Dr. Krishna G Seshadri
Consultant – Endocrinology, Diabetes and Metabolism
Sri Ramachandra Medical Center

The author can be reached at mail to:krishnagseshadri@gmail.com

Anger is not a strange emotion to any of us – we have all felt it as a fleeting annoyance or a full-fledged rage. We are surrounded by anger – the altercations in the road during rush hour, in long lines at services, at home at the end of the day. It simmers at work place. For instance, in a recent poll, nearly one-quarter of workers often feel "underground chronic anger" on the job, not just because of heavy workloads but because they feel betrayed or let down by their employers and one in six employees could recall a situation where they felt like hitting a co- worker in the last year. Domestic violence and spousal abuse are often expression of the simmering rage that is engulfing our society.

What are the roots of anger?

While anger has been around forever, its violent expression is an increasing phenomenon that concerns all of us. There is no doubt that stressful situations are at an all time high now. Some experts blame it on the frustration that comes from plodding through a society where materialism is the yardstick for success. Still others blame crowding and even global warming. Movies, media and a pop culture that glorifies the “avenging angry young man” don’t seem to help either.

Is anger abnormal?

Anger is a completely normal, usually healthy, human emotion. It is a natural, adaptive response to threats; a primeval emotion that allows us to fight and to defend ourselves when we are attacked. A certain amount of anger, therefore, is necessary to our survival. But when it gets out of control and turns destructive, it can lead to problems—at work, personal relationships, and in the overall quality of life. And it can make you feel as though you're at the mercy of an unpredictable and powerful emotion.

What are the health hazards associated with anger?

Anger can keep your blood pressure high and increase your risk for depression, heart attack, stroke, and other illnesses. Teenagers who report high levels of anger and hostility also report higher levels of anxiety, stress, sadness, and fatigue, alcohol and drug abuse, and smoking.

How do we express anger?

Obviously we can’t physically lash out every time we perceive a threat or feel annoyed. Most of us use a variety of both conscious and unconscious processes to deal with angry feelings. The three main approaches are expressing, suppressing, and calming.

Most experts believe that expressing your angry feelings in an assertive—not aggressive—manner is the healthiest way to express anger. To achieve this, you have to learn how to make clear what your needs are, and how to get them met without hurting others. Being assertive doesn't mean being pushy or demanding; it means being respectful of yourself and others.
Anger can be suppressed, and then converted or redirected. This happens when you hold in your anger, stop thinking about it, and focus on something positive. The aim is to inhibit or suppress your anger and convert it into more constructive behavior. The danger in this type of response your anger can turn inward—on yourself. Anger turned inward may cause hypertension, high blood pressure, or depression. It can also lead to pathological expressions of anger, such as passive-aggressive behavior or a personality that seems perpetually cynical and hostile.
Finally, you can calm down inside. This means not just controlling your outward behavior, but also controlling your internal responses, taking steps to lower your heart rate, calm yourself down, and let the feelings subside.
When none of these three techniques work, that's when someone—or something—is going to get hurt.

Why Are Some People More Angry Than Others?

It is true - there are some people who are more hot headed than others. Not all of them throw tantrums at every turn, some are chronically irritable and grumpy and others may withdraw, sulk, or even get physically ill.

People who are easily angered seem to have a low tolerance for frustration. They can't take things in stride, and they're particularly infuriated if the situation seems somehow unjust.

Some “angry people” are born that way. There is evidence that some children are born irritable, touchy, and easily angered, and that these signs are present from a very early age. In addition, people who come from family backgrounds that are either disruptive or lack emotional communication skills seem to have problems with anger.

Are you angry enough to seek help?

There are psychological tests that measure the intensity of angry feelings, how prone to anger you are, and how well you handle it. A simple test to decide if you need professional help is to ask yourself 1) Has my anger led to violence against myself or another person and 2) Has it affected my relationships at home, work or society. If the answer for any of these questions is yes – then you must seek a physician’s help.

Can anger be managed?

Fortunately the answer is yes, although the process is difficult and may require persistence and support. The goal of anger management is to reduce both your emotional feelings and the physiological arousal that anger causes. You can't get rid of, or avoid, the things or the people that enrage you, nor can you change them, but you can learn to control your reactions.

Relaxation

Simple relaxation tools, such as deep breathing and relaxing imagery, can help calm down angry feelings. Some steps you can try include breathing from your diaphragm, and visualizing the process, repeating a phrase like “calm down “ (or shanti) or slow exercises (like yoga); these must be done daily.

Cognitive Restructuring

In simple terms this means changing the way you think. When you're angry, your thinking can get exaggerated and overly dramatic. Try replacing these thoughts with more rational ones.

For instance, instead of telling yourself, "oh, it's awful, it's terrible, everything's ruined," tell yourself, "it's frustrating, but it's not the end of the world and getting angry is not going to fix it anyhow." Another important fact is to remind yourself that the world is "not out to get you," but you’re just going through a rough patch, which happens to everyone. Do this each time you feel anger getting the best of you, and it'll help you get a more balanced perspective.

Many angry people are also demanding people. An important part of the cognitive restructuring process is to replace demand with desire. In other words, saying, "I would like" something is healthier than saying, "I must have" something. This way, when you're unable to get what you want, you will experience the normal reactions—frustration, disappointment, hurt—but not anger.

Listening

Angry people tend to jump to—and act on—initial conclusions, and some of those conclusions can be very inaccurate. The first thing to do if you're in a heated discussion is slow down and think through your responses. Don't say the first thing that comes into your head, but slow down and think carefully about what you want to say. At the same time, listen carefully to what the other person is saying and take your time before answering.

Using Humour

"Silly humour" can help defuse rage in a number of ways. One suggestion provided by experts is to create funny imagery of the things that you actually say to people when you are angry. For instance if you want to call some one a donkey picture it .The more detail you can get into your imaginary scenes, the more chances you have to realize that maybe you are being unreasonable; you'll also realize how unimportant the things you're angry about really are. While anger is a serious emotion, it is often accompanied by ideas that if examined can make you laugh.

There are two caveats when using humor. First, don't try to just "laugh off" your problems; rather, use humor to help yourself face them more constructively. Second, don't give in to harsh, sarcastic humor; that's just another form of unhealthy anger expression.

Use common sense

Sometimes it's our immediate surroundings that give us cause for irritation and fury. Give yourself a break. Make sure you have some "personal time" scheduled for times of the day that you know are particularly stressful. Avoid discussing issues that can lead to arguments at particularly stressful times for instance immediately after coming home from work. If you find that driving through a busy road to work because it is shorter gets you into a state of rage or frustration, leave early or find another route or better still have some one else drive or take a bus.

Remember, you can't eliminate anger—and it wouldn't be a good idea if you could. We may not be able to change the things around us; but we sure can change the way we react to them.

• See if there is a real problem at work or at home that is causing anger and tackle it in earnest

• Express anger in a healthy way: