Depression, anxiety & mood
Let it out — the power of anger
by Marcelle Pick, OB/GYN NP
Are you a hothead, or cool as a cucumber? Interestingly, how women cope with anger is a critical factor in predicting their long-term health. According to a classic psychosocial epidemiological study, suppressed rage is linked with higher mortality rates, elevated risks of certain cancers, high blood pressure and cardiovascular disease in both men and women.
The difficulty with anger in women is that although it is a perfectly natural emotion, few women are taught to express it in a positive way. As girls, many of us were cautioned that anger is “unladylike,” and expressing it should be avoided at all costs. As adults, these women may have trouble untangling their anger from a knot of other emotions, like anxiety and depression. Younger women may have been raised under looser constraints, yet still find themselves bewildered, guilty, and depleted by their angry feelings, which can simmer just beneath the surface, or explode uncontrollably at random moments.
Anger is extremely powerful. It helps us clarify objectives and propels us to safety — but it can take a big toll on our health, happiness and loved ones. The key to getting the full benefit of anger is to understand its biological and emotional roots, and then to make the necessary changes to put you — not your rage — back in control.
The fight in “fight or flight”
Why do we call the instinctual response to danger “fight or flight”? Because fear makes us flee and anger makes us ready to fight — both primal emotional reflexes (as opposed to moods) that evolved to ensure our survival as a species. Two almond-shaped structures in our brains, called the amygdala, are responsible for recognizing potential danger and sounding the alarm. If a threat is perceived, the central nervous system responds by opening up the physiological floodgates, often before the thinking, executive part of our brain (the prefrontal cortex) becomes aware of what is happening.
When you grow angry, neurotransmitters inside your brain called catecholamines are released, which give you a jolt of energy and clarity that lasts about five to ten minutes. Your heart pounds, your blood pressure shoots up, and your extremities are juiced with extra blood flow. As your reactions ramp up in a rush of adrenaline, norepinephrine and cortisol, you enter a temporarily altered state of consciousness, where you are ready to engage. Some people stop thinking (rationalizing) altogether, which is why it can be so hard to recall what you said when you were really angry.
This physiological anger mechanism is the same in all humans. What differs at any given time is the individual’s capacity to govern this instinct. And this depends on many different factors, both physiological, biographical, and emotional — not to mention learned, gender-related behavior.
Anger and women
Men are generally cut a lot more slack when it comes to their anger, in part because society accepts and “relies” on their aggressiveness for protection. While many can condone a man who explodes, women who voice their anger are often looked down upon.
Biologically, the “male” hormone testosterone has been associated with aggression and irritability in men, at both low and high levels. Women with a testosterone imbalance may evidence a similar tendency to blow. They just usually express it differently. However, it’s still unclear whether people who are angry have more testosterone as a result of generating it while angry or because a dysregulation in their testosterone levels might cause excess anger.
What is clear is that men are far more likely to strike out at another person or object in anger, whereas women are more prone to express anger indirectly or at themselves. Younger women are now given more leeway to externally express anger and are doing so — but it’s often misdirected toward a “safe” target (like a spouse or child) instead of the real source. In my experience, many guilty feelings in women can be traced back to misdirected anger, and studies on gender and anger show that women most often feel shame, guilt and resentment in response to angry outbursts.
Interestingly, the same health risks that apply to men (increased risk of cardiovascular disease, stroke, hypertension and social isolation) equally affect women when they become more hostile or have a “type A personality,” described as being competitive, impatient and aggressive. Anger may help you climb the ladder to success, but at what cost?
Keeping your anger in is no picnic, either. Stifling angry feelings doesn’t make them go away — in fact the opposite is true. The same physiological response occurs, with all the accompanying risks, whether or not you actively berate someone. The more you try to bury anger, the more likely it is to emerge in some other garb, such as anxiety, depression, irritability, resentment, chronic pain, and addictive or self-destructive behavior.
So when is expression of anger healthy and positive for women? The answer lies in understanding what triggers your anger: knowing what bugs you and what will help you train your prefrontal cortex to govern your anger appropriately. Then it can be expressed at the right time and in the right place, and not wasted on shame, guilt and resentment.
Common roots of anger in women
Even though anger is a primitive reflex and may be influenced by our experience in utero, the biggest triggers are actually learned behavior. If you were raised by an angry parent or in an explosive or alcoholic household, chances are your brain has a hair-trigger stuck on “angry” mode.
Similarly, you may also carry the legacy of a parent who was passive-aggressive or controlling, or who suppressed her own anger. Many times the problem is emotion that is buried deep inside. Experiencing or witnessing physical or emotional abuse, for example, can result in suppressed anger and rage that may not appear for years. A child instinctively models the behavior of her parents, and may grow up to pass the behavior on — unless she consciously decides to change that legacy.
Then there is the “good girl syndrome.” Maybe there was one explosive parent, and the prevailing atmosphere was that something terrible might happen if you weren’t good — all the time. And no matter how far we may have come, women today are being silenced by innumerable subliminal messages. How often do we hear comments such as “Let’s not be too bitchy,” or “Is it PMS?”
But there are many less abstract triggers, as well. One much overlooked cause is diet. We recommend three balanced meals and two snacks each day to help keep moods stable. Anyone who has skipped a meal and wound up overreacting or snapping at someone knows firsthand that being hungry affects your mood. While the result is more typically irritation than anger, if you are susceptible to bouts of anger, a mood change may be the first step in your anger cascade process. Eating regular, healthy meals throughout the day can prevent overly emotional reactions that are simply a response to your body’s need for nourishment.
In addition, it’s not just when you eat, but what you eat that matters. Studies indicate that the standard high-fat, high-sugar American diet can make the whole family cranky! According to researchers at the State University at Stonybrook and Oregon Health Sciences, families who ate a diet low in damaged saturated fats (the kinds in fast foods and overly processed, packaged foods) experienced a reduction in depression and aggressive hostility, as well as lower cholesterol levels.
To achieve this kind of effect, balanced meals that include lean proteins, healthy fats and plenty of fresh, non-starchy vegetables are ideal. When a meal is balanced, it’s more likely to have a low glycemic load, which allows your body and temper to remain on slow-burn mode. By maintaining steadier insulin and serotonin levels throughout the day, foods low on the glycemic index encourage a calmer mood state. Even as adults, we are more vulnerable to temper tantrums when overdosing on high-glycemic foods like simple sugars — at least when under stress.
What’s more, excessive unhealthy fats, refined sugars, and toxins put stress on the liver. To digest these foods, the liver creates more bile — thus the adjective “bilious,” meaning peevish and irritable! An overworked liver directly affects mood. In Traditional Chinese Medicine, the liver is responsible for creating a relaxed and harmonious internal environment through the smooth disbursement of bodily fluids. “Flying off the handle” is attributed to liver disharmony, while a sudden shift in emotions can affect the function of the liver.
Low serotonin is another underlying cause of anger that can be traced to poor diet. At Women to Women, we regard depression as anger turned inside on oneself. Antidepressants may temporarily boost serotonin levels and mood, but do not provide a long-term solution if the anger goes undiagnosed. If you think you are depressed, you may be benefit from examining your relationship to anger, how well you express it (if at all), and how things might change if you allowed yourself to explore those feelings.
Both depression and anger can also be influenced by hormone imbalance, which is a big reason why so many women experience these twin emotions during perimenopause and menopause.
Hormones and anger
Sudden mood swings and irritability are two of the most common symptoms of hormonal fluctuation, whether they occur during pregnancy, PMS, perimenopause or menopause. In the body, anger creates pro-inflammatory molecules. The hormone estrogen has some anti-inflammatory qualities, and the hormone progesterone has an overall calming effect on our physiology. This may help explain why so many women find themselves in fits of rage as their progesterone-to-estrogen ratios become erratic during the perimenopausal transition. Other women may have cortisol dominance or a testosterone imbalance contributing to their anxiety and hostility.
Many of my patients have their first real experiences with anger during perimenopause and menopause — and they are often surprised and scared by the venom in their reactions. Changing hormones present a challenge to the flexibility of the endocrine system, and, similar to the days before our periods started — when a hormone shift allowed our “true” feelings to rise to the surface — menopause is a time when the curtain is lifted to reveal who is really directing the show. For many women, it is anger.
But instead of being frightened and tamping down your temper, try to see it as a source of power. After all, anger is the emotion that helps you stand your ground and fight for what is rightfully yours. What better time than midlife to make that stand?
The challenge then becomes to channel that anger in a way that serves your purposes.
Making the most of your anger — the Women to Women approach
No one likes to be around an unreasonably angry or irritable person. In fact, if we are always angry it ceases to have any power, and people will just tune us out. So, in order to access your anger and express it in a positive way, you have to train your prefrontal cortex to do its job — to think before you act if you tend to be impulsive or explosively angry; or, on the flip side, to ascertain when you are angry and tap its energy to serve your needs.
One of the first things to do is to rule out any physiological underpinnings to your anger, so you can focus on the emotion itself. Then you can explore ways to release your anger and move forward. (Note: It is rare, but pressure from a brain tumor can provoke aggressive behavior, so if taking action doesn’t help, check with your practitioner).
- Support your hormonal balance and serotonin levels with optimal nutrition. This includes a daily multivitamin/mineral complex rich in calcium, magnesium and a quality omega-3 fatty acid supplement. Reduce the amount of damaged fats, processed foods, and simple sugars in your diet. Make sure you are eating healthy fats, such as extra-virgin olive oil and foods rich in omega-3’s. If your anger is related to PMS or perimenopause, progesterone may help restore a healthy ratio between estrogen, progesterone and testosterone.
- Give your liver a break! In addition to eating a healthy diet, you can support optimal liver function by trying a detox program like our two-week Quick Cleanse. Avoid dousing anger with alcohol, which will only make you feel more irritable, angry, and depressed. You may want to look into liver-cleansing supplements or herbs like milk thistle and dandelion, to help heal and maintain the health of this crucial organ.
- Support your nerves. Cut back or wean off stimulants like caffeine and nicotine that heavily tax the nervous system. And again, be sure to get adequate amounts of omega-3 fatty acids, particularly DHA and EPA, which help “insulate” and protect our nerve cells.
- Use our Wellness Diary to track your anger pattern. Note whether you become irritable at certain times of the month, after eating certain foods, or under certain circumstances. These triggers are stressful to your body, and will set off your alarm. Learning to spot them in advance helps you retrain your reaction, giving the “thinking” part of your brain the upper hand. This is why counting to ten before you react really works! It may take practice, but working on it each and every time your anger emerges will make a big difference over time.
- Find ways to cope in the moment. Aside from counting to ten, you might try deep breathing, meditation, visualization, or physically removing yourself from the source of anger or conflict whenever it arises. Once you’ve made it through the eruption, you can take some time to clear your head. Then, when you feel calm and ready, you can fully explore your emotions and look for a way to release the anger completely from your physical body.
- Consider releasing anger through physical activity. It’s amazing how much lighter we feel emotionally after a good hard workout. But it need not mean a trip to the gym. You can turn the radio up in the car if you’re alone, and scream your head off. Pounding it out with a plastic baseball bat on a pillow, working it out on the punching bag in the basement, or the sheer hard work of gardening may also help you get clear of anger. Expressing anger in the physical plane — in a safe way — helps purge it from the body so it won’t come back to haunt you.
- Release anger through creativity. Depending on your personality and situation, a soothing activity that feeds your soul can be very healing. Allow your true colors to show through your creation — whether it’s a meal, painting, craft, song or dance — any creative pursuit that allows you unfettered self-expression can help you let go of your anger and move on.
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Voice your anger. Once calm, try speaking your truth and sharing your feelings about what happened. Without directing the anger at someone, you can discuss what happened, how it made you feel, and why you are hurting. If you do not feel comfortable talking, writing it all down in a letter or journal can be cathartic. This may also be a good way to revisit your anger patterns over time, allowing you to see common triggers and reactions emerge.
Once you’ve released this pent-up, primitive emotion, you’ll be able to act in a rational and powerful way that won’t leave you feeling guilty. You may then decide to channel your emotions into creating change and making things better — be it in your home, your community, or the world.
- Don’t be afraid to ask for help. Anger is a complicated emotion, one that may have been building up inside you for years. If you are having trouble deciphering your feelings or identifying your anger patterns on your own, consider EFT, the Quadrinity Process, or talking to a therapist to help you unravel your anger. Once you know what your true feelings are and where they come from, you can develop tools for coping with them.
Putting anger in its place
I love angry women. I think they are the source of change for the better on this planet. It’s anger that marches on Washington, anger that finds missing children, anger that fights injustice and intolerance. But misplaced or sustained anger saps real anger of its power and damages your health. So I encourage you to take some of these simple steps to put anger in its rightful place and make your temperament work for you — not the other way around.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.
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References & further reading on anger
Original Publication Date: 09/19/2007
Last Modified: 01/11/2008
Principal Author: Marcelle Pick, OB/GYN NP