Constructive And Destructive Anger In Post-Traumatic Stress Disorder: How To Cope With Your Fury

I once heard someone poignantly describe PTSD as a "horror show that never stops playing". As the brains of people who end up with this trauma-related anxiety disorder essentiallty force them to orbit the pain that caused their symptoms indefinitely, they get a "complete post-traumatic stress disorder" package they're never consulted about. Like a fog, it just takes over, not allowing us to see beyond. 

There are several reasons for this; though the diagnostic and statistical manual of mental disorders (DSM-5) neatly divides PTSD's possible symptoms into categories, all are interlinked. The kind of emotional numbness people with PTSD often experience takes positive emotions and those that make us feel vulnerable off the table, but that doesn't mean anger disappears, too. Anger is less painful than the fear, horror, or sadness that'd crop up if we fully allowed ourselves to acknowledge what happened, so we feel that instead. At the same time, the "survival mechanism" theory of the role anger plays in post-traumatic stress disorder holds that irritability, anger, and aggression serve safety in some way — they mean we're always ready to deal with threats. 

Finding healthier coping mechanisms and finding ways to let other emotions in again is hard work — and figuring out which aspects of your anger are destructive and which constructive can help make a dent in the task. How do you do that?

PTSD: What kinds of anger would be considered destructive?

The dark cloud I walked around in before I entered treatment for post-traumatic stress disorder was most certainly destructive. The anger was wholly reactive and did not discriminate. My default setting was mild irritation, and that could be turned down to total emotional anesthesia, or up to full-blown rage.

Things that made it worse for me, and that you may recognize if you have PTSD, included:

• Sudden and unexpected touches, even from people I wanted to be touched by, like my relatives. Sudden loud sounds, too. This is, of course, startle-response related.
• Immediate stresses, like a heavy workload, financial worries, fretting about needing to attend events with lots of potential triggers, and so on. The more worried I was, the more aggressive I'd be.
• Any internal or external reminder of the trauma would cause me to blow up. 
• Big crowds, and frankly, just people in general. 
• Not getting enough sleep, which was basically always. 

Though I tried to fight my instinctual irritated or angry reactions, let's just say that it took a lot of therapy before I was not angry more often than I was angry. People who had done nothing wrong and weren't in any way responsible for the trauma that led to my PTSD bore the brunt of that, and that wasn't fair. 

But some kinds of anger are constructive, too

The "fear avoidance" theory of PTSD-related anger holds that the rage people plagued by post-traumatic stress disorder live with is often the result of the disorder's avoidance symptoms. We feel fury so we don't have to be confronted with the much more painful emotions we could be experiencing instead, and that might break us if we were able to feel them. 

That explains, I think, why I was able to hold it together, albeit in an unpleasant and unhealthy way, until I started PTSD treatment — and then completely broke down, feeling all the pain, desperation, sadness, and vulnerability I had been able to keep at arm's length until then. When those feelings emerged from their box, positive emotions came with them. The anger didn't leave my life, but it was transformed. 

How can you cope with your PTSD-fueled anger?

PTSD-fueled irritability and angry outbursts can come in many forms. They can be self-destructive if they become a voice that tells you everything is your fault, if you seek an "out" through substance abuse, or if you engage in physical self-harm. They can strain and destroy relationships if they cause you to yell at people, whether in response to triggers or as a default setting. They can become outright dangerous, criminal, and even life-threatening if you find yourself physically aggressive. 

If your anger has taken on more extreme forms, you need help right now — you can't get this situation under control yourself and really have to talk to anyone who can get the ball rolling on treatment, whether that's your family doctor, a therapist, the VA, or even the emergency room. 

Even if your chronic anger has "only" made you a verbal and mental nightmare to be around for everyone in your life, including you, don't go it alone. Seek help, and if you're already in treatment, be sure to specifically talk about your anger so you can find ways to cope with it. Everything that brought you to this point has already happened, but I speak from experience when I say this state of mind doesn't have to last forever. 

PTSD-related anger is, at its core, just a symptom. It only makes sense that the underlying condition needs to be treated to allow you to get rid of it.

The road to a life in which anger no longer plays a defining role in your life may be a long one — and a painful one, too, as letting go of the rage usually means letting the most painful feelings in. It is a worthwhile road to take, however. I can't begin to explain how grateful I am that I'm no longer stuck there.