The High Cost of Anger, Part I

Unrestrained anger takes a high toll on our health and well-being.  

My experience leads me to believe that alcoholics and addicts are particularly prone to angry outbursts. Caught in the throes of addiction, we often succumb to delusions of grandeur and project an attitude that lets others know “It’s my way or the highway!” Abuse of alcohol and other drugs also makes many people highly irritable. This is due, in part, to serious nutritional imbalances and disruption of sleep accompanying addictive behavior. Substance abuse also impairs our cognitive ability and the desire to keep our anger under control. Unfortunately, many alcoholics and addicts carry their predisposition to unhealthy anger expression over into their recovery.

In understanding the negative impact of inappropriate expression of anger we need to distinguish between healthy and unhealthy anger expression. From time to time we all encounter circumstances where it is healthy and even desirable to express our angry feelings. An example that immediately comes to mind is when someone is verbally abusing us and appears totally oblivious concerning the inappropriateness of their behavior. In the interest of maintaining respect for our legitimate boundaries, in such a situation it is appropriate to tell the offender “You know, what you are saying right now is really upsetting me. Please stop!” This response provides a good example of healthy expression of anger in the form of reporting our feelings, which allows us to communicate our anger in a civilized manner without going overboard. 

By contrast, unhealthy anger expression typically “lets it all hang out” and is often delivered with the intent of taking away the recipient’s dignity. Unhealthy anger expression is abusive and is often manifest in the form of extreme verbal, emotional, and/or physical abuse. It often takes the form of “blowing up” with total disregard for the feelings and sensitivities those around us.  More often than not the intensity of the outburst is quite disproportionate to the precipitating incident.  

Let us now examine the high costs of uncontrolled anger as it impacts our health, social relations, sobriety maintenance, and our overall sense of well-being.

Growing evidence suggests that unhealthy anger expression increases our susceptibility to a wide variety of illnesses, including heart disease, stroke, hypertension, stomach ulcers, and other gastrointestinal disorders, and possibly various forms of cancer (Hafen, 1996).

Research conducted in the 1950s by cardiologists Rosenman and Friedman, which followed over three thousand healthy adult male subjects over an eight-and-a-half-year period, provides a classic illustration of the price of excessive anger in terms of dramatically increased risk of heart disease. At the onset participants were classified into two personality groupings, the overly driven “Type A” personalities and their more relaxed “Type B” counterparts. Friedman suggests that Type A behavior is manifest in three major symptoms: free-floating hostility, chronic impatience, and an exaggerated competitive drive (Friedman & Rosenman, 1959).  

Based on data from this long-range study, the authors estimated that Type A behavior doubles the risk of heart disease—the nation’s leading cause of death—in otherwise healthy individuals. More recent research indicates that within the Type A syndrome the behavioral components most associated with increased risk of heart disease include anger, hostility, cynicism, and suspiciousness.

The Rosenman and Friedman study and subsequent research provide sobering data concerning potential consequences of unhealthy expression of anger affecting our health. This is underscored by Meyer Friedman’s estimation that three-fourths of urban men are Type A, and that Type A behavior is becoming increasingly common among women (Friedman, 1996). 

Recent literature is replete with references to adverse health repercussions linked to unhealthy anger expression. Dr. Bradley Bale and his coauthors of Beat the Heart Attack Gene, offer the following advice: “If you’re prone to high blood pressure, one of the smartest things to do when angry is to check it . . . Individuals who become angry should know how their blood pressure responds. If it’s going up, they need to work diligently to manage their anger with exercise, better sleep, and biofeedback techniques” (2014).

Recently the Los Angeles Times reported on an eleven-year study of ten thousand Danish adults aged thirty-six to fifty-two at the study’s onset, designed to test for a possible association between chronic argumentative behavior and premature mortality. Shockingly, findings indicated that middle-aged adults who frequently fought with their spouses were twice as likely to die at a relatively young age compared with people who rarely fought. In aggregate, people who fought frequently with friends were 2.6 times more likely to die prematurely than people who got along with their pals, while subjects reporting frequent fights with neighbors had a three-fold likelihood of dying prematurely (Kaplan, 2014).  

While somewhat controversial, a growing body of research has emerged concerning a possible link between chronic suppression of anger and increased likelihood of cancer. Drs. Lawrence LeShan and Bernie Siegel, who have both extensively researched the mind-body connection and cancer, report observations that many people who have cancer have a tendency to refrain from expressing their anger, to suppress their emotions and be overly compliant (Duffy, 2004). Dr. Lydia Temoshok, the director of behavioral medicine at the University of Maryland Medical School, has reviewed numerous studies concerning a possible association between cancer and personality traits, and reports that the most common observations are that cancer appears to be more prevalent among people who may be described as “overly nice” with a marked tendency to suppress their anger (n.d.).

 

Unhealthy anger expression obviously takes a heavy toll on the quality of our relationships with spouses and other family members, friends, coworkers, and business associates, not to mention the price we pay in terms of diminished life satisfaction. In addition, it can be a major contributor to job loss and career derailment, as few bosses or associates are willing to indefinitely put up with a chronic “loose cannon.”

I also believe that habitual unhealthy anger expression is a significant contributing factor to relapse to drinking and drug use, as well as failure on the part of many alcoholics and addicts to recognize their problem and seek appropriate treatment. Simply put, chronic rage significantly impairs our ability to take an honest look at ourselves and undertake corrective action.  

The next and final installment in this two-part series will present suggestions for minimizing the adverse consequences of unhealthy means of expressing our anger as they affect our health, sobriety maintenance, and overall well-being. In the meantime, I encourage you to reflect on your own patterns of dealing with anger, together with possible steps you may want to take toward modifying this behavior. Until next time—to your health!

Bale, B., Doneen, A., Cool, L. C., & King, L. (2014). Beat the heart attack gene: The revolutionary plan to prevent heart disease, stroke, and diabetes. New York, NY: Wiley.

Duffy, N. (2004). A cancer-prone personality? Retrieved from http://www.journeythroughcancer.org/CanerProne

Freidman, M., & Rosenman, R. H. (1959) Association of specific overt behavior pattern with blood and cardiovascular findings; blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. JAMA, 169(12), 1286–96.

Freidman, M. (1996). Type A behavior: Its diagnosis and treatment (pp. 31). New York, NY: Springer. 

Hafen, B. O. (1996) Mind/body health: The effects of attitudes, emotions, and relationships. Boston, MA: Allyn and Bacon.

Kaplan, K. (2014). Excessive arguing with family and friends may lead to early death. Los Angeles Times. Retrieved from http://www.latimes.com/science/sciencenow/la-sci-sn-conflict-with-family-friends-early-death-20140508-story.html

Temoshok, L. (n.d.) Unraveling the ‘Type C’ connection: Is there a cancer personality? Retrieved from http://www.healingcancer.info/ebook/lydia-temoshok