Understanding anger

Cleveland Clinic says healthy handling means noticing the feeling and letting it pass, rather than spreading the negativity. Healthy anger can give you energy to speak up, set a boundary or change something unfair.

It can look like

• Saying calmly, “I’m upset about this, and I want to talk about it”
• Taking a break before replying
• Standing up against unfairness without hurting anyone
• Using the energy to fix the problem
• Letting it go once the situation is over

Example: Leo’s manager keeps giving him extra work late on Friday. He feels angry. Instead of snapping or sulking, he waits until Monday and says, “I want to do good work, and late Friday requests make that hard. Can we plan earlier?”

Outward anger can include yelling, slamming doors, breaking things, starting fights, threats or violence. The NHS lists shouting, starting fights and breaking things among behaviours linked to anger.

Even when it feels good in the moment, outward anger often damages trust, frightens others, and leaves the angry person feeling ashamed afterwards.

Some people hide their anger, or were taught that anger is “not allowed”. Cleveland Clinic says suppressing anger can affect thinking and behaviour, and can cause or worsen physical problems.

Bottled anger often leaks out in other ways: muttering, sulking, sarcasm, the silent treatment, or a sudden explosion over something small after weeks of holding it in.

The NHS notes some people turn their anger on themselves, which can include self-harm. If that is happening to you, please talk to someone you trust or your clinical provider.

Cleveland Clinic describes chronic anger as being angry more often than not. It has been linked to high blood pressure, heart disease, headaches, skin problems and digestive problems.

Holding onto grudges and resentment keeps anger alive long after the event. Mayo Clinic suggests that letting go of grudges may help you and the other person learn and strengthen the relationship.

When someone we care about lets us down, the first feeling is often hurt. But hurt feels vulnerable, so it can quickly turn into anger.

Example: Sam’s friend forgets her birthday. She texts something sharp. Underneath, she feels unimportant and sad. Saying “I felt hurt” might have opened a much better conversation.

Anger and fear share the same alarm system in the body: fight or flight. Cleveland Clinic notes anger can be the result of feeling out of control, and that anger and anxiety can feed each other.

Example: A parent shouts at their teen who came home two hours late. Underneath is terror that something terrible had happened.

The NHS notes feeling humiliated is one of the mental signs linked to anger. When we feel embarrassed or ashamed, anger can be a way to push the feeling away and protect our pride.

Feeling stressed, tired or hungry makes anyone more irritable. The American Academy of Pediatrics notes hunger and tiredness make tantrums more likely in young children, and the same is true for adults.

Quick check before you react

• Am I hungry?
• Am I exhausted?
• Am I stressed about something else?
• Am I in pain or unwell?

Cleveland Clinic lists perceived unfairness, unmet needs, conflict with loved ones and being mocked among common anger triggers. Anger here is a signal: something matters to you.

Asking “What need is not being met?” can turn anger into a clear request, like “I need more help with the housework” or “I need to be listened to.”

Cleveland Clinic notes anger can be a reaction learned in childhood, or shaped by personal and relationship history. A small trigger today can stir up old pain from years ago, making the reaction much bigger than the moment.

In a 2024 study funded by the National Institutes of Health (NIH), 280 healthy adults were randomly given one of four tasks. Some spent eight minutes recalling and talking about a memory that made them angry. Others recalled something that made them anxious, read sad sentences, or simply counted out loud.

In the anger group, blood vessels were much less able to widen (dilate) than in the counting group, and this lasted for up to 40 minutes after the task ended. Sadness did not have a clear effect. The vessels’ inner lining helps control this widening, and problems with it are thought to be an early step towards hardened arteries.

A 2014 review pooled nine studies of people who had a heart attack, stroke or heart rhythm problem, and asked what happened just before. In the two hours after an outburst of anger, the rate of heart attack or similar heart events was about 4.7 times higher than at other times.

The authors stress that the extra risk from a single, occasional outburst is small for most people, because the spike is short. For example, they estimated that one angry outburst a month adds only about one extra heart event per 10,000 people per year among people at low heart risk.

The same review found the risk climbs for people who have frequent outbursts and for people who already have heart risks, like a past heart attack or stroke. The NIH study authors also suggest repeated anger may have a cumulative effect on the blood vessels over time.

This links to what Cleveland Clinic says about chronic anger: being angry more often than not has been tied to high blood pressure and heart disease.

You don’t have to fear every flash of irritation. Feeling angry is normal. The goal is to spend less time at the boiling point, which is exactly what the skills in the “Managing anger day to day” guide are for.

Heart-friendly anger habits

• Step in early, at a 4 or 5 on your anger thermometer, not a 9
• Use slow breathing to calm the body’s alarm
• Move your body regularly to burn off stress
• Notice if you are angry most days, and get support if so
• Keep up regular check-ups with your clinical provider

Many anger programmes use a scale, like a thermometer, to help people notice how angry they are. It turns a vague feeling into a number you can act on.

An example scale

• 0–2: calm or mildly annoyed
• 3–5: irritated, tense, starting to heat up
• 6–8: very angry, body is fired up, harder to think
• 9–10: about to explode or exploding

Decide in advance: “At 5, I take a break.” Below 5, you can usually still talk things through. Above 7, it is time to step away and cool down first.

How we interpret a situation shapes how angry we feel. The VA explains that after trauma, people may see threat everywhere, and that angry thoughts can be noticed and replaced with more balanced ones.

Common “hot” thoughts

• “They did it on purpose.”
• “They always do this.”
• “I can’t stand this.”
• “They should know better.”
• “Everyone is against me.”

Cooler alternatives

• “Maybe they didn’t realise.”
• “This happens sometimes, not always.”
• “This is annoying, but I can handle it.”
• “I can ask for what I need.”

Ideas for each stage

• Trigger: know your triggers and plan for them
• Thoughts: question hot thoughts
• Build-up: breathe, move, take a time-out
• Peak: leave the situation safely
• Cool-down: give it time; don’t restart the argument
• After: repair, learn and plan for next time

Adult life brings many triggers: work stress, money worries, traffic, caring for others, and conflict at home. Cleveland Clinic notes anger is shaped by personal and relationship history, health and current circumstances.

In a large U.S. survey, problem anger was more common in younger adults and in men.

Unmanaged anger in adults can strain relationships, careers and health. The good news is that anger skills can be learned at any age.

NIMH notes that men with depression may seem angry or irritable rather than sad. NIMH also notes men are less likely than women to have received mental health treatment in the past year.

Many boys grow up hearing “boys don’t cry”. Anger can become the one “allowed” emotion, covering up hurt, fear, loneliness or shame underneath.

Some women grow up being told anger is “unladylike” or “too much”. Anger that is always swallowed can turn into resentment, anxiety, low mood or physical tension. Cleveland Clinic notes suppressed anger can affect thinking, behaviour and physical health.

Healthy anger is for everyone. Learning to say “I’m angry about this” calmly and clearly is a skill, not a flaw.

The American Academy of Pediatrics says tantrums are a normal part of development, happening most between ages 1 and 3. In the teen years, NIMH notes that depression can show up as irritability rather than sadness.

In a large U.S. survey, repeated explosive anger started at an average age of 14, so childhood and the teen years are an important time for support.

Cleveland Clinic notes anger can be a reaction learned in childhood. In a large U.S. survey, problem anger in adults was linked with hard experiences in childhood and with parents’ own struggles.

Questions to reflect on

• Was anger loud, silent, or never shown in my home?
• Was I allowed to be angry as a child?
• Who do I sound like when I’m angry?
• What would I like to do differently?

The U.S. Department of Veterans Affairs explains that anger is part of how we survive danger. After trauma, the threat response can get “stuck”, so even everyday stress can set off a full survival reaction.

How trauma can feed anger

• The body stays keyed up, so irritability becomes the normal state
• Aggression can become the main way of dealing with threat
• Thoughts like “You can’t trust anyone” make others seem hostile
• Some people use alcohol or drugs to ease the tension

Anger management, often using CBT, can help with all of these: calming the body, expanding responses beyond aggression, and building more balanced thoughts.

Cleveland Clinic lists ADHD among conditions linked to chronic anger, and the NHS lists irritability and a quick temper as possible signs of ADHD in adults. Feelings can rise fast, and the brain’s brakes can be slower.

Cleveland Clinic also notes that people with rejection sensitivity, which seems most common with ADHD, may have outbursts of anger or crying after feeling rejected.

NIMH lists increased anger or irritability as a sign of depression. Children and teens may be irritable rather than sad, and men may seem angry or irritable instead of sad.

Cleveland Clinic notes anger and depression or anxiety can feed each other.

Cleveland Clinic lists generalised anxiety among conditions linked to chronic anger, and notes anger can mask anxiety and fear. When you feel on edge all the time, small things can tip you over.

Cleveland Clinic lists bipolar disorder and borderline personality disorder among conditions linked to chronic anger. In these, anger can come with strong mood shifts or intense emotions.

Cleveland Clinic advises people with explosive anger to avoid alcohol and recreational drugs, which can increase violent behaviour. The NHS warns against using alcohol, drugs or gambling to deal with anger.

Cleveland Clinic lists oppositional defiant disorder (ODD) and disruptive mood dysregulation disorder (DMDD) among conditions where anger management can help children. In plain words: some children have frequent, intense anger and defiance that goes well beyond normal.

Parent training and therapy can help a great deal. Talk to your child’s pediatrician if you are worried, and see the “Anger in kids & teens” guide.

A Cleveland Clinic psychologist says rage rooms and smashing things probably give only short-lived relief, and for people with a history of violence or destructive anger, they likely reinforce harmful ways of coping.

Expressing anger is healthy. The key is how: calmly naming it, solving the problem, and calming the body work better than exploding.

The NHS reminds us that most people feel angry sometimes. Anger can even be useful, pushing us to make changes. Trying never to feel angry often leads to bottling it up.

Genes and history shape anger, but they are not destiny. Cleveland Clinic says anger management helps people gain more control over their emotions, and some see effects fairly quickly with consistent practice.

Abuse is a pattern of behaviour used to gain and keep power and control over someone. Anger management alone is not the answer to abuse, and anger is never an excuse.

NIMH notes men with depression may seem angry or irritable rather than sad. Looking beneath the anger can uncover something that needs care.

A good first step is your clinical provider, a therapist or a counselor. You can ask about anger management programmes, CBT or other therapy. Cleveland Clinic notes a therapist may also check whether something else, like depression or trauma, is driving the anger.

In the U.S., SAMHSA’s FindTreatment.gov is a free, confidential locator for mental health services near you.

See

• “Anger in kids & teens”: tantrums, teen anger and helping your child
• “Anger in relationships”: fighting fair, and when someone’s anger affects you
• “Explosive outbursts & rage”: outbursts, alcohol, safety and repair
• “Impulse control”: making room for a pause
• “Managing anger day to day”: cooling down, skills and therapies

Find A Helpline (findahelpline.com) lists free, confidential helplines in many countries, by phone, text or chat.