All the rage

By R.J. Ignelzi, SignOnSanDiego.com

After waiting in line at the airport for 20 minutes, you step away for 10 seconds to throw a gum wrapper in the trash. In your brief absence someone boldly takes your place and refuses to let you back in line. Do you:

A. Scream obscenities and take a swing at the interloper with your carry-on bag?

B. Glare daggers and then silently shuffle to the back of the line?

Hopefully, your reaction is somewhere in between the extremes because exploding or imploding with anger can lead to major health problems and even death.

“Anger is the most lethal emotion from a heart-health perspective,” says cardiologist Dr. Mimi Guarneri, medical director for the Scripps Center for Integrative Medicine. “Research shows that one angry outburst increases the risk for heart attack by 230 percent.”

That statistic, alarming as it is, is only part of the story, and it seems that an increasing number of people are lashing out in anger these days. Between angst over job losses and home foreclosures, frustration over deteriorating retirement accounts and irritation over injustices (think AIG’s million-dollar bonuses), fuses are short and tempers are hot.

“People are frustrated and worried. They feel that things are happening to them and it’s overwhelming,” says Carol Jackofsky, a licensed clinical social worker and director of workplace communications at Scripps Memorial Hospital in La Jolla. “If they don’t have a good outlet for their frustration, if they can’t communicate it or if they feel misunderstood, that’s when they often react in anger.”

Handled properly, anger isn’t a bad thing. It actually can be healthy to feel some anger to protect you from dangerous situations and motivate you to resolve problems.

“Anger is a normal emotion that everyone feels no matter what race, sex or culture,” says Dr. Fadi Nicholas, a psychiatrist at Sharp Mesa Vista Hospital. “Anger becomes a bad or unhealthy feeling when it’s not expressed constructively.”

When you experience chronic anger or hostility, your body produces stress hormones that have a negative effect on your health. Adrenaline raises cholesterol, narrows the arteries, raises blood pressure and increases the heart rate. Cortisol, another stress hormone, leads to weight gain around the waistline, diabetes, cognitive decline, osteoporosis and an inability to fight infection and illness.

Researchers find that people who remain angry and irritable much of the time also tend to have a less healthy lifestyle. Angry people are usually less physically active, neglect nutrition, hygiene and sleep, smoke more and drink more alcohol.

And just because you suppress your anger doesn’t mean you’re any healthier than someone who throws a raging tantrum.

“If you stifle anger and you’re fuming inside, it still raises your blood pressure and it does the same (damage) as if you exploded,” Guarneri says.

Although our innate temperament and personality play a role in how we react to stressful situations, it’s what we learned or experienced growing up that largely determines our anger response.

Typically, people who are easily angered come from families that are disruptive, chaotic and not skilled at emotional communications.

“We learn certain things from the people who raise us. Coping skills and how to resolve conflict are things we learn as children. So, if conflict was resolved through anger in your childhood, then you learn anger,” Guarneri says.

People can get into the habit of explosively displaying their anger, so that they don’t even realize how they’re coming across and that they’re hurting other people, relationships and themselves.

HOW TO RETOOL YOUR REACTIONS TO STRESS
Dr. Mimi Guarneri, a cardiologist and medical director for the Scripps Center for Integrative Medicine, recommends that everyone have a “healthy toolbox” of the following resources or coping mechanisms to help stabilize and calm stressful situations that may produce an angry response.

Communicate the problem calmly. It’s important to be assertive, not aggressive, in a situation that could become heated. State your concerns and needs clearly and directly without hurting others or trying to exert power over them.

In the example of someone rudely cutting into line at the airport, an appropriate response might be to calmly explain your situation to the person or to an airport or security manager.

Be aware of and acknowledge your angry feelings. Is your voice rising? Is your facing getting warm? Is your neck tightening? Is your breathing more rapid? The more aware we are of the early symptoms of disappointment and irritation that can quickly lead to anger, the more likely we can take steps to solve the problem, decrease our anger and prevent a potentially violent scene.

Disengage yourself from the stressful situation. Take a timeout. When you realize things are getting heated and someone’s pushing your buttons, do some deep breathing (count 5 seconds as you slowly inhale from the diaphragm and another 5 seconds as you slowly exhale).

Recite a mantra to yourself. “If you get into a mental cycle of going over and over (the stressful situation) in your head, recite a calming word or phrase silently to yourself,” Guarneri says. “Research shows that people who recite mantras are calmer, less anxious, sleep better and have a better sense of well being.”

Think loving thoughts. “Before you say something stupid that you’ll regret, do some deep breathing and think about something you love or appreciate, like your dog or your grandchild,” Guarneri says. “These thoughts shift your perception and let you look (at the situation) through a new set of lenses.”

Talk it out. “Talk over everything that happened with someone you trust and who understands you,” says Carol Jackofsky, a licensed clinical social worker and director of workplace communications at Scripps Memorial Hospital in La Jolla. “Discuss your frustrations, what made you angry and how you could have handled it differently. Once you get it out, then you can start to heal.”

Make sure your “emotional account” has plenty of reserves. “Like a savings account, you don’t want to be bankrupt in emotions. If you’re not eating or sleeping well or have unhealthy relationships, you will eventually be emotionally bankrupt,” says Dr. Fadi Nicholas, a psychiatrist at Sharp Mesa Vista Hospital, and that’s when anger flares.

“You need to keep your emotional bank account full – exercise, sleep enough, eat right – so you have something to fall back on when something goes wrong.”

Restructure the way you think. Be more positive and more realistic in your expectations. Try not to use the words “never” (“You never help me with housework”) or “always” (“You’re always late”). If you absolutely demand fairness, appreciation, etc., and these demands aren’t met, your disappointment could become anger.

Use humor to deflect anger. “The healthier you are emotionally, the easier it is to make fun of yourself. Try to laugh off (what’s making you angry) as much as you can,” Nicholas says.

Practice the golden rule. “Use religion or whatever system you want to bring yourself back to a more transcendental way and try to treat other people like you’d want to be treated,” Nicholas says.

Work up a sweat. “Exercise will make your fuse longer. It gives you more energy and makes you feel better about yourself,” Nicholas says.

If heart-pounding cardio isn’t your exercise cup of tea, then practice yoga or tai chi, or just slowly stretch your body to help relax your muscles and make you feel calmer.

Write it down. “Journaling can help you better understand (the situation) by simply putting it in writing. It often doesn’t look as bad as you think it is,” Nicholas says.

Limit your caffeine. If you seem to be on edge and anger easily, try cutting back on coffee and other caffeinated beverages, which can keep you revved up.

Consider getting professional help. If your anger seems out of control, is hurting your relationships or has escalated into violence, you may benefit from seeing a psychotherapist or an anger management professional. Role-playing in controlled situations, such as anger management classes, can help you practice your coping techniques.