8 Tips For Managing PTSD And Anger

Content/Trigger Warning: Please be advised, the below article might mention trauma-related topics that could potentially be triggering. If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and is available 24/7.

Post-traumatic stress disorder (PTSD) is a complex mental health condition develops after a person experiences or witnesses a traumatic or series of traumatic events. The symptoms that accompany this stress disorder can create significant obstacles due to the nightmares, hypervigilance, flashbacks, and intrusive thoughts that intervene with a person’s ability to function with ease and peace of mind. Society, as a whole, needs to be better informed to understand post-traumatic stress disorder as the news and television media features characters with PTSD who act out their anger in violence. The more educated people can become on things like PTSD and anger, the better we will be able to help and support those who are living with the lingering effects of trauma.

If you are experiencing PTSD, know that there are treatments available that can help you regain control when you are feeling intense anger. 

In honor of PTSD awareness month, we are presenting a PTSD topic overview to help you understand PTSD and how it manifests in anger when someone is triggered by a traumatic event.

What Is PTSD?

In the early 1900s, post-traumatic stress disorder, or PTSD, was commonly called "shell shock” and was generally associated with combat veterans. People today continue to connect PTSD with soldiers coming back from war, yet people can experience it for several reasons, all of which include some sort witnessed or experienced trauma. This could be from war, a car accident, assault, a natural disaster, or tragically losing a loved one.

The disorder is more common than you might think. According to the American Psychiatric Association, "an estimated 1 in 11 people will be diagnosed with PTSD in their lifetime." Keep in mind that this statistic reflects a diagnosis of this prominent stress disorder. Many more live with the disorder than who are diagnosed. For example, the U.S. Department of Veteran’s Affairs reports that approximately 1 out of 6 people in the United States will have post-traumatic stress disorder at some point during their lives.  Additionally, 5% of adults in the U.S..

What Are The Symptoms Of PTSD?

When someone experiences a traumatic event, the brain will act quickly to take the body into survival mode. This is commonly known as a state of “fight or flight”.  This initial event can lay the ground for the brain and body to be constantly hypervigilant for another event to occur to defend from danger and harm. Over time, this may lead to a chronic state of hypervigilance and other associated symptoms that characterize post-traumatic stress disorder. 

To be diagnosed with PTSD, the APA explains that the traumatic event does not have to be something that you experience first-hand. For example, you may experience it if you find out that a loved one was killed in a traumatic way. In the same line of thought, PTSD does not present itself the same in every person that is diagnosed. Some people experience symptoms soon after experiencing a traumatic event. But for others, symptoms might not begin to show for years after the event has occurred. 

These symptoms can be split up into four different categories:

Intrusive Thoughts And/or Memories

Intrusive thoughts are characteristically formed without the ability of a person to control them as they arise. They include involuntary memories that may repeat, nightmares or distressing dreams, flashbacks of the traumatic event or events. A flashback may be so vivid that the person experiencing one may see it happening or relive the traumatic event as if it is in reality. 

Avoidance

In the event of trauma, it is understandable why a person may avoid any reminder of the traumatic event. People with PTSD will avoid people, activities, objects, and situations that can possibly trigger a distressing memory. They may also avoid talking about the trauma and will completely avoid thinking or remembering it to the best of their ability. 

Alterations In Thinking And Mood

In order to save the mind from trauma, the brain will experience a sort of amnesia of the event that caused it. They may not remember significant parts of the event. Negative thinking and perception of self and others is another distorted process a person with PTSD may develop. They may feel ongoing feelings of shame, fear, guilt, and anger along with blaming themselves for the trauma. 

Changes In Physical And Emotional Reactions

A person with PTSD may have extreme difficult in emotional control and experience persistent feelings of irritability and low mood. They may act impulsively and participate in risk-taking behaviors that are dangerous. They may also have trouble concentrating and continually hypervigilant, startling at loud sounds or unexpected arrivals. They may be prone to self-destructive behavior and anger attacks. 

The intensity of the symptoms that a person experience can increase and decrease throughout the day or appear with long breaks of time in between. There may be certain things that cause symptoms to intensify. For instance, a person who was involved in a traumatic event that involved gunfire or explosions may be triggered by a car backfire triggering. For others, getting stuck in a traffic line bothers them to the point that anger flares and gets out of control.

Common responses to a survivor's traumatic event are anger and self-destructive behavior combined with suppressing and avoiding any reminder or memory of the trauma. It is not healthy to keep feelings bottled up. If this sounds like you, the best health decision you can make for yourself is to find a licensed therapist.

PTSD And Anger

Dysregulated anger and increased levels of aggressive behavior are commonly found in people living with PTSD. While anger is a natural response to many traumatic events, it can lead to many problems if out of control. If you or someone you love was harmed in any way, it can bring an onset of many difficult emotions. Your natural reaction might be anger, which may seemingly help you to deal with the initial response to the situation. Feeling angry is normal for people in many situations. However, when you have PTSD, the anger often does not subside and may lie just below the surface, ready to emerge at the slightest provocation. 

Your family and friends might notice that you have a short temper and try to point it out to you. But it can be difficult to recognize in yourself because the feeling does not subside and may just seem like your go-to state of mind.  This can become extremely problematic if your reactions are too intense for what the situation calls for and effects the peace of those around you, including yourself. During times like this, anger management skills can help you calm down and respond more appropriately.

Anger from PTSD can also cause problems in your family, friend relationships, and intimate relationships. If you are frequently experiencing angry outbursts, you can make it difficult for people to be around you. They may be frightened of what kind of response you will have if they accidentally upset you. For people with anger management issues, anger can quickly get out of control without the realization that it is happening. The first step to take if you recognize your anger is out of control is to reach out to mental health professional or healthcare provider. They will be able to diagnose the cause as you both can development a treatment plan to improve the quality of your relationships and your general well-being. 

PTSD And Managing Anger

If you live with PTSD and deal with anger, you can learn to manage your symptoms. Here are some tips to help you out when you feel angry.

1. Learn To Recognize Your Anger

There are different types of anger that you could be experiencing. If you experience PTSD, it is important to learn how to identify your anger. Constructive anger is different than deconstructive anger. Constructive anger is something that you can control and helps you to control the situation with a healthy response. It's a healthy form of anger where you can see another person’s point of view, but perhaps you do not agree with it.

Deconstructive anger, on the other hand, is not healthy. This is when you do not know how to handle your anger properly and react explosively and aggressively. For example, when you are in heavy traffic during peak traffic hours, you may scream or threaten cars around you or you take things out on someone else for some other reason. It can cause you to overreact to situations, be harsh with your loved ones, or suppress the anger inside, which can lead to substance abuse or self-harm.

When you can recognize your anger, you can begin to address it. This will help you to identify if you are having healthy anger that you can control and respond to in a healthy way or unhealthy anger that you need to learn how to address.

2. Get A Service Dog

Service dogs are not just for people who have physical disabilities. There are psychiatric service dogs that are trained to help people who are struggling with mental health challenges. For example, a dog that's trained for someone with PTSD can be trained to create a barrier between their owner and others, go around corners first to check for people, and sense when their owner is having a nightmare and wake them up. Dogs can be trained to sense anxiety levels and to remind people to take their medication.

Psychiatric service dogs are different than therapy dogs. A psychiatric assistance dog (PAD) helps people with mental health diseases, such as depression, anxiety, or bipolar disorder, manage symptoms and other associated challenges. These dogs are professionally trained and certified to provide comfort and support as well as perform other daily tasks (i.e., retrieving medication or water for anxiety attacks, bringing the patient a phone, getting help for a patient if needed, etc.).

3. Remove Yourself From The Situation

There is nothing wrong with taking a timeout when you need to. This is something that parents do with their children to help them calm down, and it's just as effective for adults. For example, if a man gets triggered by a PTSD event and cannot understand his wife or her point of view, it is best to tell her he needs some time alone to process it. The same can happen if a wife gets triggered by PTSD and needs some separation from her partner.

When you remove yourself from a situation, it can help you to calm down. Then you are more likely to think clearly.

If you feel that your anger is starting to build, excuse yourself and step away from the situation. Then, you can use another strategy or tactic to help dissolve your anger. It is sometimes helpful to discuss a "code word" or phrase with your family ahead of time so that if you are feeling triggered, you can discreetly let them know that you need to leave. You may even consider a silly word like “monkeys” or “bananas” which can break the usual pattern of events. 

4. Practice Mindfulness Meditation

Mindfulness meditation is something that you can practice on your own, use from an app, or learn from an experienced therapist. It is one of the more effective coping skills you can learn if you are experiencing anger in PTSD. This meditative practice involves a calm intention in noticing your thoughts, feelings, bodily sensation, and environment around you moment-by-moment.  The practice of mindfulness meditation helps you to become more aware of your feelings while not indulging in them. It also allows you to explore the feelings you are having without judging them, bringing you a sense of calm in simply being in the moment. 

Mindfulness meditation can also teach you how to control your emotions and your thoughts. When you purposefully think about things that will know will help bring you calm, you may notice a significant reduction in both your physical and emotional responses to anger.

5. Make Exercise Part Of Your Regular Routine

Many people understand that physical activity is good for both your mental and physical health, especially after an appointment with your healthcare provide. Research has also shown that regular exercise is highly beneficial for people managing post-traumatic stress disorder. An peer-reviewed article published in Frontiers In Psychology analyzed 19 studies that examined the effects of aerobic exercise on symptoms of PTSD. The study’s authors found that exercise positively impacts PTSD by improving cognitive functions, reducing hypersensitivity and internal arousal cues (like anger), while normalizing the heightened stimulation of the fight or flight response.  

If you deal with anger and stress, exercise can help you to find a positive way to release some of your pent-up anger. Physical activity helps you to release energy by providing a positive outlet for internal frustrations and stress. Finding an activity to participate in on a regular basis can help you to have something that will distract you from thoughts, fears, or memories that can cause you to experience negative emotions.

6. Get Enough Sleep Each Night

When you are operating on little sleep, it can be difficult to keep control of emotions such as anger, moreso when you are managing a stress disorder, such as PTSD. Unfortunately, one of the intrusive symptoms of PTSD involves nightmares, night terrors, and distressing dreams. This may make it incredibly difficult to get a good night’s rest. While attending regular therapy sessions will help reduce the severity of these symptoms, you can get a handle on your sleep by practicing healthy sleep hygiene. Turn off your electronics well-before you go to bed, reduce or eliminate your caffeine intake, and creating a bedtime that is consistent and is not too late. Avoiding alcohol and nicotine is also advised. 

7. Track Your Symptoms

Keeping a journal or tracking your symptoms can help you to learn about the external or internal triggers that remind you of the trauma you have experienced. The more you become aware of the events, situations, or stimuli that tend to set off your anger, the easier it will be to control. Not knowing or being unaware of these triggers makes it incredibly difficult to learn how to manage it. But once you can recognize the triggers and spot any patterns that you have, you will more vigilant of a situation that may cause you to lose your temper and take action to stop that from happening.

8. Go To Therapy

There are many different types of therapy that effectively treat people with PTSD, including medication. In 2017, the American Psychological Association (APA) and the Veteran Health Administration and Department of Defense (VA and DoD) published treatment guidelines for post-traumatic that encompasses the spectrum of therapeutic approaches for people with the disorder. However, these guidelines do not include medications, but simply psychotherapy. According to these guidelines

, the strongly recommended treatments include prolonged exposure (PE), cognitive processing therapy (CPT), and cognitive behavioral therapy (CBT).

Talking with an experienced therapist can help you learn the proper ways to cope with your anger and other symptoms of PTSD. They can help you learn how to solve problems, deal with a hectic work schedule, and pursue appropriate treatment options.

There are also other forms of treatment available, such as medications, to help you learn to overcome and control the symptoms of PTSD. Certain martial arts such as tai chi which is a form of moving meditation that has a calming effect on the body’s nervous system.

It's important that you work with a professional if you're living with PTSD to learn what the best forms of treatment are to help you find relief from your symptoms.

Educate Yourself About PTSD

Healthwise is an excellent website with many informational articles on PTSD. You will recognize the Healthwise logo by the three red circles with one embedded into the other. Adam Husney MD, Kathleen Romito MD, and Jessica Hamblen Ph.D. are practitioners in family medicine. They are a few of the medical reviewers on the site, so you know the information is accurate and current.

There are many blogs, websites, and videos that can teach you about anger management, unhealthy behaviors, and trouble dealing with anger and PTSD. An internet search will help you find them and there are many informative articles at BetterHelp.

Managing Trauma With BetterHelp

There is a large body of research showing that online therapy can be a valuable component of a treatment plan when addressing symptoms of trauma. For example, in a study published by the Anxiety and Depression Association of America, researchers found that online cognitive-behavioral therapy (CBT) was an effective means of decreasing symptoms of PTSD. Online interventions can eliminate these barriers. Online cognitive-behavioral therapy works by helping individuals to reframe negative thought patterns that may be underlying unwanted emotions and behaviors, such as depression or anxiety arising out of trauma, so that individuals can understand triggering situations and how to manage them.

As discussed above, an online therapist can help you address complicated issues related to PTSD or anger. If you’re not comfortable meeting face to face, online counseling is a better option, as you can attend sessions from the comfort of your home. With BetterHelp, you won’t have to worry about going to an office or discussing your treatment plan with anyone but your therapist. Also, you’ll have the option of participating in counseling completely unknown—BetterHelp doesn’t require your contact information when you register. A qualified professional can guide you on the path to better mental health as you deal with trauma. Below, you can read reviews of BetterHelp therapists written by those who have sought help in the past.

Counselor Reviews

“I really enjoy working with Daniel. His expertise and knowledge in his field are extensive yet relatable. He provides effective strategies in working through PTSD issues with a kind and direct technique. I highly recommend him!”

“Paula is wonderful. She has been here for me since day one, and I feel like she truly is in my corner. She is patient, kind, and is excellent in dealing with chronic trauma and PTSD. She teaches me how my brain works, how I can deal with my emotions (and that it's okay to have them!), and she is helping me process the things that happened to me. She had good insights, and levels with me very well.” 

Conclusion

The more you understand about post-traumatic stress disorder and problematic anger, the better you will be able to manage issues as they arise. While your symptoms may seem difficult to manage and overwhelming at times, know there is support available with mental health therapy. Take the first step by contacting a therapist when you are ready.