Which Is Best? Medication Or Therapy For Anger Disorders

By Mary Elizabeth Dean|Updated July 29, 2022

Chances are you've been angry at some point in your life. Even the most level-headed people get mad sometimes, but if you find yourself having angry outbursts on a regular basis — or know someone who is dealing with them — these symptoms might signal a bigger problem. It's okay to let out your emotions, both good and bad, but when you start to feel angry all the time without knowing why, it can cause problems in your life. Luckily, there are several things you can do to win back control over your emotions and pull back on your aggressive behavior. One such thing is online therapy. 

It Can Be Hard To Know If Therapy Or Medication Is Right For You, But We Can Help

While the fifth edition of the  Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t currently have a diagnosis specifically for anger issues, anger can be part of a wide range of mental disorders, including things like:

  • Intermittent Explosive Disorder (IED) — mental health disorder characterized by repeated and sudden episodes of aggressive behavior or overblown reactions to different situations that lead to violent behavior.
  • Oppositional Defiant Disorder (ODD) — behavior disorder mainly diagnosed in children that is characterized by aggressive episodes and frequent defiance toward others
  • Bipolar Disorder — serious mental disorder that causes frequent mood swings, racing thoughts, and changes in energy levels
  • Personality Disorders (Narcissistic, Borderline, Antisocial, and Paranoid) — mental health conditions including antisocial personality disorder and paranoia that involve long-term patterns of unhealthy thoughts and behaviors
  • Attention Deficit Hyperactivity Disorder (ADHD) — a disorder that causes hyperactivity, racing thoughts, and aggressive impulses

The symptoms of these mental health disorders, such as anxiety, irritability, or racing thoughts, can worsen a person’s anger issues.

Impulsive, aggressive outbursts can also happen when someone tries to bury their feelings for a long time. Over time, these emotions start to bubble to the surface until the person finally explodes and starts to engage in aggressive behavior.

According to previous research, intermittent explosive disorder is more common than people once thought, with more than 7 percent of the U.S. population experiencing this type of anger in their lifetimes. The study found that angry outbursts and aggressive behavior can result in a lot of property damage, and that the average age of onset for IED was around 14 years old. While you may remember a time in your life that you acted out in anger, the fifth edition of the Diagnostic and Statistical Manual clarifies that IED consists of at least three destructive outbursts within a 12-month period.

Anger Management and its Connection to Domestic Violence

Anger plays a complicated role in situations involving domestic violence. Abusers typically feel that they are entitled to exert control over their partners. If their partner doesn’t give them this control or they fail to meet their expectations, the abuser may grow angry and engage in acts of domestic violence.

While some people try to recommend anger management for situations involving domestic violence, this response is usually not an appropriate treatment for preventing abuse. Many abusers use their anger as a weapon. Therefore, the inability to control their anger is usually not an issue for them. Most anger management programs also do not teach participants why using their anger to manage or manipulate their partner is wrong.

If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available. Call 1-800-799-SAFE (7233) or Text "START" to 88788. You can also use the online chat.

Choosing a Method That's Right for You

Uncontrolled and unpredictable anger can be a danger to those who experience it, the people closest to them, and sometimes to innocent bystanders who are at the wrong place at the wrong time. Anger can affect all aspects of your life, including work and family. If you or someone you know is suffering from an anger disorder, it's important to reach out to a mental health professional and seek treatment.

Fortunately, there are several effective treatment options available for people suffering from anger disorders. An important first step in learning how to manage anger is diagnosing the underlying reason for it. This information will allow your health care provider to make an informed decision on what the first line of treatment should be.

As a patient, you should know that treatments for anger disorders differ depending on the person and situation. You may need to try more than one treatment before finding one that works because what works for one person might not work for you. The important thing is to be patient until you find a treatment that works for you and then stick to that treatment to help you in managing anger issues and learning to keep them under control.

Different Types of Therapy To Treat This

Different types of therapy, including cognitive-behavioral therapy, are used in the treatment of anger disorders such as intermittent explosive disorder. These types of treatments can be very effective because they teach you how to deal with stress and anger in healthier, more effective ways. For example, by helping individuals realize when their thought processes lead to angry outbursts, therapists can help create long-term positive changes for their clients. As the saying goes: change your thoughts, change your life.

Depending on the severity of the anger disorder, you may have many different options when it comes to the type and intensity of therapy you choose to take on. Mental health professionals are available to you through a wide range of platforms. You may have the ability to choose between in-person therapy sessions, online counseling, group therapy, or even going to a residential anger management treatment facility, depending on the severity of your anger and the effect it has on your life. According to the American Psychiatric Association, the majority of research on anger management treatment has focused on cognitive behavioral therapy. This type of cognitive therapy supports patients in learning how to reshape unhelpful thought patterns.

In-Person Therapy Sessions. In-person therapy sessions are great because they allow you to see an experienced professional for a set amount of time regularly. Some people prefer in-person to online or phone therapy. Certain patients will also prefer speaking to a therapist one-on-one over attending group therapy.

It Can Be Hard To Know If Therapy Or Medication Is Right For You, But We Can Help

Therapy that takes place in-person gives the patient a chance to build a relationship with their therapist based on trust and mutual understanding. Some cons of in-person therapy are the fact that it can be expensive, and sometimes it's hard to get appointments.

Online Counseling. Online counseling is a relatively new phenomenon, but it's already proving its merit by giving more people access to quality help. Online counseling has found innovative ways to pick up the slack and offer customers affordable counseling services. Services like BetterHelp connect you with a counselor specifically matched to your needs; you can message them from anywhere using a computer or a mobile app on your smartphone. Many counselors can provide cognitive behavioral therapy, which has been shown to produce clinically significant changes in patients.

Group Therapy. If traditional in-person therapy and online counseling are a little over your budget or just not your style, group therapy is another excellent option. Not only do people with intermittent explosive disorder have access to a trained mental health professional, but they also become members of a built-in support group at the same time. In group therapy sessions, you get to share your challenges, experiences, and triumphs with other group members, who can become a pivotal part of overcoming or living with an anger disorder. This type of therapy is probably best for social people who don't mind talking about their problems in front of others.

Residential Anger Management. If your anger disorder is severe and impacts your life in debilitating ways, a residential anger management program might be an option to consider. Though more intense, this form of treatment allows you to dig deep and learn to control your anger, so you can reclaim your life. Some upsides to residential anger management programs are that they allow you to escape your regular life and forget about your usual worries (and anger triggers) while you are getting better. By providing support groups, they can also help people with psychiatric disorders feel less isolated in their diagnosis. This option takes a lot of commitment, though, and not everyone with an intermittent explosive disorder diagnosis is willing or able to put everything on hold for treatment.

While research is still limited, the American Psychiatric Association shares recognizes family therapy and psychodynamic therapy have shown promise as possible treatments for anger disorders.

Different Medications to Treat This

In addition to therapy and support groups, some medications are also available to help treat anger disorders.

According to Harvard Health, "Research on drug treatment [for intermittent explosive disorder] has been limited. Some medications are known to reduce aggression and prevent rage outbursts, including antidepressants (namely selective serotonin reuptake inhibitors or SSRIs), mood stabilizers (lithium and anticonvulsants), and antipsychotic drugs." While medications are used to help reduce anger, for many patients, it will not stop anger completely.

Antidepressants (SSRIs). Antidepressants help treat anger and reduce anxiety resulting from various mental and emotional disorders, including depression and personality disorders. Selective serotonin reuptake inhibitors (SSRIs) are a popular type of antidepressant for these disorders. SSRIs increase serotonin levels in the brain by blocking the reabsorption of serotonin by neurons.

Mood Stabilizers (Lithium and anticonvulsants). In many cases, SSRIs are the first choice for treating issues for people with intermittent explosive disorder or anger in patients with depression and personality disorders because they are proven to be effective. In cases where patients' anger issues don't respond to SSRIs, other medications such as mood stabilizers that address symptoms like racing thoughts are also an option. Some anti-seizure medications work as mood stabilizers (such as carbamazepine and Divalproex).

Antipsychotic Drugs. Previous research has suggested that the atypical antipsychotic drug, Clozapine, can be effective in treating Schizophrenic patients who are hostile and aggressive. "The reduction of aggressive behaviors by clozapine may be explained not only regarding sedative or antipsychotic effects but also by its ability to reduce impulsivity," the researchers explained.

Another study stated that while antipsychotic drugs like Clozapine, Olanzapine, and Quetiapine can help with anger and aggression associated with anger disorders, these medications have more side effects that make them less ideal for long-term treatment.

Safe Ones You Can Take To Treat Your Symptoms

Sometimes medication is the best way to get anger under control in the short term, but with the help of other forms of treatment like therapy, patients might not have to be on medication for too long. Other times, certain medications that have been deemed safe may be used for long-term maintenance.

Of course, medications always come with the risk of side effects and addiction. It's important to always take medication as prescribed by a doctor and be on the lookout for any side effects when starting a new medication. For medications that do involve some risk, doctors may do routine health checks to make sure that potential side effects are closely monitored. Patients should always be careful and consult their doctor before coming off any medication for anger.

People with intermittent explosive disorder who are reluctant to take anger management medication may find some help in alternative treatments such as calming herbs and essential oils, along with therapy. Practices like daily mindfulness, exercise, and meditation can help patients with anger find calm and balance, but it takes patience and persistence to make these options work.

How BetterHelp Can Help You and Your Symptoms 

If you are struggling with anger problems, you don't need to fight the battle alone. The counselors at BetterHelp are online and ready to help. BetterHelp is an online therapy platform that can offer all of the help you need. The best thing about getting help from a BetterHelp professional is convenience. You can get help right from your living room. See below for some reviews of BetterHelp Counselors, from clients experiencing similar issues.

BetterHelp Counselor Reviews

"Steve is amazing and does a good job at making this seem like less of a counseling session and more of a conversation between friends. He helped me talk through my anger issues and road rage and gave me lots of problem solving tools. I highly recommend him!"

"Regina helped me pinpoint where my anger issue stemmed from in the very first session, and has been helping me become more self aware of my warning triggers. Very insightful and helpful!"

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