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In a recent survey for the Mental Health Foundation, 28% of adults said they worry about how angry they sometimes feel, and 32% have a friend or relative who has problems dealing with anger.

Anger is a normal healthy emotion that is part of our body’s survival mechanism. However, at times it can be triggered when it is not helpful. This can have a significant impact on a persons function, happiness, relationships and self-esteem. Anger and frustration are often associated with loud and aggressive behaviour, but it is just as common for a person to withdraw and ‘bottle up’ their emotions.

What is anger?

Our levels of anger can vary from being felt as a mild annoyance or irritation to an extreme feeling of rage. For some people, anger can get out of control and cause problems with relationships, work and even the law. Uncontrolled anger can lead to arguments and physical fights, but sometimes it causes people to ‘bottle up’ emotions and feel withdrawn. It can cloud your thinking and judgment and may lead to actions that are unreasonable and/or irrational and cause you to feel guilty. Uncontrolled anger often leads to feelings of depression and low self-worth.

What causes anger?

Anger is a normal emotion that we all feel at times. Common causes of anger include:

  • Feeling upset, sad or low in your mood
  • Feeling anxious or stressed
  • Being tired, hungry or in pain
  • Losing someone you love (grief)
  • Feeling undervalued
  • Feeling misunderstood
  • Feeling threatened
  • Medical conditions or coming off certain medicines
  • Stimulants
  • Lack of sleep and/or feeling tired
  • Alcohol
  • Sexual frustration
  • Feeling out of control
  • Situations that feel unfair or unjust

When a person thinks of their cause of anger they often look for something that has

happened to them, a situation, event or other people’s behaviour. We call these our external causes of anger. We also have a second cause of anger: our own thoughts, feelings and beliefs and interpretation of the event or situation which we call our internal causes of anger.  The two are very closely linked and it is a combination of both the internal and external causes that leads us to feel the way that we do.

Behavioural causes

Throughout our lives we learn to react to events or situations in certain ways. This is shaped, and continues to be shaped, by our role models and experiences from birth to the present day. Our learnt experiences often account for the fact that some people seem better able to manage their feelings of frustrations or anger in a constructive and helpful way, whilst others may bottle up their feelings or have unhelpful outbursts. As a consequence a learnt pattern of unhelpful behaviours can build up, which in the long term can become more and more difficult to overcome. It could be that you may not have had the opportunities to learn effective ways of managing and expressing your emotions in the past, but everyone can learn to constructively express their emotions in the future.

Our thinking styles

Our interpretation of an event and thoughts that we have about the situation may account for us feeling frustrated or angry. For example, a situation in which we feel wronged in some way can be particularly difficult. Or where we feel that an injustice has been made that we feel is unacceptable. The way we think about anger may also influence the way we express or control it. For example, we may we think that anger should be hidden or “bottled up” rather than expressed. This style of coping may be beneficial in the short term, but will often have a long-term cost. Finding other ways to manage emotions in a more appropriate and sensitive way will have a more positive effect.


There may be certain events or situations which are more likely to trigger an angry reaction. This will be different for different people and could include things such as debt, inconsiderate driving, rude behaviour or harm to a loved one.

In treating anger however it is more important to understand what maintains the problem than what causes it.

What maintains anger?

There may be a noticeable pattern of triggers to feeling frustrated or angry. For example, whilst driving, looking after the children or when you start talking about money. It might be that our thoughts and experiences in these situation affect how we anticipate the outcome to be in the future, which can cause people to feel ‘stuck’ in a vicious cycle. There may be consequences which reinforce angry behaviour; both costs and benefits. In some instances people learn that angry behaviour can achieve short-term gain. For example, having others respect your status or getting your own way. It can also be associated with significant long-term costs, such as damaged relationships. Considering and recognising your own benefits and costs is important when looking for more helpful ways of managing frustrations and anger.

When looking more closely at what prevents us from overcoming unhelpful anger, it becomes clear that our behaviour, thoughts, feelings and physical sensations all interact and combine to create a vicious cycle of anger.

Becoming aware of the effects anger has on our physical health

The effects of stress and bodily changes that result from recurrent unmanaged anger can eventually cause harm to many different systems of the body. Some of the short- and long term health problems that have been linked to unmanaged anger include:

  • Headache
  • Digestion problems, such as abdominal pain
  • Insomnia
  • Increased anxiety
  • Depression
  • High blood pressure
  • Skin problems, such as eczema
  • Heart attack
  • Stroke

Treatment for anger and frustration

Cognitive behavioural therapy (CBT) can help you learn to manage anger in a number of ways.  The first step to breaking the cycle is to become more aware of the ways that anger affects you – your triggers.  Your CBT therapist can also help you to learn to challenge negative thinking, change your behavioural response, learn new coping strategies, improve communication skills and help you to improve your lifestyle and reduce stress.