The Interconnection Between Anger Management and Substance Abuse

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Substance use disorder (SUD) affects millions of individuals and families each year. Chronic substance abuse has the potential to cause changes in mood, temperament, and behavior. Sometimes, people become violent, aggressive, or unable to control their anger while under the influence of mind-altering substances. In addition, research indicates people with unmanaged anger issues develop SUD at a higher rate. According to the Journal of Psychiatric Research, "Subjects with [intermittent explosive disorder (IED)] are at increased risk of developing substance use disorder, compared to those without IED." Pathways Recovery Center uses evidence-based and holistic treatments to help clients manage anger and recover from substance abuse

Anger is a powerful emotion. Individuals with poor impulse control or difficulty managing emotions may respond to anger-inducing situations by engaging in maladaptive or unhealthy behaviors, including substance abuse. Anger management classes or individual therapy help people learn to identify the source of their anger and respond appropriately. Avoiding substance abuse by learning to channel anger effectively reduces the risk of severe health side effects and improves the overall quality of life for clients in treatment. 

Understanding the Nexus: Anger and Addiction

People feel anger for many different reasons. Sometimes, people who don't know how to process a situation or emotion may respond with anger. Difficulty regulating emotions like anger interferes with personal and professional relationships. Often, people with anger issues attempt to control their emotions by self-medicating or using other maladaptive coping mechanisms. 

For some individuals, substance abuse causes uncharacteristic irritation, aggression, anger, or violence. Multiple factors may contribute to unusual behaviors, including: 

  • Hormone imbalances
  • Alcohol or drug abuse
  • Genetics 
  • Health conditions affecting neurotransmitters 
  • Side effects of some prescribed medications
  • Psychological causes 
  • Socioeconomic factors 

Anger can be both a cause and a side effect of substance abuse. Studies have shown that alcohol is a "common cause of aggression because it can lower the repressive barriers of prior controlled emotions, including rage." Overwhelming emotions, including anger, may also cause people to rely on substance abuse as a way to control problematic behaviors. 

Unmanaged anger is a risk factor for many psychological and physical health issues, including heart disease and mental health disorders. If left unchecked, anger can fuel substance abuse while the substance abuse amplifies anger or other strong emotions. The cyclic nature of these conditions makes professional mental health treatment the best way to address concurrent SUD and anger management issues. 

Triggers and Responses: The Role of Anger in Substance Abuse

Anger clouds judgment, reduces self-confidence, causes conflict in relationships, significantly increases stress, and makes it difficult for some people to heal and move forward in their recovery. Some people use various substances to control anger and help them manage emotional responses. However, substance abuse is an unhealthy coping mechanism and generally only worsens issues related to anger. Treatment gives clients the skills to replace maladaptive coping mechanisms with healthy alternatives. Identifying the triggers of anger helps clinicians provide personalized treatment.

Some of the most common triggers contributing to both substance abuse and angry outbursts include:

  • Chronic or acute stress 
  • Fear 
  • Anxiety 
  • Frustration 
  • Guilt or shame 
  • Loneliness

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), "Anger has many benefits, including helping people identify and begin to address problems in their lives and giving them energy to react to threats. It also has its downfalls. It has been linked to heart disease, high blood pressure, trouble sleeping, problems with digestion, headaches, depression, and anxiety." 

People who learn to effectively manage their anger using psychotherapy and other tools often decrease their risk of developing mental health disorders or substance abuse. Pathways Recovery Center uses anger management, individual therapy, and peer support to help clients learn to manage their anger constructively during recovery. 

Implications of Unmanaged Anger on Recovery

Unmanaged anger during recovery from substance abuse can lead to outbursts, aggression, or difficulty maintaining emotional stability. Recovering from substance abuse is often more challenging for individuals who cannot regulate their emotions effectively. Many people experience heightened levels of emotions, including anger, during the withdrawal stage of treatment. 

Psychoeducation is an essential tool for reducing mood swings and angry outbursts during withdrawal and early recovery. Studies have shown that psychoeducation ensures "clients learn about other resources that can be helpful in recovery, such as meditation, relaxation training, anger management, spiritual development, and nutrition." Pathways Recovery Center uses psychoeducation to reduce the adverse side effects of SUD. 

Unmanaged anger during treatment for SUD impacts recovery by doing the following:

  • Interfering with self-reflection and self-awareness
  • Triggering cravings, intrusive thoughts, or other symptoms of SUD
  • Damaging trust and limiting communication between clients and the care team
  • Undermining positive lifestyle changes and coping strategies
  • Increasing the risk of impulsive or risk-taking behaviors

Unmanaged anger can negatively impact a client's commitment to recovery unless the anger is adequately addressed. People are more likely to relapse if they allow their anger to fester and control their behaviors. Individuals with anger issues benefit from working with a therapist to find healthy ways to manage anger. 

According to MedinePlus, "You may need help controlling your anger if you:

  • Often get into arguments that spin out of control
  • Become violent or break things when angry
  • Threaten others when you are angry
  • Have been arrested or jailed because of your anger"

Pathways Recovery Center uses anger management to help clients learn conflict resolution, healthy communication, and emotion regulation. Successful anger management reduces stress, improves self-awareness, and increases self-confidence. 

Anger Management: A Cornerstone of Comprehensive Treatment

Many people are unaware of precisely what happens during anger management sessions in addiction recovery treatment. In most cases, anger management involves the following: 

  • Discussing the consequences of anger
  • Identify triggers 
  • Learning to control or manage physiological arousal
  • Education clients on the underlying causes of anger 
  • Creating preventative strategies 
  • Developing healthy coping skills

Most people diagnosed with SUD experience some form of irritation, anger, or rage during treatment and early recovery. Emotions are often on a hair trigger, and the effects of substances on the brain may make people more prone to mood swings. Therapy and anger management are ideal for eliminating, reducing, or managing unwanted outbursts of anger or related emotions during treatment for substance abuse. 

Anger management classes and therapy help people heal while providing them with the tools to better understand and control their reactions. Some of the techniques used in anger management include:

  • Cognitive-behavioral therapy (CBT)
  • Mindfulness 
  • Mindfulness-based cognitive therapy (MBCT)
  • Relaxation exercises 
  • Exploring alternative forms of self-expression 

Anger management helps clients improve problem-solving and communication skills. Resolving social conflicts before the situation deteriorates makes it easier for people to retain control of their emotions and avoid angry outbursts. 

Pathways Recovery Center uses anger management as a way to address impulse control and behavioral issues that may otherwise interfere with a client's recovery and mental health. Clinicians conduct comprehensive assessments during admissions to determine if anger management and other services will help clients progress with their recovery. The techniques and information learned in anger management sessions provide clients with greater insight into their behaviors and guidance on how to make positive changes. 

Success Stories: Triumph Over Anger and Addiction

Often, people with anger issues experience highly explosive reactions to everyday occurrences while undergoing treatment for substance use disorder. Recognizing anger triggers and controlling emotional responses allows clients to heal and grow. Witnessing others benefit from anger management therapy and other treatments can help people gain greater self-awareness and motivate them to make necessary changes. Below is a real-world example of how someone in treatment reacted to everyday stressors with anger and how therapy helped them regain control. 

#1. Vanessa's Anger Issues

In one case study, a woman was instructed by her primary care physician to abstain from caffeine to help reduce some mental and physical side effects she was experiencing. 

“Vanessa’s team reported that a focus on the elimination of caffeine resulted in behavioral outbursts and violence, and they requested that the focus of the treatment be to decrease aggression and increase willingness to adhere to the staff’s requests. The psychotherapist’s need to develop a therapeutic alliance with Vanessa and focus on her wants and needs was first priority.”

#2. Addressing Vanessa's Anger Using Therapy

“Vanessa was angry and frustrated because of all of the controls and restrictions in her life, and expressed this through behavioral outbursts and aggression at the staff and others around her. Vanessa resented the staff for making decisions for her, and she was never informed by the primary care physician about the reason for the caffeine restriction. The first order of business in the psychotherapy is to build rapport and trust, and this is what the therapist focused on before addressing Vanessa’s inappropriate behavior.”

Vanessa was given context for the requested lifestyle change and provided with the support she needed to manage her angry outbursts. Psychoeducation combined with anger management helps people in treatment better understand their situation and how to cope with it. 

#3. Vanessa Benefitted From Treatment

Vanessa had a dedicated care team providing her with directions for improving her overall quality of life. The extreme anger she experienced was caused by a combination of frustration, confusion, stress, and biological changes caused by caffeine withdrawal. Individuals in recovery from other addictions often experience similar situations. Therapy, integrative care, education, and anger management allow clients to successfully navigate recovery without experiencing severe anger problems. 

Tips for Those Struggling With Anger and Substance Abuse

Self-help strategies are an excellent way for people in recovery to experience anger without letting it affect their mood and behavior. Pathways Recovery Center encourages clients to work with their therapist or other members of their support system to find healthy ways to self-manage anger responses and anger triggers. Below are three tips for people struggling with anger and substance abuse. 

#1. Briefly Step Away From the Situation

One of the most effective ways to manage anger is by creating some form of physical or psychological distance from the source of the anger. For example, if reading the news makes someone feel irrationally angry, reducing news consumption or temporarily avoiding the news removes the trigger. 

A few common anger triggers people can step away from include: 

  • Stressful social interactions 
  • Family conflicts
  • Public disagreements 
  • Events or activities causing stress

Physically stepping away from an overwhelming situation, even for a few minutes, significantly reduces feelings of anger and stops angry outbursts before they occur. 

#2. Breathing Exercises and Relaxation Techniques

Everyone reacts to triggers in different ways. Anger may cause sometimes unexpected physical and emotional reactions, including:

  • Muscle tension 
  • Heart palpitations
  • Shortness of breath 
  • Increased blood pressure 
  • Excessive sweating 
  • Loss of control 
  • Difficulty making objective decisions 
  • Biased views

Breathing exercises and relaxation techniques naturally reduce or eliminate the physiological effects of unmanaged anger. Studies have shown that strategies "to assist patients with relaxation have long been a hallmark component of psychotherapy; however, they can be utilized throughout healthcare environments as complementary therapies to treat patients experiencing various types of distress, including but not limited to anxiety, depression, pain, and stress." Reducing stress through relaxation techniques helps clients in recovery avoid feeling overwhelmed or angry.

#3. Attend an Anger Support Group

Support groups provide peer encouragement and community engagement. People with anger issues and co-occurring SUD benefit from sharing with others who have similar life experiences. Anger or impulse-control support groups are available in many cities both in-person and online. 

People looking for local or online support groups find them by doing the following: 

  • Checking online directories for community-based self-help groups 
  • Asking a family doctor, community clinic, therapists, or other clinicians 
  • Reaching out to recovery groups and organizations

Case managers at Pathways Recovery Center assist clients in locating resources, including community-based support groups. Many people benefit from attending groups during outpatient treatment and aftercare. Clients in residential treatment gain the same type of support from group therapy sessions. 

Recognizing When Professional Help Is Needed

People with anger management issues should seek professional help for their impulse-control problems as soon as they cause emotional distress or interfere with their ability to function. Many individuals wait until anger interferes with relationships, work, or education before reaching out for support. However, early intervention and treatment is the best way to resolve behavioral issues related to anger before they interfere with a person's overall health. 

Some warning signs indicating a person may benefit from professional mental health treatment include: 

  • Legal problems caused by anger issues 
  • Experiencing domestic violence or maladaptive relationship dynamics
  • Job loss or other career problems caused by angry outbursts at work 
  • Violence against others or their property in response to minor stressors

Unmanaged anger has the potential to cause severe side effects, including substance abuse and mental health disorders. Getting professional treatment reduces the risks and ensures people receive the care they need to establish healthier behaviors. 

Pathways Recovery Center - Dual Diagnosis Treatment

Individuals with anger issues affecting their mental health benefit from a dual approach to treatment. IED and other impulse-control disorders have the potential to increase the risk of relapse or derail treatment if left unaddressed. Integrative care and personalized treatment plans provide the best outcomes for most people with co-occurring anger management issues. 

Pathways Recovery Center conducts a detailed intake interview to determine what factors may impact a client's recovery and ability to effectively participate in treatment. The clinicians use the information they learn during the interview to determine if persistent anger issues require additional treatment. Clinicians collaborate with clients and their loved ones to create personalized care plans that may include anger management, skills development, family therapy, and other forms of treatment. 

Anyone struggling with substance abuse and anger management issues would benefit from attending professional addiction recovery programs. The compassionate care team at Pathways Recovery Center helps clients navigate challenges and overcome obstacles interfering with their ability to build a strong foundation for a healthier future. 

Impulse-control issues are common among individuals diagnosed with substance use disorder. Substances often affect areas of the brain responsible for impulse control. Addictive substances have the potential to cause uncharacteristic angry outbursts, extreme irritation at minor stressors, and violence. During detox, withdrawal, and early recovery, many clients continue to struggle with emotion regulation. Clients with anger issues benefit from participating in anger management classes or therapy. Pathways Recovery Center offers anger management as part of residential treatment services. Clients at every level of care have access to essential therapeutic support and anger management sessions. To learn more about our programs and the services we offer, call us today at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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