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Anger: Managing Intense Emotions

Comments [21]

Taryn M. Stejskal and Jeff Kreutzer, The National Resource Center for Traumatic Brain Injury, Virginia Commonwealth Model Systems of Care

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Part of the Greatest Challenges Families Face Series

After a brain injury, many survivors and family members experience a number of strong emotions. Many people say that one of the most difficult emotions to handle is anger. Anger can weaken your ability to solve problems effectively, make good decisions, handle changes, and get along with others. Concerns about anger control are very common. In fact, many people say that they feel angry more often, get angry more easily, and have more difficulty controlling their anger than they did before the injury. This article provides information about controlling your anger after an injury, the dangers of anger, recognizing early warning signs for anger, and ideas about how to better control anger.

Why is controlling anger so hard?

For many people, family members and survivors alike, controlling anger can be more difficult after an injury. Anger may be demonstrated in many ways including irritability, hostility, yelling, cursing, and even threatening or being physically aggressive with others. There are several reasons why you and/or your loved ones may have difficulty managing anger effectively. First, brain injury can cause chemical changes in the brain, making it harder to manage anger and frustration. Second, there are many changes after an injury. You may be upset by changes in your capabilities, for example, your ability to participate in activities you previously enjoyed. Third, sometimes people try to regain control over their lives through the expression of anger. After an injury, many people encounter a number of problems they do not know how to solve along with very few solutions. All of these problems may make you feel hopeless and out of control. Fourth, you may find that people do not understand you. You may feel frustrated with you insurance company, treatment providers, and you may feel like people do not understand you or the circumstances your family is experiencing.

Also, there are a variety of reasons why you may have difficulty helping your loved one manage his or her anger. First, the person may be unpleasant to be around. Second, you may be more concerned with protecting themselves or other family members. Third, you may be afraid that their actions will make the problem worse. All the changes can make controlling your emotions harder. Still, you care about your loved one and want to help. Family members and friends are often in the best position to help one another control anger effectively. In this way, family members and friends can help one another work on self-control and reinforce positive changes.

The dangers of anger

Did you ever notice that the word “anger” is just the word “danger” without the “d”? Anger can be dangerous because you may not be thinking clearly when you speak or act. Many people often regret things they have done or said in anger later on. In fact, anger can:

  • cause you to hurt yourself or others physically or emotionally.
  • make people avoid you, or worse yet, be afraid of you.
  • contribute to feelings of depression, loneliness, or isolation.
  • be a factor is poor decision making.
  • add to your list of problems.

As you can see from this list, anger tends to not do many positive things for people. Your best bet is to be begin to recognize when you are getting angry to avoid losing your temper.

What are some of the early warning signs of anger?

The first step in controlling your own anger is recognizing the early warning signs. Early warning signs are emotional or physical changes you may notice as you begin to feel angry. Here is a list of common early warning signs. Review the list and see if you can recognize additional early warning signs you would like to add to the list.

  • Muscles tensing, clenching your jaw or fists, or tightening your shoulders
  • Feeling your face flush or feeling hot
  • Noticing your heart beating faster than usual
  • Churning or knots in your stomach
  • Headaches
  • Pacing
  • Over or under eating
  • Feelings of being sad, overwhelmed, impatient, or irritated.

Also, there are patterns of thinking that can make you and/or your family members more prone to anger. People who are angry more often tend to blame people for their problems. Also, people get angry more often when they take things personally or believe others are out to get them. Finally, many people get angry over “little” things like getting lost, not having enough gas in the car, or finding dishes left in the sink. Try to prioritize the big and small issues in your life. You will feel better when you tackle the important issues and don’t sweat the small stuff.

Tips and ideas for controlling anger

Once you recognize you and your family members’ early warning signs for anger, you can take steps to help yourself and your family member(s) cope with anger more effectively. We’ve talked to lots of survivors and their families to find out ways they manage their anger. Here is a list of strategies that have worked for other people. Talk these ideas over with trusted family, friends, or professionals and pick out some tips you think will work for you and your family:

  • Recognize that you have the power to control your emotions.
  • Controlling your emotions in a skill. The more you practice, the better you’ll get.
  • Remember that ups and downs are normal parts of life. Realize that it is normal to feel angry about what has happened to you, but if you stay angry, and take your anger out on others, you are just making things worse. Instead of focusing on the downs, try to focus on the good things in your life and look forward to the ups!
  • Tell yourself to relax.
  • Breathe slowly and deeply.
  • Don’t say or do the first thing that comes to mind. Count to ten. Waiting to respond can help you consider other people’s feelings before you speak or act. This way, you will do not things you regret afterwards.
  • Consider taking a break or leaving the situation. Oftentimes, when interactions get heated, it is best to take some time away and come back to the conversation after you have calmed down. Perhaps, you can make an agreement with other family members that you will state that you need to take a break. Don’t forget to agree on a time to resume the discussion later.
  • Make plans in advance to handle situations that cause anger. There may be a few circumstances that you know are going to upset you. Perhaps these circumstances are traffic, coming home to a messy house, and or trying to get your child ready for bedtime. Plan to use strategies to manage your anger in these situations ahead of time.
  • Try to keep an open mind. Oftentimes, people get angry when they think they know what another person is saying, but they are not listening closely. Try to remind yourself that your family and friends are trying to help in the best way they know how. In order to reduce misunderstandings, try to repeat what you heard the other person say, “So what you are telling me is that you do not think it is a good idea for me to stay at home alone.”
  • Explain yourself calmly. Many people get angry when they feel misunderstood. Truly, it can be tiring to continue to explain your situation to others. Try to be positive and sensitive to other people’s feelings. Doing so will make it easier for others to understand you.
  • Develop new or continue to use constructive ways to deal with anger. Many people say they feel better when they go for a run, play a video game, write in a journal, take a walk, or talk with a friend. Having constructive strategies at your fingertips will help you blow off some steam when you begin to feel irritated.
  • Give yourself credit when you do control your anger. Instead of beating up on yourself, praise yourself when you do keep your emotions under control. Also, ask yourself, what was different about situations in which you are able to control your anger. Recognizing the circumstances or the actions you took not to get angry can be a powerful tool in learning to control your anger better.

Are you stuck being angry? You need not be. Please remember, people who are angry for a long time often have trouble seeing the positive and expressing positive feelings. If you feel uncomfortable about your anger, talk with trusted family, friends, or professionals about your feelings. Also, consider joining a support group, so you can learn how others have dealt successfully with difficult feelings.

From the National Resource Center for Traumatic Brain Injury, Virginia Commonwealth Model Systems of Care. Reprinted with permission. www.neuro.pmr.vcu.edu.

Taryn Stejskal, PhD Taryn Stejskal, PhD, Taryn Stejskal, PhD is a licensed marriage and family therapist and the founder and president of Wellness Strategies, P.C.; a private practice specifically developed to meet the unique needs of individuals, couples, and families after one person has sustained a neurological injury.

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Comments [21]

I'm not sorry I got uncontrollably angry the times I did soon after my subarachnoid bleed. Especially when two people I still hold partly responsible were close by. Twenty-two years later I dream about them with anger which still frightens me. I don't know if writing a book or writing down anything will heal in any way or make it worse.

Feb 21st, 2017 6:19am

:( You expect me to use a broken tool to fix the tool that is broken? I have brain damage. Control my anger? Really? smh. This article just adds to the fact that I am becoming more and more aware of what a burden I've become. Of course I get frustrated. You label THAT as anger?? That pisses me off.

Perhaps some compassion. Try listening to those of us who have this crap .. and stop making it about YOU. If you think this is more difficult or even as difficult for you then you need to step back. seriously caregivers who impose guilt on sufferers are bullies. And, yes, that makes ME angry.

Sep 8th, 2016 11:01am

I got my major TBI five years ago and have banged the crap out of my head several times since due to lack of spacial awareness. I had what I call acidic anger and rage. Thankfully I found Neurofeedback and it has reduced the anger to a manageable level.  It gives me time to grasp what is happening and I can regain control most times before I explode. I now am learning to be patient again with myself and others.  Give it a try.  It is worth it, your family and friends will thank you for it.

Sep 7th, 2016 12:54pm

The article started to make me angry....or at least irritable - it's all very well saying 'you have the power to control your anger' - that's the problem - it is really difficult to control and sometimes its just uncontrollable and out before you know it and there you are shouting and throwing and ranting and crying humiliating the person that you are angry with and yourself in the process. When you say 'don't do or say the first thing that comes to mind' - there is no pause button - it's out. you are shouting and being vicious before you can stop it. The words have already left your mouth. It's too late. The only things I have learned since getting frontal lobe brain damage in 2002/3 are: (1) learn to recognize the feelings - for me like a pressure cooker about to blow - and try to walk away before it's too late and you hit the tipping point and off you go - or stay in if you are edgy (though hard if you have to go to work); (2) avoid noisy confusing spaces with too much stimulation and things going on at once; (3) for me, although I do not have epilepsy, epilim works to reduce the amount of uncontrollable outbursts of anger; (4) don't drink alcohol - not any - 2 days later it makes me all emotional and angry - not when i am drinking. But I know that most of the time I don't have control over my emotions, including anger - the best I can do is stay away from people so I don't let loose on someone who does not deserve my reaction - even if there is something to be cross about - it's the over reaction that is humiliating for everyone, including me - I hate it. 

Aug 19th, 2016 7:01am

That is one huge wrong in the world. We have had the simple truth hidden from us for so long and as the generation go further that truth became myth or an old wives tale. The chemical balance in our brain is the absolute answer to everything. Along with environmental impact and what we are told. Take a person who has depleted dopamine and serotonin levels from using opioids...they can't stop using because the physical pain is worse than being set on fire and they know the drug makes the pain go away. Now take the addict who has tried several times but failed and is told how weak they are and now they live with shame. So they get frustrated with their own " weak mind" and try and fail over and over. When the simple answer is replacing the neurotransmitters in their brain with supplants rather than opioids and guess what....they don't hurt, they aren't tired or angry now when they stop using the opioids. We don't need these damn drug detox centers that lock you up and watch you go through hell. We need neurotransmitters and counseling to get those " bad me" thoughts out. It REALLY is that simple. I know. To go from using high doses of opioids to zero with no withdrawal symptoms ( or as soon as I felt it coming I dosed again with neurotransmitters). I should get a grant and prove it but putting all those expensive detox centers out of business and ruining the CPS From stealing children would probably get me killed.

Jul 31st, 2016 2:04pm

Absolutely sobbing my heart out. I've come across the page and this condition by accident. Brain surgery 9 years ago following a bleed on my brain. I've tried everything to feel normal, I've got no friends, I pushed my family to breaking point, my son lives with my mother as I'm unable to cope and every single thing on this page I suffer from. Never heard of tbi... Been diagnosed with depressant. I'm sobbing I can't breath it's not my fault then guys? Family have been supported but attitude is stop blaming your brain surgery for your behavior. Get up stop sleeping, why you so angry, I tried to commit suicide, I've been so lost. Really? There's really a reason I'm not just mad? Or angry? Omg I can't breath... I cannot believe there's a reason for my behavior. Doctor after doctor has seen me. Why haven't they diagnosed this? 9 YEARS I'VE BEEN ALONE! love to all and I mean that... It's scary being us!!!!

Jan 23rd, 2016 2:25am

Imagine trying to recover from it while having close family members mock your struggles, while remaining willfully ignorant and arrogant as well. Imagine that same pattern also happened for the entirety of your life before the injury with life-crippling, inherited mental illness. I cant wait to see the arrogant persecutors of the downtrodden humbled. Enough is enough. They need to be stopped.

Dec 11th, 2015 2:36pm

Wow! So true with comments I read! So desperate for my family member. Talk about anger? And rage? Becomes angry or in a rage in seconds you are shocked into what do I do now with this person who has a severe brain injury...diffuse Axonal injury. The screaming and coming at you with a closed fist. Has not hurt me but I guarantee you it's come a close call. Try living that way and not knowing when the rage is coming. It's absolutely horrible! Tried all types techniques to calm that person down and none work. Get up in the morning and you're thinking okay what's coming next. This person deals with severe headaches and much pain. He is two years post injury. Not many who know him want to be around him. If you only have Medicaid it's worse trying to find doctors who have the knowledge to treat brain injuries of this type. Many doctors don't want to deal with Medicaid patients. Lack of knowledge is unbelievable. Caretakers know more than they do. Neurologists? The ones I have taken my family member to don't know how to treat a TBI patient. Psychiatrists? Appointments are far and few. Rehab? Where? Many of the best places are for the rich. Nursing homes won't accept them because they don't have the type of facility to treat them or they say that person would be a danger around others. So, when I die, who is going to take care of him? How many end up in the prison system and how many in the prison system entered the system because of brain injuries and just rot away because they won't receive the proper care they deserve? We need to treat people withTBI's as we would do with anyone with I. E. Cancer, heart disease etc. we need more free funding from our government.

Nov 5th, 2015 6:57pm

After reading last comment. I too have many problems with family member who is post TBI Diffuse Axonal Injury. Worst is the anger which turns into rage. Constant screaming, yelling at you, blaming you for past problems, putting you down, threats keep your eyes forward, don't move and there you are scared stiff to move and he continues screaming at you. I was so desperate I cashed in whatever I could and sent family member overseas to his wife and kids. I couldn't take it any more waking up each morning and wondering what was going to happen today or what was going to finally happen to me. If your family has only Medicaid believe me medical care does not reach out far enough to treat TBI. And here you are alone with this family member at your home and In this state, difficult to even get an neurologist experienced withTBI. Ones I met, good with medicating patients with seizure disorders but don't know squat about TBI's. And if you are cursed only to have Medicaid? Your family is not going to get the treatment he or she deserves. Now that family member overseas he continues to deal with constant headaches, personality changes, anger, hard time controlling his impulses, tell lies or half truths. Don't know what to believe when talking with him. Delusions, hallucinating when under any stress. I am praying my family member may have an option to go to China for stem cell surgery. I have been following for over a year now their success rate and some may say it won't work but in desperate situations call for desperate means. I pray daily to The Lord to give me the means to send my family member to China to get treatment. If that be His Will

Oct 20th, 2015 10:01am

I am so tired of dealing with my son's anger and rage. He has a brain injury and won't take any control to help himself. I feel stuck because no one will help with him.

Aug 30th, 2015 6:48pm

Try Nonviolent Communication to ease any anger by connecting with your values like respect, trust honesty... Find a values list on the internet or at http://walkyourtalk.org . Just ask "What am I needing and look down the list and dwell on the value. Sort of like magic....

Aug 15th, 2015 7:35pm

None of these things help me so id love to know what your diagnosis is there, i suffered a severe tbi in 02/08 and it has got better from the intial first two years majorly but still is terrible and till this day clonazepam may help me for a moment but will not overcome the intense anger outbursts

Jul 8th, 2015 4:28pm

Controlling stress is the key to controlling anger.  Anger is part of the limbic system fight or flight response.  Brain injury recovery is more about learning the biology of brain injury and the role the emotional nervous system plays.  It has taken 38 years living with a brain injury to know this and hope my experience can help other people with brain injuries deal with many of the symptoms caused by the limbic system fight or flight response.

Jul 8th, 2015 11:06am

a large problem in anger can be frustration and the unstable sympathetic parasympathetic bridge. Frustration with family or friends who wont understand your limitations and expect you to perform as before,co workers and medical who are cardiovascular.pulminary based and dont und er stand neurogenics. Best to reprogram yourself to realize 90 to 100 of yo u r recovery you will have to run yourself. Be kind to yourself. Alway talk adult adult to others..never get angry even when upset..it hurts you more....

Jul 6th, 2015 5:07pm

Let's see... in that 1st year after the mtbi I was unable to do a thing on your list but see a therapist. Why? I was in the first percentile for short term memory and I was dealing with extreme hyperacusis and much pain. Many things on your list were things that I learned to deal with over time. You could talk to me all day about something if you wanted but give me a distraction or change the subject and all of it would be gone. Thankfully, mine showed itself as a sailor's mouth not physically lashing put at others, but it was not acceptable for anyone to be around. I can tell you I said things that I had never thought of much less said aloud. In hind sight, it usually happened when I allowed myself to become overwhelmed. However, my "this is too much-walk away switch" was missing. I would think I was handling things just fine until I wasn't. At that point I was cussing loudly or cussing while stuttering. I was trying to make a return at a Target for a $100 item. I always paid with my credit card there. They could not find the transaction at the customer service desk. I was doing ok, until I wasn't. I lost it. I ended up yelling my feelings that contained cuss words. A nearby lady waiting at the 1 hr photo pick up told me off (without cussing) for my behavior. I told her I had a brain injury and I was doing the best that I could. She basically told me I needed a keeper or a helper whenever I went anywhere. I told her I didn't have money for that, family within a 1000 miles, and the insurance wouldn't help me. I asked her, "Who is going to help me? You?" While some might have bad enough injuries that they have someone to help. Mine was mild. I had no external injuries other than a bruise that quickly went away. I was not who I was before and basically after a month or so friends and acquaintances basically forgot I had a problem. I ended up isolated and alone except my immediate family. Especially after my driving privileges were taken away because I could not pay adequate attention to drive. Over time and finally alzheimer's meds for a 36 yr old I began to have a little memory. It was then that some of the suggestions were able to be learned and even then it took years!!! Perhaps now that more is being learned about brain injury these things might be addressed. Quite frankly though nothing on your list was possible for those first few years. How and when will someone figure out how to help someone like me during that time?

Jul 6th, 2015 10:02am

I enjoy listening to psychologists and psychiatrists discussing Pain. Most have never endured any so they sit there calming looking at you like you area default program. 

Reading these articles only anger me more. Most doctors do not have a clue and our medical system is inadequate, inefficient and incapable. Same with pain management people. I went 4 years with trigeminal nerve pain and NOT ONE doctor diagnosed it. Finally, a well trained PT who left the medial system discovered and sent me to the correct doctor for help. 

Jul 6th, 2015 9:36am

I had triple skull fracture eleven years ago and couple skull fractures before that it has been a long hard road I am just now seeing therapist by choice no doctors ever informed my family it has not been fair to me or them!

Mar 29th, 2015 1:36am

What about the USE of anger? I would be this-far-recovered from my TBI if I HADN'T gotten angry!

Nov 23rd, 2014 8:44am

Why don't you mention anything about the Emotional Nervous System?  The Limbic System is where the fight or flight response is generated.  What people see is anger and unless we control the stress and anxiety that triggers the fight or flight response you are just treating the symptoms i.e. anger.  Mindfulness-based stress reduction helps with this as does other Mindfulness techniques.    

Oct 23rd, 2014 6:06pm

I find the urgency of this article woefully inadequate . Family's are in grave danger of their loved ones 'head injury' anger. Mainly beacause they don't believe they are in danger because the person never used to be like that. Domestic violence among the families of head injury patience is very real and needs to be seriously stressed to that patient family before they leave the hospital .

Sep 8th, 2014 4:45pm

Hate has no real therapeutic value. It’s like getting drunk. It helps you push away reality for a few glorious hours. But then, there is the lousy morning after, and a terrible headache to wake up to. http://bit.ly/aTL9va

Aug 5th, 2010 7:02am

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