PTSD Related Conditions The Link Between PTSD, Anger, and Irritability By Matthew Tull, PhD Matthew Tull, PhD Twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial process Updated on February 20, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Table of Contents View All Table of Contents How Anger Is Linked to PTSD Signs of Anger in PTSD Types of Anger Impact Treatment Coping Anger and post-traumatic stress disorder (PTSD) often occur together. Common in this condition, anger is one of the hyperarousal symptoms of PTSD and it may affect relationships with people around you. It's important to know that the anger of people with PTSD can become so intense that it feels out of control. When that happens, you may become aggressive toward others or even harm yourself. That doesn't always happen, however, and not everyone with PTSD lashes out angrily. This article discusses the connection between anger and PTSD and some of the effects it can have. It also discusses treatments and coping strategies that can help. How Anger and PTSD Are Connected After experiencing trauma, people frequently experience a variety of symptoms, including intrusive thoughts, hypervigilance, irritability, hostility, avoidance, anxiety, and depression. Other challenges, including troubling memories, problems sleeping, and unhealthy coping mechanisms, can also make anger worse and more challenging to manage. Anger is only one symptom of PTSD. While people with PTSD may experience anger, it is not a requirement for receiving a PTSD diagnosis. People with PTSD also experience anger in a variety of ways. Sometimes this anger is directed outward and may appear as aggression or even violence toward others. But this is not necessarily the case. More often than not, someone with PTSD who tends to feel extreme anger tries to push it down or hide it from others. This can lead to self-destructive behavior. Disclosing Your PTSD Diagnosis Signs of Anger in PTSD Anger and irritability are hyperarousal symptoms of PTSD. Think of hyperarousal as a constant state of "fight or flight." This heightened anxiety can have a variety of symptoms including: Difficulty sleepingIrritabilityHypervigilance While anger is a common response to these symptoms, there are ways to cope with each of these. Anger can be constructive at times, helping to motivate and fuel change. But it can also be a destructive force that can lead to damage to individuals and to others. Hypervigilance in PTSD and Other Disorders Types of Anger in PTSD People often primarily view anger as a negative or harmful emotion. But that's not always the case. It's true that anger can often lead to unhealthy behaviors like substance abuse or impulsive actions. Yet, feeling angry isn't "bad" in itself. It's a valid emotional experience and it can provide you with important information. You may have heard anger classified into two types: constructive anger and destructive anger. Constructive anger can help with healing, forward movement, and recovery, while destructive anger can cause harm. It's a good idea to understand this difference and find ways of managing both in your life. Constructive Anger Channels negative emotions into actions Anger is manageable Helps resolve problems Can be healing Destructive Anger Involves lashing out spontaneously Anger is often unmanageable Creates more problems Increases stress levels 11 Anger Management Strategies to Help You Calm Down Impact of Anger and PTSD Anger related to PTSD can have a number of damaging effects. For veterans with anger issues, it can make returning to civilian life more challenging. It can also create issues with relationships, contribute to chronic stress, and lead to unhealthy coping mechanisms. Anger and PTSD in Combat Veterans Military service is connected to an increased risk for PTSD. It's become clear that veterans are at risk for a number of mental health problems, including PTSD and extreme anger. While troubling and disruptive, there is help available. The more we learn about PTSD in veterans, the more we are learning about effective therapies, and more service members are finding help. The Connection Between PTSD and Military Service PTSD and Relationship Violence Unfortunately, research has found a connection between PTSD and relationship violence. Research has found that having both depression and PTSD increases the likelihood of relationship aggression. If your relationship is affected by PTSD, it's wise to learn about the association between it and violence. While the two are connected, not everyone with PTSD engages in abusive behavior. However, if you or someone you know is a victim of relationship violence, it's important to know there are resources available. Self-Destructive Behaviors in PTSD Although intense anger can cause people with PTSD to be aggressive toward others, more often than not they'll try to push down or hide their anger. This can be effective in the short term, but in the long term, it can build up anger until it's out of control. When that happens, some people turn their anger on themselves in the form of self-destructive behaviors. This may include substance abuse or deliberate self-harm. Forms of Self-Harm Common in People With PTSD Treatment for Anger and PTSD Treatments for PTSD include medication, psychotherapy, or a combination of the two. Medication Antidepressants are often prescribed to treat symptoms of PTSD, including symptoms related to mood and sleep. Four types of selective serotonin reuptake inhibitors are recommended for treating PTSD: Zoloft (sertraline) Paxil (paroxetine) Prozac (fluoxetine) Effexor (venlafaxine) Psychotherapy Therapy can also help people process trauma and manage symptoms of PTSD, including feelings of anger. Cognitive behavior therapy (CBT) is a type of therapy that is often recommended. This approach helps people identify negative thinking and replace those thoughts with more helpful, realistic, and positive ones. Other types of therapy can also be helpful, including cognitive processing therapy (CPT), exposure therapy, and eye movement desensitization and reprocessing (EMDR). Coping With Anger and PTSD Anger can be a very difficult emotion to manage, especially if it feels intense and out of control. Rather than turning to unhealthy behaviors to try to cope, it's a good idea to learn useful anger management techniques. At times, it can seem like a long road. Eventually, something may click and you'll find a few techniques that work for your life. Take a Time-Out From Anger Within those useful anger management skills is the suggestion to take a "time-out" when you feel yourself starting to get angry. You can do this by: Developing a plan for how you will deal with anger before it happensBeing aware of signs that you are getting angry, such as rapid breathing, increased heart rate, and muscle tensionTelling the people you are with that you need to take time out to cope with your feelingsGoing to a quiet place where you can practice your anger-coping skillsGiving yourself time to cool off When you develop a time-out plan, you give yourself specific steps to take when you feel anger. Many people with PTSD have found this a great source of relief and an excellent strategy for their relationships. Use Self-Soothing Skills for Anger Self-soothing skills can be useful when you find yourself getting angry. They're easy to learn and use because they're designed to make you feel better, and you do them on your own. Beneficial self-soothing strategies can include: Soaking in a warm bathDoing some gentle stretchingDrinking some warm herbal teaBurning a favorite candleReading a bookWatching a favorite movie or tv showListening to soothing music Self-soothing skills make use of your five senses—touch, taste, smell, sight, and sound. The key is to focus on the activity. By remaining mindful of something other than your anger, your mind and body naturally become calmer. Seek out Social Support Talking with others as a way of "getting your emotions out" can be effective in preventing anger from building up inside. For one thing, it can help you see another person's point of view. It also gives you the opportunity to express your frustrations in a constructive way. Reach out to people you trust who will understand and support your feelings. Support groups for PTSD are widely available and many people have found them to be a great help with their own challenges. Anger management courses can also be helpful. Learn Anger Management Skills Believe it or not, coping skills for managing anxiety can also help manage your anger effectively. Why? Because intense anger and anxiety are similar emotions in that both tend to ignite a "fight or flight" response. Helpful strategies that can help you better manage feelings of anger include: Being aware of your anger triggers and identifying the emotions that are contributing to anger Assessing whether your anger is constructive or destructive Removing yourself from the situation when it gets to be too much Engaging in brisk exercise to reduce stress and increase your frustration tolerance Finding distractions to take your mind off your anger Deep breathing Practicing mindfulness and meditation Finding someone you trust to talk things out with Writing in a journal Doing yoga When you learn skills for coping with intense anxiety, you're also learning ways to keep your anger at less intense levels. Remember that your PTSD triggers may provoke either feeling, so it's worth your time to learn coping skills for both. How Anger Can Affect Your Health A Word From Verywell Anger can sometimes occur as a hyperarousal symptoms of PTSD. It can be challenging to manage and can have a devastating impact on relationships and well-being. Fortunately, there are treatments that can help you cope with PTSD and learn more deal with your anger more effectively. If you or a loved one are struggling with PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology. Psychiatry Res. 2017;252:215–222. doi:10.1016/j.psychres.2017.03.008 Kimble M, Boxwala M, Bean W, et al. The impact of hypervigilance: evidence for a forward feedback loop. J Anxiety Disord. 2014;28(2):241–245. doi:10.1016/j.janxdis.2013.12.006 Claycomb M, Roley ME, Contractor AA, et al. The relationship between negative expressivity, anger, and PTSD symptom clusters. Psychiatry Res. 2016;243:1-4. doi: 10.1016/j.psychres.2016.06.012 Xue C, Ge Y, Tang B, et al. A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS One. 2015;10(3):e0120270. Published 2015 Mar 20. doi:10.1371/journal.pone.0120270 Creech SK, Benzer JK, Ebalu T, Murphy CM, Taft CT. National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: First year outcomes. BMC Health Serv Res. 2018;18(1):582. doi:10.1186/s12913-018-3401-6 Dixon-Gordon KL, Tull MT, Gratz KL. Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators. J Affect Disord. 2014;166:359–367. doi:10.1016/j.jad.2014.05.033 American Psychological Association. Medications for PTSD. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin National Alliance on Mental Illness. Post traumatic stress disorder. Mauss IB, Butler EA, Roberts NA, Chu A. Emotion Control Values and Responding to an Anger Provocation in Asian-American and European-American Individuals. Cogn Emot. 2010;24(6):1026–1043. doi:10.1080/02699930903122273 Schnyder U, Ehlers A, Elbert T, et al. Psychotherapies for PTSD: what do they have in common? Eur J Psychotraumatol. 2015;6:28186. doi:10.3402/ejpt.v6.28186 Kim YR, Choi HG, Yeom HA. Relationships between exercise behavior and anger control of hospital nurses. Asian Nurs Res (Korean Soc Nurs Sci). 2019;13(1):86-91. doi:10.1016/j.anr.2019.01.009 By Matthew Tull, PhD Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for PTSD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.