may avoid stimuli associated with the trauma, and experience depression, sadness, anxiety, and anger.

People who experience PTSD-related anger are more likely to experience certain other symptoms, such as:

Relationship problems, including disruptions in marriages and relationships with children.
Feelings of isolation, especially when a person with PTSD wants support but has difficulty controlling their anger around other people.
Physical health problems related to anger, including headaches, chronic pain, and even cardiovascular health issues.
Legal problems, particularly if they act out aggressively or self-medicate with illegal substances.
GETTING HELP FOR PTSD-RELATED ANGER
PTSD can disrupt a person’s life and relationships. It can make them feel hopeless and even suicidal. But no one has to live with the aftereffects of trauma forever. PTSD is highly treatable. Some strategies that can help include:

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