Dr. Shyam P Lohani

Everyone becomes angry. As basic as happiness, anxiety, and disgust, or sadness, anger is one of the elemental human emotions. It is a normal, instinctive response to a threat. Sometimes, anger is necessary for our survival. Therefore, anger is a normal as well as healthy emotion and only becomes a problem when we have a problem with controlling it. Anger is associated to fight flight or freeze response of the sympathetic nervous system. When one gets angry, his/her level of stress hormones is secreted in an increased amount and causes a speedup of heart rate and breathing. Sometimes, anger is needed to protect our loved ones or to combat injustice.

Stress hormones
However, excessive anger can cause problems. Increased blood pressure and other physical changes linked to anger can distort judgment and harm both physical and mental health. It can also undermine relationships. Prolonged-release of stress hormones also impairs short-term memory, and weakens the immune system. There are pieces of evidence that uncontrolled anger is particularly harmful to cardiovascular health besides several mental health problems. Anger, often, escalate to verbal or physical violence that may harm both ourselves and others around us.

Underlying causes such as depression, alcoholism, attention deficit hyperactivity disorder, bipolar disorder, oppositional defiant disorder, obsessive-compulsive disorder, intermittent explosive disorder, and grief can cause anger in some people Anger affects different organs of our body including the heart, brain, and muscles, basically by increasing testosterone levels and decrease in cortisol levels. The signs and symptoms of anger are rise in blood pressure, speed up in heart rate, tingling sensation, and muscular tension. There are a number of emotions that is seen along with anger. The emotional symptoms before, during, or after an episode of anger include irritability, frustration, anxiety, rage, stress, feeling overwhelmed, and guilt.

Researchers from Harvard Medical School which was funded by the US National Institutes of Health and published in the peer-reviewed European Heart Journal in 2014 showed a risk of a heart attack increased nearly fivefold, and the risk of stroke increased more than threefold immediately after two hours following anger.

However, the overall long-term impact on cardiovascular health is fairly small. The people most affected in the study are those who were at higher risk of cardiac events and people who get angry frequently. The study did not include the general population with fairly good heart health. The association between anger and cardiovascular health has several reasons that include the fact that psychological stress can increase the heart rate and blood pressure. Moreover, the above study is good for suggesting potential links, but cannot prove cause and effect.

People who may need professional or medical help are those who have trouble with the law frequently, regularly have intense arguments with family members, friends, or colleagues and physically assault a partner or child.
Anger issue management is complex and anger issues should be addressed by mental health professionals such as psychologists or psychiatrists. They can diagnose whether there are underlying conditions that trigger anger and suggest appropriate treatment. Anger management can include one or more of the following techniques as relaxation techniques, behavioural therapy, and treatment for depression, anxiety, or ADHD, anger management classes, anger management exercises at home, and support groups.

Mental health professionals suggest three main steps for controlling anger include recognising the early signs of anger, giving time and space to process the triggers, and applying techniques that can help to control the anger. It is often difficult to stop anger when it starts. However, detecting the emotion early can provide us redirect our thought process. Psychologists suggest avoiding trigger altogether whenever possible but when confronted with a trigger, it may help to leave a place and go for a short walk and make contact with a person who is not immediately involved, such as a friend, family member, or counselor and vocally express the thoughts behind the anger to a person who is not the focus of the reaction.

Management techniques
Anger management techniques help tranquil a person or distract them long enough to process the thoughts in a beneficial way. An effective technique is different for different people and finding a suitable method can be a key in mollifying episodes of intense anger. Some techniques include deep, slow breathing, easing physical tension, exercise, and creating distractions. Moreover, it is suggested that focusing on solutions than problems increases the chances of a resolution and reduces the likelihood of an angry reaction to an event. Lastly, at least seven hours of quality sleep each night also contributes to the well-being of mental and physical health as researchers have linked sleep deprivation to a number of health problems, including anger.

(Prof. Lohani is the clinical director at the Nepal Drug and Poison Information center. lohanis@gmail.com)