Anger is a normal human emotion, and everyone gets mad from time to time. Anyone can have anger problems, but it is more common for males to have them. However, when the intensity of a person’s anger or aggression is significantly disproportionate to situations or happens with considerable frequency, it’s an indicator that something’s wrong.
Many things can trigger anger, including stress, family problems, and financial issues. For some people, anger results from an underlying disorder, such as alcohol use disorder or depression. Anger itself isn’t considered a disorder, but anger is a known symptom of several mental health conditions.
Anger is present as a key criterion in five diagnoses within DSM-5: Intermittent Explosive Disorder, Oppositional Defiant Disorder, Disruptive Mood Dysregulation Disorder, Borderline Personality Disorder and Bipolar Disorder.
Intermittent explosive disorder (IED) is characterized by impulsive anger attacks that vary greatly across individuals in severity and consequence. It is estimated that about 2.7% of people in the U.S. have intermittent explosive disorder. In IED, the onset of impulsive and problematic anger typically occurs in late childhood or adolescence. In adults, it is more commonly seen in people in their 20s and 30s, and rarely does it begin after age 40. Those who grew up in an abusive home or who have suffered multiple traumas are at higher risk for IED and other anger issues. People who have a first-degree relative with IED have an increased risk for developing it too. Some people are chronically angry—they feel irritable and mad most of the time. For others, intense anger can occasionally flare up without warning, or it manifests regularly, seemingly without overt provocation. Sudden rages may also be associated with a boost in energy, racing thoughts, heart palpitations, chest tightness, tingling, or increased tension. Symptoms of problematic anger and IED include:
– Episodes of rage
– Verbal tirades and temper tantrums
– Irritability
– Physical and/or verbal altercations with others
– Engaging in slapping, punching, pushing, or other bodily harm
– Physical aggression leading to damage of property, people, or animals
Oppositional defiant disorder is a type of disruptive behavior disorder that primarily involves difficulties with managing emotions and behaviors. This condition is most often diagnosed and treated in childhood, but it may also be detected in adults. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), oppositional defiant disorder is diagnosed when an individual exhibits at least four symptoms across any category, frequently, and with people other than siblings. The categories and their associated symptoms are as follows:
Angry/irritable mood
– Frequent temper loss
– Touchy or easily annoyed
– Angry and resentful
Argumentative/defiant behavior
– Regularly arguing with authority figures, such as teachers and employers
– Defying or refusing requests or rules
– Deliberately annoying others
– Blaming others for their behavior
Vindictiveness
– Spiteful or vindictive behavior 2 or more times within 6 months
Disruptive mood dysregulation disorder (DMDD) is a condition in which children or adolescents experience ongoing irritability, anger, and frequent, intense temper outbursts. The symptoms of DMDD go beyond a “bad mood.” DMDD symptoms are severe. Children or adolescents with DMDD experience:
– Severe temper outbursts (verbal or behavioral), on average, 3 or more times per week
– Outbursts and tantrums that have been happening regularly for at least 12 months
– Chronically irritable or angry mood most of the day, nearly every day
– Trouble functioning due to irritability in more than one place, such as at home, at school, or with peers
Youth with DMDD are diagnosed between the ages of 6 and 10. To be diagnosed with DMDD, a child must have experienced symptoms steadily for 12 or more months.
Anger and aggression are core features of Borderline Personality Disorder (BPD), contributing strongly to the individual as well as the societal burden caused by the disorder. Across studies, patients with BPD have shown increased, more frequent and prolonged episodes of anger and reported an increased prevalence of reactive aggression. Reactive aggression is commonly defined as a response to social threat, provocation, or frustration, and is strongly associated with anger. Since increased reactive aggression is found in various mental disorders, it might be better regarded and explained as a transdiagnostic phenomenon. Borderline Personality Disorder (BPD) is characterized by impulsiveness, interpersonal difficulties, emotional instability and dysfunctional cognitive processes. In addition to these symptoms, anger rumination is a cognitive mechanism often prominent in BPD.
Feelings of anger and irritability are prominent symptoms of bipolar disorder (BD) that may occur during hypomanic, depressive and, especially, during mixed mood states. Rage or anger is an overlooked symptom of bipolar disorder, but it frequently coexists with both depressive and manic moods.