Which Is Best? Therapy Or Medication For Anger Disorders

By: Mary Elizabeth Dean

Updated July 17, 2020

Medically Reviewed By: Wendy Boring-Bray, DBH, LPC

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.

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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 illness 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.

Anger Management and 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 feel 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.

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 health care professional and seek treatment.

Fortunately, there are several effective treatment options available for people suffering from anger disorders. An important first step in resolving your anger is diagnosing the underlying reason for it. This information will allow your health care provider(s) 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 reduce your anger and learn to keep it under control.

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Therapy

Different types of therapy, including cognitive-behavioral therapy, are used in the treatment of anger disorders. 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. American psychiatric 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.

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
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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.

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. Group therapy not only provides you with access to experienced counselors who are trained to help, but you also get a built-in support group at the same time. In group therapy, 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. This option takes a lot of commitment, though, and not everyone is willing or able to put everything on hold for treatment.

Medication

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

According to Harvard Health, "Research on drug treatment [for IED] 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 resulting from various mental 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 IED 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.

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

Finally, individuals 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.

Safe Medication For Anger

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 always to 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.

Individuals 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

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.

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!"

FAQ's (Frequently Asked Questions)

Is there a mental disorder for anger?

Anger itself is not a mental disorder. However, there are mental health conditions that have anger or irritability as a potential symptom.

People with IED, for example, experience angry outbursts that come on suddenly. It can be jarring for the person with intermittent explosive disorder and those around them when they lose their temper. Someone displaying symptoms of IED needs to see a mental health professional. Intermittent explosive disorder can be dangerous if left untreated. People who don't seek help for their rage can end up hurting the people they love emotionally, physically, or in both manners. People with intermittent explosive disorder can engage in behaviors such as:

  • Verbal arguments
  • Yelling
  • Physical altercations including pushing, hitting, or fistfights
  • Harming people
  • Hurting animals

intermittent explosive disorder is a severe mental illness and needs treatment by a medical professional. After an episode of explosive anger, the person may feel embarrassed and have a sense of remorse. However, intermittent explosive disorder doesn't go away. That's why if you or a loved one suffer from it, seek treatment from a therapist and (if needed) a psychiatrist. A person with intermittent explosive disorder can learn anger management techniques, so they're not ruled by their temper. They need to seek appropriate mental health treatment and stick with it. Anger issues can feel intimidating, but that's where therapy can help. If you have intermittent explosive disorder, your temper can improve when you address it in treatment.

Other mental health conditions such as mood disorders like Bipolar disorder or personality disorders like Borderline Personality Disorder can also come with anger as a symptom, though not everyone with psychiatric illness has angry outbursts.

Anger is a normal emotion that we all experience from time to time as human beings, and it is healthy to feel it. Anger becomes a problem rather than a typical experience when you do things that you later regret. If you relate to any of the following behaviors, it's time to get help. You struggle to manage your impulses surrounding anger, experience it frequently, or without a specific cause, it affects your relationships, you harm yourself or others as a result, or if you become verbally, emotionally, or physically abusive as a result of your anger. If any of these things are true for you, you are likely experiencing anger issues.

Note that some people internalize anger rather than expressing it outwardly. A person with anger issues or a mental health condition that lists anger as a symptom might injure themselves, think negative or aggressive thoughts toward themselves, or focus their anger inside of themselves in other ways.

How do you treat anger issues?

According to American psychiatric professionals, in order to treat anger issues, a person will typically need to start by finding the root cause of their anger. With a severe condition such as intermittent explosive disorder, sometimes it's hard to admit there's a problem. Many different things can cause angry outbursts, and it's essential to figure out if it's stress or a mental health condition. If a person has a severe condition like intermittent explosive disorder, sometimes it's hard to admit there's a problem. Once they come to terms with their diagnosis, they can get better. With intermittent explosive disorder, it's crucial to get treatment.

Other issues besides IED could cause anger. It may be a result of past experiences or trauma, bullying, a mental illness, or another mental health concern. But once you find a doctor, you can get the help you need. Sometimes, people are ashamed of the anger that they experience and fear coming forward, but one of the most effective ways to work through anger and learn to cope with it is by going to therapy. Different kinds of therapy can help with anger problems.

Behavioral therapy is known to be an effective treatment for anger issues. When you work on changing your behavior, you will see results in managing anger issues. Behavioral therapy is a great tool to help individuals learn to regulate their emotions. Anger is an emotion that can be difficult for some people to feel. In behavioral therapy, your therapist will support you in feeling anger and being non-judgmental about it. There's a form of therapy called cognitive behavioral therapy where a person learns to reframe their negative thought patterns. In this form of treatment, a person who has anger problems can look at their thinking and start to see what triggers their rage. Once they're aware of the triggers, they will learn to work through them in cognitive behavioral therapy. An individual with an anger disorder can benefit from CBT. They can learn how to step back from their thoughts and see what is and isn't true. Cognitive behavior therapy helps individuals restructure their thoughts, which can reduce frustration and anger levels.

Health care providers, which include mental health clinicians, have a "privacy policy" of sorts in a place called the HIPAA law that requires them to keep sensitive client information private. HIPAA requires that the clients have their rights reserved unless the person is in danger, and there is a piece of information that must be revealed to keep the client safe.

What is extreme anger a symptom of?

Extreme anger can be a symptom of a mental health condition such as intermittent explosive disorder. Many other mental health conditions have anger as a symptom. It's not just intermittent explosive disorder. People who experience depression sometimes can feel irritable. When their irritability reaches a level of frustration, that could manifest as anger. Another mental health condition that could cause anger is PTSD. People who have experienced trauma can have episodes of rage or anger. As a result, they may engage in self-destructive behavior such as alcohol or drug abuse. People who have bipolar disorder also experience anger, and during both depressive and manic episodes, when their mood fluctuates, they can snap at people in anger.

Sometimes anger is a response to being afraid. When a person experiences high levels of anxiety, it could make them feel angry. They are afraid and, as a result, could feel frustrated, and be short with their temper. If you find that your anger

What is the best medication for anger?

The medication prescribed to a person who is experiencing troubles with anger will depend on their specific diagnosis. For those with intermittent explosive disorder, taking a mood stabilizer may help with their erratic emotional states. If you are seeking medication for anger issues, it's important to remember to use it in conjunction with therapy. Medicine alone will not solve your problems with anger. It's crucial to seek support in the form of therapy. Along with medication, working with a counselor can help you learn to manage your temper better and find strategies and coping skills for anger problems.

Why am I so easily angered? There are a number of reasons behind why you are easily angered. For instance, people suffering from chronic pain can easily grow irritable. People with intermittent explosive disorder, borderline personality disorder, or other mental health problems are also prone to developing a short temper. But something as simple as being cancelled on for dinner can cause someone to grow angry as well. It is important to remember that feeling angry from time to time is normal. However, when this anger becomes uncontrollable or out-of-proportion, it can become a major problem in your life.

What environmental factors can trigger extreme anger in people? Environmental factors such as physical discomfort, poor communication, and overstimulation can trigger extreme anger in people struggling with a mental health condition. The manner in which a person was raised or taught to deal with their emotions can also contribute to their inability to properly manage their anger.

What medications are used to treat intermittent explosive disorder? Antidepressants like selective serotonin reuptake inhibitors (SSRIs), mood stabilizers, antipsychotic drugs, and antianxiety drugs are usually used to treat intermittent explosive disorder. While there is no specific medication designed to treat IED at the time, other medications can be prescribed to help patients manage their symptoms.

What category does the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) place IED in according to the American Psychiatric Association? According to the American Psychiatric Association and the Diagnostic and Statistical Manual of Mental Disorders, the IED falls under the category of “Disruptive, Impulse-Control, and Conduct Disorders.”

How can I instantly reduce anger? If you struggle with maintaining anger control, there are quick techniques you can follow to effectively fix it. For instance, many people speak out harshly in anger before they have enough time to collect their thoughts. Before saying anything, take a few moments to breathe and think about what you really want to say. Practicing deep-breathing exercises or repeating a calming mantra can also help you reduce your anger.

How do you release repressed anger? Leaving repressed anger unaddressed can seriously harm your mental health. People dealing with repressed anger can cause a number of issues, such as chronic fatigue, digestive issues, passive aggressiveness, and depression. Learning techniques such as keeping your mind in the present, engaging in positive self-talk, and releasing anger through a healthy fitness regime can help you release your repressed anger.

Are temper tantrums only prevalent in children? No, adults can and do have temper tantrums. That being said, people typically don’t name these outbursts as “tantrums.” Many people see these inappropriate behaviors as simply “blowing off steam.” But dealing with adults who are prone to throwing tantrums can be taxing on everyone around them. If you find yourself dealing with someone who is having a tantrum, it is important to speak to them in a calm and even tone. Try not to take their behavior personally. If necessary, it is okay to walk away.

What happens if I don’t seek treatment for my anger? There are a number of risk factors associated with unmanaged anger. People with anger issues are at risk of developing high blood pressure and chest tightness from heart disease. That’s why it is important to learn how to properly manage your anger and prevent it from harming your physical health.

Are there support groups available for people with IED? People struggling with depression, anxiety, or other mental problems stemming from IED can join support groups to help supplement their treatment. If you are interested in joining a group, ask your primary care physician or mental health counselor for a referral.

Does anger play a role in situations involving domestic violence? Anger and domestic violence have a complicated relationship. Domestic violence doesn’t usually result from one partner’s inability to control their anger. Instead, they often use their anger to manipulate or exert control over their partner. Because anger management programs usually focus on anger that stems from external factors or misaligned emotions, they are not appropriate for treating someone who has engaged in domestic violence.

Conclusion

When considering the question, "Which is best, therapy or medication for anger disorders?", the answer isn't always clear. Studies have shown that both therapy and medication can be effective in treating anger disorders, including IED and anger related to other psychiatric disorders. The best option is the one that works best for you. That might mean medication, therapy, or a combination. Why wait? Take the first step today and find a doctor who can help you through this difficult part of your life.


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