Anger: Don't Put a Lid on It
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Anger: Don't Put a Lid on It

Anger is a natural emotion. But when anger is mismanaged or hidden, it can cause health problems. Dealing with anger starts with not letting small annoyances build up to a raging fury.

Tommy Bolt, a golfer known for his fiery temper as well as his graceful swing, once gave a golf clinic and asked his 14-year-old son to step up and "show all the nice folks some of the things I taught you."

The teenager stepped onto the green and then obediently hurled a nine iron into the blue sky. Bolt often lost his temper and tossed his clubs like an angry child because he never learned anger management techniques.

A Gallon of Anger

Most of us have been taught that anger is a bad thing, and that people who express anger are somehow out of control. Experts say, however, that anger is no different than loneliness, desire, fear , or any of the many emotions you experience on a daily basis.

One way to understand anger is to imagine that you are carrying a bucket holding, let's say, a gallon of anger. As you go through your day, events and people will pour into your bucket a pint, a quart, two quarts or perhaps even half a gallon of things that make you angry.

"Anger doesn't just come out of nowhere," says Dr. Howard Glazer, PhD, clinical associate professor of psychology at Cornell University Medical College. "When your bucket is filled, it flows over, not into a puddle, but into an explosion of anger." And that explosion is what's dangerous to your health.

The likely result? You kick the dog, slam doors, chew out sales clerks, yell at your mate, or snap at the kids. One way to cope is to deal with small upsets as they happen. If an aggressive driver in traffic makes your blood boil, work off the anger later at the gym or by talking to a friend about lousy, rotten inconsiderate motorists. Or turn up the car radio loud and sing along with your favorite music.

A Threat to Your Health

Anger management is vital to your health because the chemicals released in your body during a temper tantrum are as dangerous to your cardiac health as smoking or a high-fat diet.

"I personally consider anger the Achilles heel of heart disease," says cardiologist Stephen T. Sinatra, MD, assistant clinical professor of medicine at the University of Connecticut School of Medicine and director of the New England Heart Center in Manchester, Connecticut.

It's probably no coincidence that the term we commonly use to express anger—feeling "mad"—is rooted in an early term for insanity. "The real threat happens when we deny anger and drive it underground, where it gradually changes into rage," says Dr. Sinatra, author of Heartbreak & Heart Disease. "Rage is the ugliest of all emotions because it is an uncontrolled fury that can be dangerous to ourselves and others." Unexpressed anger can stem from a major emotional injury in childhood, a divorce, a job loss, even a snub from a store clerk, or some other real or perceived insult.

According to Dr. Sinatra's research, the body retains anger, which can be a factor in arthritis, high blood pressure, cardiovascular disease, and other conditions. "A surgeon operating on a diseased heart can't tell if the patient ate a high-fat, high-cholesterol diet, or if he had simmering anger," says Sinatra. "The blockage in the vessels looks just the same." Moreover, he has found that many of his patients hide profound sadness, heartbreak, and hurt with seething anger.

A Threat to Family Health

Rage can also lead to shaken babies, battered mates, car accidents, and worse. While women tend to internalize their anger and become depressed, men are more likely to strike out and harm somebody.

"Nothing can be more provocative than a misbehaving child," adds Dr. Glazer of Cornell. "Because women spend more time with children, learning anger management is a first step to reducing physical violence against children. Anger management may be a misnomer; it is actually anger consequence management that should be learned."

Men and women who lash out in anger learned that response at home. They are also more likely to raise children who use violence when their anger goes unchecked.

Advice for Coping With Anger

Turn on the Waterworks

"Cry," says Dr. Sinatra. "Men and women who cry develop far less heart disease. Tears are the best remedy for detoxifying the body of hostility and excess anger."

Deal With the Little Things

Dr. Glazer often tells his anger management patients to keep notes on minor irritants and low-level annoyances that cause them to do a slow burn. "When you deal with little irritants as they occur, you create a little tap in your bucket that lets anger seep out, little by little," Dr. Glazer says.

The typical lists of exasperating things include snarled traffic, rude people, endless phone tag, brusque bosses, incompetent co-workers, and other seemingly trivial items. Research at Colorado State University reveals that about 75% of anger is caused by interactions between people.

Some people, however, have so much unresolved anger that they walk around with a virtually full bucket. So any small irritation causes them to blow their tops. "These persons basically have an emotional disability," says Dr. Glazer. Nonetheless, the great paradox in anger management is many people think they should not express anger. We can express ourselves in different ways from aggressive ones. We need to use assertive ways of expression, which basically implies we talk about our feelings and ask what we would like out of respect for the other person

Just Say No

One basic anger control technique is learning to say "no"—to set boundaries and stand by them. Other exercises may include using a louder-than-normal voice to express negativity, jutting out your jaw, and making a fist and using arm motions that strike out. But the only thing you actually hit is air or pillows.

Count It Out

Thomas Jefferson once advised when you get mad, count to ten before speaking. But he also said when you are really angry, count to one hundred. Deep breathing also often works because it can slow the heart rate and lower blood pressure.

Vent on Paper

If somebody ticks you off, many experts still advise writing a long poison-pen letter and then tossing it out.

Be Frank

Communication also works to clear the air when somebody pushes your buttons. Pull them aside and tell them in frank, unemotional language exactly why you are so upset. For example, "You probably didn't realize how your tardiness threw my schedule off kilter for the rest of the day."

And the next time the stranger next to you lights up a cigar, tell him exactly how his objectionable behavior makes you feel. "Do you mind? Cigar smoke gives me a headache." You'll feel better for it (and probably live longer).


American Psychological Association

Mental Health America


Canadian Mental Health Association

Canadian Psychiatric Association


Anger Management: Is there another way to express your angry feelings?. University Counseling Center website. Available at: Accessed July 25, 2008.

Faupel A, Herrick E, Sharp P. Anger Management: A Practical Guide. London, England: David Fulton Publications; 1998.

Last reviewed June 2008 by Theodor B. Rais, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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