Q. I have an anger management problem and don’t suffer fools well. Can you help me?

By on February 23, 2016


Many people request help for “Anger Management”, however, not all anger problems are the same. If the problem is not only when the person is drinking or coming off alcohol or drugs, then we need to search for some situational, psychological, or medical problem.

Situational problems are when persons have some stressful situation that is affecting other parts of their life, these are usually job-related, family, financial, or other social problems. One’s partner or spouse may have some problem irritating the person in question, but the irritation is usually only with that partner. The treatment in these instances is to alleviate the causative situation.

4155-165591Anger seen in psychological problems can span almost any kind of mental illness. It is commonly seen in depression, manic, or hypomanic episodes, attention-deficit hyperactivity disorder hyperactive-type (ADHD), and less commonly in persons with anxiety or panic. In depression or mania, irritability is usually present only when the person is depressed or manic, while in ADHD the person has always been irritable, impatient, and intolerant of others in a consistent way, although they may be able to subdue these feelings to some degree in social situations where it is expected to be polite. Note that it is  not necessary for persons who have ADHD hyperactive type to have obvious inattention so that the name ADHD can be misleading to the general public. Impatience itself is a type of problem in calmly paying attention to a situation. Each one of these conditions has specific treatments that may be a combination of psychopharmacology integrated with psychotherapy that can be applied.

Certain personality styles may also show anger and irritability when their needs are not met. Some persons have high attachment needs and are angered by separation in relationships, some persons need to be in control of others and are angered easily when others try to control them, and some persons get angry if they are not the center of attention. Education and psychotherapy may be helpful for these persons.

Regarding medical problems, persons who have stroke, dementia, or acute delirium may be easily angered, and persons in pain or those talking certain kinds of medications may become irritable. The many facets of medical problems and mood changes are too complex to discuss in this short article.

For your specific inquiry then, assuming you do not have substance use, a difficult social situation or a medical problem, the details of your moods and the time course and triggers to your angry episodes would need to be elucidated to then make a treatment plan.

Doug Berger, M.D.,
Director, Meguro Counseling Center
This article is for informational purposes only, please consult a professional for personalized care.

About Douglas Berger, M.D., Ph.D.

Dr. Douglas Berger and his staff at the Meguro Counseling Center in the Shibuya-Ebisu area provide mental health care for individuals, couples, and families, in both English and Japanese. www.megurocounseling.com