Tips For Managing Contingent Anger And PTSD
Post-traumatic stress disorder (PTSD) is a complex mental health condition that can develop after a person experiences or witnesses a traumatic event or a series of traumatic events. Symptoms can be both mental and physical and may significantly interfere with daily functioning, work, relationships, and overall well-being.
One symptom in particular that may cause significant distress and disruption in a person’s life is PTSD-related anger and similar negative emotions. See below for an overview of PTSD— referred to as PTS by some groups—and its key symptoms, how anger can be related to PTSD, and tips for managing this symptom and others.
What is post-traumatic stress disorder (PTSD)?
In the early 1900s, post-traumatic stress disorder was commonly referred to as "shell shock” and was associated exclusively with combat veterans. People today continue to connect PTSD with soldiers coming back from war; however, combat is far from the only experience that can cause an individual to develop the condition.
It can also arise as a result of events that involve an extreme threat or danger like a car accident, an assault, a natural disaster, relationship violence or abuse that may or may not involve exploitation, a traumatic birth, a serious medical diagnosis, or the loss of a loved one. PTSD may also occur even if the individual didn’t witness the traumatic event firsthand, such as if they heard about the traumatic death of a loved one. It may occur at a young age or at any stage of adulthood.
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According to estimates by the American Psychiatric Association, around one in 11 people will be diagnosed with PTSD in their lifetime after experiencing trauma. Keep in mind that many trauma survivors—more than this number—will likely live with the disorder but not be officially diagnosed. The US Department of Veterans Affairs estimates that as many as one in six people in the United States will experience the condition at some point in their life, diagnosed or not.
Key symptoms of PTSD
When someone experiences or witnesses a traumatic event, the brain will act quickly to engage in survival mode—commonly known as “fight or flight.” This initial event can then lay the groundwork for the brain and body to be constantly prepared to respond to another event during which it may need to defend itself from danger and harm. The result can be a chronic state of hypervigilance and other associated symptoms that characterize post-traumatic stress disorder.
Note, however, that PTSD does not present in the exact same way in every person who experiences it. Exactly when any of the three key aspects or categories of symptoms manifest in relation to the traumatic event can also vary from person to person. Most who will develop PTSD start experiencing symptoms within three months, but for others, it can take years.
In general, however, the key emotional and physical feelings and symptoms of PTSD can be divided into the following categories. Familiarizing yourself with each one can help you recognize if you or a loved one ever experiences them so you can seek the appropriate support. Doing so can be a powerful way to observe PTSD Awareness Month during June and year-round.
Intrusive thoughts and/or memories
Intrusive thoughts are unwanted thoughts that appear involuntarily. In someone with PTSD, they can also take the form of replayed memories, nightmares or distressing dreams, or flashbacks to the traumatic event(s). A flashback in particular may be so vivid that the person experiencing it could feel as though they’re being forced to relive the event(s).
Avoidance
Avoidance behaviors are another of the key aspects of this disorder. It’s common for people with PTSD to avoid people, activities, objects, and situations that could possibly trigger a distressing memory of the traumatic event(s). They may also avoid talking about the trauma and even avoid thinking about or remembering it as best they can.
Alterations in thinking and mood
In order to try and defend itself, the brain may experience a sort of amnesia related to a traumatizing event(s). As a result, the individual may not remember significant portions of the experience. They may also find themselves frequently engaging in negative thinking about themselves or the world and might experience persistent feelings of shame, fear, guilt, or anger, along with potentially blaming themselves for the trauma.
Changes in physical and emotional reactions
A person with PTSD may have significant difficulty with emotional control and may experience persistent feelings of irritability, low mood, and/or anger attacks. They may also act impulsively and participate in risky/self-destructive behaviors or other unhealthy behaviors. PTSD could cause trouble concentrating and hypervigilance—such as the automatic response of startling at loud sounds or unexpected arrivals—as well.
Dysregulated extreme anger and related self-destructive behaviors are commonly observed in people living with PTSD. As the US Department of Veterans Affairs reports, PTSD can cause a person’s threat response to get “stuck” on the highest setting. As a result, they could have intense anger and aggression constantly simmering just below the surface. These may be easily triggered even by seemingly mundane situations, resulting in the person reacting with greater intensity than the situation requires—including in those that don’t involve an extreme threat or any threat at all.
Such intense, easily triggered PTSD anger can cause distress for both the person experiencing it and those around them. It can cause a person to do a poor job at work and experience conflict in relationships. Even more seriously, it has the potential to result in self-injury, physical harm to others, legal consequences, or even death. Plus, chronic, untreated anger has been associated with various health problems over time, such as high blood pressure and increased risk of heart attack.
One study of military veterans with PTSD indicates that nearly half of them reported engaging in physical aggression as a result of the condition, which points to the need to address this common symptom. The study also suggests that treatment for PTSD can help reduce levels of both anger and aggression in those diagnosed with the disorder.
Feeling intense anger after experiencing trauma?
Strategies to help those with PTSD manage anger
If you’re experiencing symptoms of PTSD, it’s generally recommended that you seek immediate professional support. Untreated PTSD can have devastating effects on a person’s mental health, relationships, and career as well as the health and safety of those around them. In addition to this treatment, you might also consider the following tips for managing the arousal anger you may feel as a result of PTSD.
Practice mindfulness meditation
Meditation is an ancient spiritual and cultural practice with its roots in various parts of Asia that has recently become more popular worldwide—at least partially because research suggests that it may offer a host of potential health benefits. It’s also been studied in the context of PTSD, with findings indicating that it may help address a variety of symptoms—including the very difficult emotion of intense anger.
According to a 2018 study, mindfulness meditation may help in “restoring connectivity between large-scale brain networks”—representing a remarkable form of the brain healing itself. The study goes on to say specifically that it may help an individual “reduce ruminative tendencies,” adopt a more nonjudgmental, accepting attitude, and learn to better control their attention so they may be less likely to be triggered by certain stimuli. You can find a plethora of written guides, videos, and audio tracks for free online that can help you get started with mindfulness meditation to help treat symptoms of PTSD.
Stick to an exercise routine
It’s not news to most people that getting regular exercise can have both physical and mental health benefits, so it may not be surprising that it can be helpful for those who feel extreme anger or are experiencing symptoms of PTSD as well. One review of 19 studies on the topic found that aerobic exercise may positively impact those with PTSD by improving cognitive functions and reducing hypersensitivity and internal arousal cues for emotions such as anger.
Other studies on individuals who were not presenting with symptoms of PTSD also suggest that regular exercise appears to correlate with lower levels of state anger and higher levels of anger control. Finding a form of exercise that gets your blood pumping and that you enjoy may help you better manage it when you experience anger or similar emotions—whether they’re associated with PTSD or not.
Track your triggers
Although increased levels of anger in those with PTSD can be caused by the body and brain being on high alert, there are outside factors that can trigger the release of this anger. Learning what these unique factors are for you can help you learn to control your responses to them. One way to do this is to write down what triggers the difficult emotion of anger each time it happens. From there, you can look for patterns and then take extra care when you encounter these particular situations in the future.
For example, you might practice deep breathing, engage in progressive muscle relaxation, or repeat a calming visualization or mantra next time you find yourself in a triggering situation, Or, you could play calming music in your headphones or splash cool water on your face. Finding strategies like these that work for you could help you avoid letting your anger and PTSD symptoms that are similar get out of control in these moments.
Connect to community
Experiencing symptoms of PTSD can feel isolating, especially when loved ones and others around you don’t understand what you’re going through. For this reason, it can be helpful to connect with others who can relate. Seeking out people in your local community or online who have been or are in your situation can help you feel seen, and you may be able to get support, advice, coping skills, and resources with each other.
Online or in-person support groups are one avenue for this. You could also search for group therapy online or near you for PTSD or anger management in general if you’re looking for a more structured form of community support related to this topic.
Speak with a therapist for cognitive behavioral treatment or similar
In 2017, the American Psychological Association, the Veteran Health Administration and the Department of Defense published guidelines for PTSD treatments, recommending the methods that are most strongly supported by scientific evidence. These methods are all therapy-based, including trauma-focused cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), and eye movement desensitization therapy (EMDR). In some cases, medication like selective serotonin reuptake inhibitors may be recommended in conjunction with therapy.
A trained clinician is typically a recommended resource for helping you understand which form of talk therapy might be best for your situation. Taking the first step to meet with one is a constructive action you can take toward receiving the appropriate care. A therapist can help you process the trauma you experienced in a healthy way, provide a nonjudgmental listening ear, and offer you actionable coping strategies to help you manage your symptoms—including anger and aggression. They may also serve as a person’s point of contact for managing any mental health challenges they may experience in the future.
Seeking therapy for PTSD
You can seek this type of support from a therapist in person or online. For those who have trouble locating a therapist near them or who simply prefer to engage in therapy from the comfort of their own home, online therapy may be a preferable option—and research points toward its efficacy. For example, a 2020 study suggests that online therapy can be effective in treating symptoms of PTSD in addition to being a more convenient option for many, including those who fear the stigma sometimes associated with seeking in-person mental health care.
If you’re interested in connecting with a therapist online, you might consider an online therapy platform like BetterHelp. With this service, you can get matched with a licensed therapist who meets your needs and preferences according to a brief questionnaire you’ll fill out when you sign up. You can then meet with them via phone, video call, and/or in-app messaging to address the challenges you may be facing. If you’re interested in learning more, you can see below for reviews of BetterHelp therapists from clients who have faced similar challenges.
Counselor reviews
“I really enjoy working with Daniel. His expertise and knowledge in his field are extensive yet relatable. He provides effective strategies in working through PTSD issues with a kind and direct technique. I highly recommend him!”
“Paula is wonderful. She has been here for me since day one, and I feel like she truly is in my corner. She is patient, kind, and is excellent in dealing with chronic trauma and PTSD. She teaches me how my brain works, how I can deal with my emotions (and that it's okay to have them!), and she is helping me process the things that happened to me. She had good insights, and levels with me very well.”
Takeaway
Why do people with PTSD get angry?
People with PTSD may often experience intense emotions, including sudden anger, fear, and anxiety, as their brain reacts differently to perceived danger. Trauma survivors may have a sensitive “fight or flight” response, making them more likely to feel angry when they are reminded of their past trauma.
How do you calm down PTSD rage?
Individuals can calm down PTSD rage through various techniques. Cognitive behavioral treatment, a common therapy for PTSD, may be useful and include deep breathing, mindfulness, and grounding exercises. Loved ones may want to avoid escalation and speak calmly, helping the affected individual feel less threatened and more in control.
Are people with PTSD more aggressive?
Individuals with PTSD can show aggressive behaviors more frequently, not because they are naturally inclined to aggression but because they may feel threatened or are reliving a life-threatening event. Aggression is often a misguided form of self-defense closely linked to their trauma experiences.
What happens when you yell at someone with PTSD?
Yelling at someone with PTSD can worsen their symptoms and potentially provoke a strong defensive reaction. They might perceive an extreme threat, which can trigger a survival mode. The individual might experience increased fear or aggression in response to what their brain perceives as a threat.
What does a PTSD episode look like?
A PTSD episode can involve flashbacks, which can occur as if the individual is reliving the trauma and intense emotional distress. They might also experience physical reactions, such as shaking, panic, or heart palpitations. These episodes are often accompanied by an extreme change in mood and behavior, and they are often linked to specific triggers.
How do you deal with a PTSD meltdown?
Dealing with a PTSD meltdown involves first defending the safety of the person and those around them. Then, grounding techniques can help the person reconnect with reality, which might involve something tactile or focusing on breathing. Once the immediate crisis has passed, encourage professional help through therapy or counseling.
What not to say to someone with PTSD?
It's important not to say things that could be perceived as dismissive or accusatory, such as "get over it," "it happened a long time ago," or "you're just overreacting." Such statements can lead to feelings of self-blame and often fail to acknowledge the impact of their trauma.
How does a person with PTSD behave?
A person with PTSD may behave in ways that are unpredictable to those around them. For example, they may show signs of hypervigilance, irritability, or withdrawal. They may also act aggressively or use substance abuse as a coping mechanism. However, these signs and symptoms are often a sign of mental illness and not their character.
What happens when someone with PTSD is triggered?
When someone with PTSD is triggered, they may experience intense psychological distress. After being exposed to a specific trigger, the individual could develop physical feelings of pain, flashbacks, or emotional outbursts. These reactions may lead to a rapid response from their stress hormones.
What does PTSD do to the brain?
PTSD can cause changes in the brain, particularly in areas involved in processing emotions and memory. The brain may become overly reactive to stimuli, easily interpreting them as threats. This heightened state of alertness can then lead to trouble concentrating, mood swings, and other cognitive impairments.
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