The Link Between PTSD, Anger, and Irritability

Table of ContentsView AllTable of ContentsHow Anger Is Linked to PTSDSigns of Anger in PTSDTypes of AngerImpactTreatmentCoping

Table of ContentsView All

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Table of Contents

How Anger Is Linked to PTSD

Signs of Anger in PTSD

Types of Anger

Impact

Treatment

Coping

Close

Angerand post-traumatic stress disorder (PTSD) often occur together. Common in this condition, anger is one of the hyperarousalsymptoms of PTSDand it may affect relationships with people around you.

It’s important to know that the anger of people with PTSD can become so intense that it feels out of control. When that happens, you may become aggressive toward others or even harm yourself. That doesn’t always happen, however, and not everyone with PTSD lashes out angrily.

This article discusses the connection between anger and PTSD and some of the effects it can have. It also discusses treatments and coping strategies that can help.

How Anger and PTSD Are Connected

After experiencing trauma, people frequently experience a variety of symptoms, including intrusive thoughts, hypervigilance,irritability, hostility, avoidance, anxiety, and depression. Other challenges, including troubling memories, problems sleeping, and unhealthy coping mechanisms, can also make anger worse and more challenging to manage.

Anger is only one symptom of PTSD. While people with PTSD may experience anger, it is not a requirement for receiving aPTSD diagnosis.

People with PTSD also experience anger in a variety of ways. Sometimes this anger is directed outward and may appear as aggression or even violence toward others. But this is not necessarily the case.

More often than not, someone with PTSD who tends to feel extreme anger tries to push it down or hide it from others. This can lead to self-destructive behavior.

The Link Between PTSD, Anger, and Irritability

Anger and irritability arehyperarousal symptoms of PTSD. Think of hyperarousal as a constant state of"fight or flight." This heightened anxiety can have a variety of symptoms including:

While anger is a common response to these symptoms, there are ways to cope with each of these. Anger can be constructive at times, helping to motivate and fuel change. But it can also be a destructive force that can lead to damage to individuals and to others.

Hypervigilance in PTSD and Other Disorders

Types of Anger in PTSD

People often primarily view anger as a negative or harmful emotion. But that’s not always the case. It’s true that anger can often lead to unhealthy behaviors likesubstance abuseor impulsive actions.

Yet, feeling angry isn’t “bad” in itself. It’s a valid emotional experience and it can provide you with important information.

You may have heard anger classified into two types: constructive anger and destructive anger. Constructive anger can help with healing, forward movement, and recovery, while destructive anger can cause harm.It’s a good idea to understand this difference and find ways of managing both in your life.

Constructive AngerChannels negative emotions into actionsAnger is manageableHelps resolve problemsCan be healingDestructive AngerInvolves lashing out spontaneouslyAnger is often unmanageableCreates more problemsIncreases stress levels

Constructive AngerChannels negative emotions into actionsAnger is manageableHelps resolve problemsCan be healing

Channels negative emotions into actions

Anger is manageable

Helps resolve problems

Can be healing

Destructive AngerInvolves lashing out spontaneouslyAnger is often unmanageableCreates more problemsIncreases stress levels

Involves lashing out spontaneously

Anger is often unmanageable

Creates more problems

Increases stress levels

11 Anger Management Strategies to Help You Calm Down

Impact of Anger and PTSD

Anger related to PTSD can have a number of damaging effects. For veterans with anger issues, it can make returning to civilian life more challenging. It can also create issues with relationships, contribute to chronic stress, and lead to unhealthy coping mechanisms.

Anger and PTSD in Combat Veterans

Military service is connected to anincreased risk for PTSD. It’s become clear that veterans are at risk for a number of mental health problems, including PTSD and extreme anger.

While troubling and disruptive, there is help available. The more we learn about PTSD in veterans, the more we are learning about effective therapies, and more service members are finding help.

Causes and Risk Factors of PTSD

PTSD and Relationship Violence

Unfortunately, research has found a connection betweenPTSD and relationship violence. Research has found that having both depression and PTSD increases the likelihood of relationship aggression.

Self-Destructive Behaviors in PTSD

Althoughintense angercan cause people with PTSD to be aggressive toward others, more often than not they’ll try to push down or hide their anger. This can be effective in the short term, but in the long term, it can build up anger until it’s out of control.

When that happens, some people turn their anger on themselves in the form ofself-destructive behaviors. This may include substance abuse or deliberate self-harm.

An Overview of Self-Harm and Cutting

Treatment for Anger and PTSD

Treatments for PTSD include medication, psychotherapy, or a combination of the two.

Medication

Antidepressants are often prescribed to treat symptoms of PTSD, including symptoms related to mood and sleep. Four types of selective serotonin reuptake inhibitors are recommended for treating PTSD:

Psychotherapy

Therapy can also help people process trauma and manage symptoms of PTSD, including feelings of anger.

Cognitive behavior therapy(CBT) is a type of therapy that is often recommended. This approach helps people identify negative thinking and replace those thoughts with more helpful, realistic, and positive ones.

Other types of therapy can also be helpful, includingcognitive processing therapy(CPT),exposure therapy, andeye movement desensitization and reprocessing(EMDR).

Coping With Anger and PTSD

Anger can be a very difficult emotion to manage, especially if it feels intense and out of control. Rather than turning to unhealthy behaviors to try to cope, it’s a good idea to learn useful anger management techniques.

At times, it can seem like a long road. Eventually, something may click and you’ll find a few techniques that work for your life.

Take a Time-Out From Anger

Within those useful anger management skills is the suggestion to take a “time-out” when you feel yourself starting to get angry.

When youdevelop a time-out plan, you give yourself specific steps to take when you feel anger. Many people with PTSD have found this a great source of relief and an excellent strategy for their relationships.

Use Self-Soothing Skills for Anger

Self-soothing skillscan be useful when you find yourself getting angry.They’re easy to learn and use because they’re designed to make you feel better, and you do them on your own.

Beneficial self-soothing strategies can include:

Self-soothing skills make use of your five senses—touch, taste, smell, sight, and sound. The key is to focus on the activity. By remaining mindful of something other than your anger, your mind and body naturally become calmer.

Seek out Social Support

Talking with others as a way of “getting your emotions out” can be effective in preventing anger from building up inside.For one thing, it can help you see another person’s point of view. It also gives you the opportunity to express your frustrations in a constructive way.

Reach out to people you trust who will understand and support your feelings.

Support groups for PTSDare widely available and many people have found them to be a great help with their own challenges.Anger management coursescan also be helpful.

20 Worst Things to Say and Do to Someone With PTSD

Learn Anger Management Skills

Believe it or not, coping skills formanaging anxietycan also help manage your anger effectively. Why? Because intense anger and anxiety are similar emotions in that both tend to ignite a “fight or flight” response.

Helpful strategies that can help you better manage feelings of anger include:

When you learn skills for coping with intense anxiety, you’re also learning ways to keep your anger at less intense levels. Remember thatyour PTSD triggersmay provoke either feeling, so it’s worth your time to learn coping skills for both.

How Anger Can Affect Your Health

A Word From Verywell

Anger can sometimes occur as a hyperarousal symptoms of PTSD. It can be challenging to manage and can have a devastating impact on relationships and well-being. Fortunately, there are treatments that can help you cope with PTSD and learn more deal with your anger more effectively.

If you or a loved one are struggling with PTSD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with PTSD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C.PTSD’s risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.Psychiatry Res. 2017;252:215–222. doi:10.1016/j.psychres.2017.03.008Kimble M, Boxwala M, Bean W, et al.The impact of hypervigilance: evidence for a forward feedback loop.J Anxiety Disord. 2014;28(2):241–245. doi:10.1016/j.janxdis.2013.12.006Claycomb M, Roley ME, Contractor AA, et al.The relationship between negative expressivity, anger, and PTSD symptom clusters.Psychiatry Res. 2016;243:1-4. doi: 10.1016/j.psychres.2016.06.012Xue C, Ge Y, Tang B, et al.A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.PLoS One. 2015;10(3):e0120270. Published 2015 Mar 20. doi:10.1371/journal.pone.0120270Creech SK, Benzer JK, Ebalu T, Murphy CM, Taft CT.National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: First year outcomes.BMC Health Serv Res. 2018;18(1):582. doi:10.1186/s12913-018-3401-6Dixon-Gordon KL, Tull MT, Gratz KL.Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators.J Affect Disord. 2014;166:359–367. doi:10.1016/j.jad.2014.05.033American Psychological Association.Medications for PTSD.Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence.Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkinNational Alliance on Mental Illness.Post traumatic stress disorder.Mauss IB, Butler EA, Roberts NA, Chu A.Emotion Control Values and Responding to an Anger Provocation in Asian-American and European-American Individuals.Cogn Emot. 2010;24(6):1026–1043. doi:10.1080/02699930903122273Schnyder U, Ehlers A, Elbert T, et al.Psychotherapies for PTSD: what do they have in common?Eur J Psychotraumatol. 2015;6:28186. doi:10.3402/ejpt.v6.28186Kim YR, Choi HG, Yeom HA.Relationships between exercise behavior and anger control of hospital nurses.Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(1):86-91. doi:10.1016/j.anr.2019.01.009

12 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C.PTSD’s risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.Psychiatry Res. 2017;252:215–222. doi:10.1016/j.psychres.2017.03.008Kimble M, Boxwala M, Bean W, et al.The impact of hypervigilance: evidence for a forward feedback loop.J Anxiety Disord. 2014;28(2):241–245. doi:10.1016/j.janxdis.2013.12.006Claycomb M, Roley ME, Contractor AA, et al.The relationship between negative expressivity, anger, and PTSD symptom clusters.Psychiatry Res. 2016;243:1-4. doi: 10.1016/j.psychres.2016.06.012Xue C, Ge Y, Tang B, et al.A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.PLoS One. 2015;10(3):e0120270. Published 2015 Mar 20. doi:10.1371/journal.pone.0120270Creech SK, Benzer JK, Ebalu T, Murphy CM, Taft CT.National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: First year outcomes.BMC Health Serv Res. 2018;18(1):582. doi:10.1186/s12913-018-3401-6Dixon-Gordon KL, Tull MT, Gratz KL.Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators.J Affect Disord. 2014;166:359–367. doi:10.1016/j.jad.2014.05.033American Psychological Association.Medications for PTSD.Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence.Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkinNational Alliance on Mental Illness.Post traumatic stress disorder.Mauss IB, Butler EA, Roberts NA, Chu A.Emotion Control Values and Responding to an Anger Provocation in Asian-American and European-American Individuals.Cogn Emot. 2010;24(6):1026–1043. doi:10.1080/02699930903122273Schnyder U, Ehlers A, Elbert T, et al.Psychotherapies for PTSD: what do they have in common?Eur J Psychotraumatol. 2015;6:28186. doi:10.3402/ejpt.v6.28186Kim YR, Choi HG, Yeom HA.Relationships between exercise behavior and anger control of hospital nurses.Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(1):86-91. doi:10.1016/j.anr.2019.01.009

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C.PTSD’s risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.Psychiatry Res. 2017;252:215–222. doi:10.1016/j.psychres.2017.03.008Kimble M, Boxwala M, Bean W, et al.The impact of hypervigilance: evidence for a forward feedback loop.J Anxiety Disord. 2014;28(2):241–245. doi:10.1016/j.janxdis.2013.12.006Claycomb M, Roley ME, Contractor AA, et al.The relationship between negative expressivity, anger, and PTSD symptom clusters.Psychiatry Res. 2016;243:1-4. doi: 10.1016/j.psychres.2016.06.012Xue C, Ge Y, Tang B, et al.A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.PLoS One. 2015;10(3):e0120270. Published 2015 Mar 20. doi:10.1371/journal.pone.0120270Creech SK, Benzer JK, Ebalu T, Murphy CM, Taft CT.National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: First year outcomes.BMC Health Serv Res. 2018;18(1):582. doi:10.1186/s12913-018-3401-6Dixon-Gordon KL, Tull MT, Gratz KL.Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators.J Affect Disord. 2014;166:359–367. doi:10.1016/j.jad.2014.05.033American Psychological Association.Medications for PTSD.Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence.Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkinNational Alliance on Mental Illness.Post traumatic stress disorder.Mauss IB, Butler EA, Roberts NA, Chu A.Emotion Control Values and Responding to an Anger Provocation in Asian-American and European-American Individuals.Cogn Emot. 2010;24(6):1026–1043. doi:10.1080/02699930903122273Schnyder U, Ehlers A, Elbert T, et al.Psychotherapies for PTSD: what do they have in common?Eur J Psychotraumatol. 2015;6:28186. doi:10.3402/ejpt.v6.28186Kim YR, Choi HG, Yeom HA.Relationships between exercise behavior and anger control of hospital nurses.Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(1):86-91. doi:10.1016/j.anr.2019.01.009

Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C.PTSD’s risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.Psychiatry Res. 2017;252:215–222. doi:10.1016/j.psychres.2017.03.008

Kimble M, Boxwala M, Bean W, et al.The impact of hypervigilance: evidence for a forward feedback loop.J Anxiety Disord. 2014;28(2):241–245. doi:10.1016/j.janxdis.2013.12.006

Claycomb M, Roley ME, Contractor AA, et al.The relationship between negative expressivity, anger, and PTSD symptom clusters.Psychiatry Res. 2016;243:1-4. doi: 10.1016/j.psychres.2016.06.012

Xue C, Ge Y, Tang B, et al.A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.PLoS One. 2015;10(3):e0120270. Published 2015 Mar 20. doi:10.1371/journal.pone.0120270

Creech SK, Benzer JK, Ebalu T, Murphy CM, Taft CT.National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: First year outcomes.BMC Health Serv Res. 2018;18(1):582. doi:10.1186/s12913-018-3401-6

Dixon-Gordon KL, Tull MT, Gratz KL.Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators.J Affect Disord. 2014;166:359–367. doi:10.1016/j.jad.2014.05.033

American Psychological Association.Medications for PTSD.

Kaczkurkin AN, Foa EB.Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence.Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin

National Alliance on Mental Illness.Post traumatic stress disorder.

Mauss IB, Butler EA, Roberts NA, Chu A.Emotion Control Values and Responding to an Anger Provocation in Asian-American and European-American Individuals.Cogn Emot. 2010;24(6):1026–1043. doi:10.1080/02699930903122273

Schnyder U, Ehlers A, Elbert T, et al.Psychotherapies for PTSD: what do they have in common?Eur J Psychotraumatol. 2015;6:28186. doi:10.3402/ejpt.v6.28186

Kim YR, Choi HG, Yeom HA.Relationships between exercise behavior and anger control of hospital nurses.Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(1):86-91. doi:10.1016/j.anr.2019.01.009

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