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 July 11, 2020 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 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. Overview Keep in mind that anger is only one symptom of PTSD; in fact, it's not a requirement for receiving a PTSD diagnosis. Although it can be, it's not always violent, either. 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. Let's take a deeper look at anger in PTSD. There are a number of situations where it tends to occur and some ways to help keep it under control that you will find helpful. Disclosing Your PTSD Diagnosis Hyperarousal Symptoms of PTSD Andy Smith/Getty Images 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 sleeping, irritability, and hypervigilance. There are, however, ways to cope with each of these. Hypervigilance in PTSD and Other Disorders Constructive and Destructive Anger in PTSD Halfpoint Images/Getty Images 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. 11 Anger Management Strategies to Help You Calm Down Anger and PTSD in Combat Veterans Westend61/Getty Images The conflicts in Iraq and Afghanistan have taught us more about their impact on men and women in military service. It's become clear that veterans are at risk for a number of mental health problems, including PTSD and extreme anger. Yet, it's key to remember that you are not alone in this. There are a variety of treatment options available and other vets that are feeling the same way. 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 PeopleImages/Getty Images 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 is abusing or will abuse their partner. However, if you or someone you know is a victim of relationship violence, it's important to know there are resources available. Unfortunately, research has found a connection between PTSD and relationship violence. On a yearly basis, between eight and 21% of people in serious intimate relationships take aggressive actions against their partners. Self-Destructive Behaviors in PTSD jupiterimages/Getty Images 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 the 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. While this is common with PTSD, there are ways to cope with it that you'll want to know. Forms of Self-Harm Common in People With PTSD Anger Management Techniques Westend61/Getty Images As you probably know, 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 and mitigate or forget it, it's a good idea to learn useful anger management techniques. Included in these are simple things like exercise, practicing mindfulness, and finding someone you trust to talk things out with. 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. How Anger Can Affect Your Health Taking a Time-Out From Anger Thomas Barwick/Getty Images Within those useful anger management skills is the suggestion to take a "time-out" when you feel yourself starting to get angry. It's an easy skill to learn. 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 for relief and an excellent strategy for their relationships. Using Self-Soothing Skills for Anger JGI/Jamie Grill/Getty Images Have you heard about using self-soothing skills to help manage your anger? They're easy to learn and use because they're designed to make you feel better, and you do them on your own. 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 about something other than your anger, your mind and body naturally become calmer. Seeking out Social Support Barry Rosenthal/UpperCut Images/Getty Images 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. Of course, it's important to make sure that you 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. Find Help With these Online Anger Management Classes Anxiety Management Skills JGI/Jamie Grill/Getty Images 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. 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. 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. What Happens in Anger Management Classes? 7 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 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 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. Published 2015 Aug 14. doi:10.3402/ejpt.v6.28186 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.