Have you ever wondered why some people get angry without warning and for little to no reason? These individuals are considered “rageaholics,” but some of them may be diagnosed with intermittent explosive disorder (IED). Interactions with individuals who experience this may be negative or even abusive. They can present with bullying behavior, physical aggression, rudeness, and sometimes, domestic violence.1
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Signs of a Rageaholic
Individuals who are considered rageaholics or who experience IED can span in age from children to older adults; however, it is more common in younger individuals. Their experiences can be quite scary to observe, especially for someone who has never seen it. In children, signs of being a rageaholic generally begin around 12 to 14 years of age.2
Signs of an angry outburst in children are:3
- Tantrums
- Tirades
- Significant arguments
- Shouting
- Fighting
- Threatening or attacking people or animals
- Damaging their own or other’s property following anger cues like increased heart rate or closed fists
For adults, signs of outbursts are similar to those in children, although they may also include impulsive and physically or verbally violent behavior. Typically, the angry individual’s reaction is significantly mismatched with the situation itself. Indicators of these outbursts can also include domestic abuse, throwing and/or breaking things, and road rage.1
Signs of an angry outburst in adults are:
- Irritability
- High energy levels
- Shaking
- Racing thoughts
- Increased heart rate
- Rage
Signs of rageaholics or IED are seen in over 16 million Americans, and studies suggest that males may be more aggressive than females. They further suggest that while males and females can be equally aggressive, males are more anger-responsive to provocation whereas women may respond with non-aggressive behaviors.1,4
Health Risks of Being a Rageaholic
Individuals who are rageaholics or have IED experience a number of physical and mental health risks as a result of angry outbursts and behaviors. These risks, which include high blood pressure and physical injury, can occur over the short and long-term and impact their life in a number of significant ways.
Short-Term Risks
For individuals who experience these outbursts, short-term consequences include unhealthy changes in the body, trouble maintaining relationships, and being arrested.
Short-term health risks of being a rageaholic include:1
- Increased blood pressure
- Difficulties with interpersonal relationships due to mismatched responses and aggression
- Difficulties with mood related to stress of not being able to manage one’s emotions and reactions
- Difficulties with school or career and income due to reactive behaviors leading to not being able to maintain classes or work schedule
- Risk of physical injuries as a result of the verbal and physical aggression that may occur for certain individuals
- Risk of being arrested due to these behaviors, especially with physical fighting and threats
Long-Term Risks
Long-term risks of rage can be significantly dangerous to an individual’s physical health as well as their ability to function and maintain a healthy, happy life.
Long-term risks of being a rageaholic are:1
- Unfinished education, especially if individuals do not have a lot of support in schools and drop out
- Instability in work history and employment due to difficulties with maintaining appropriate behaviors in the workplace
- Difficulty maintaining relationships and poor social skills due to continuous anger and difficulty with communicating concerns in relationships
- Difficulties with alcohol as well as other substances and potential abuse
- Instability in mental health, especially in increased risk of self-harm or suicide related to these behaviors, as well as increased risk for a mood disorders over time (depression, anxiety, etc.)
- Difficulties with managing physical health, including increased risk for diabetes, heart disease, stroke, chronic pain, and ulcers
- Potential for incarceration in prison due to behaviors
Underlying Causes for a Rageaholic
Understanding the influence or drive of one’s rageaholic behaviors (e.g., abuse, stress, and familial history) can help the individual become more self-aware, reduce their short- and long-term risks, and improve their quality of life.
Causes for becoming a rageaholic may include:1
- Growing up in a verbally or physically abusive environment
- Growing up in an anger-filled environment
- Having a family history of rage or IED
- Differences in brain structure, specifically limbic system and frontal lobes
- Trauma to the brain or head
- History of other mental health disorders, especially those with impulse control, disruption, or personality issues that can impact their ability to function
Potential Rage Triggers
Before an episode of rage, someone may be triggered by:5
- Stressful situations in which an individual may not be able to predict the outcome or control their anxiety about the outcome
- Non-verbal body language like seeing people roll their eyes, being stared at, closed arms, or being crowded
- Verbal cues such as being interrupted, teased or bullied, threatened, yelled at, or mocked
How & When Does Normal Anger Become Rage?
Typical anger responses and rage outbursts differ in a number of ways, especially in regards to individuals’ behaviors related to their emotions. Where normal anger may simmer over time and come out in conversation, rage outbursts are less predictable. This anger will appear suddenly and without adequate observable reason. Outbursts of rage are also typically shorter (30 minutes or less) but more difficult to endure.1
Where normal anger may look like raised voices or yelling at its most extreme, rage outbursts can be much more dangerous. This level of anger and rage also looks like yelling, but can include explosive physical and verbal aggression, throwing and breaking items, tantrums, road rage, and domestic violence.1,6
Treatment For Rageaholics
Treatment options for rageaholics include inpatient treatment, outpatient treatment, therapy, medication, and learning and applying coping skills for anger management.
Inpatient Treatment
If rageaholics find themselves being arrested, physically and verbally aggressive, or continuously argumentative with their support system, they may benefit from residential programs. They would stay there daily and work with individual and group therapists. They would also potentially be monitored for medication or guided and encouraged in exercise and self-care.
By engaging in these residential activities, rageaholics will learn how to express their emotions, increase self-control, become more self-aware about triggers, and manage anger without suppressing emotion.7
Outpatient Treatment
For people who are not a threat to others and/or can’t stop their routine, intensive outpatient treatment can help. In these programs, the individual will attend intensive individual therapy and potentially move to a more regular schedule of sessions. This allows them to experience their regular routine while learning how to manage and cope with their emotions and increase awareness of their triggers.
It is also not uncommon for outpatient individuals to attend 12-step rageaholic group meetings to increase their support system and engage in conversation with others who have experienced rage and outbursts.6,7
Cognitive Behavioral Therapy (CBT)
The most common type of therapy for anger management is CBT. The goal is to increase awareness of negative thoughts behind the anger, help identify the connection between behavior and outburst, increase communication skills, learn how to problem-solve, and increase the ability to handle stress. CBT generally lasts about twelve to twenty sessions, although this can change depending on the treatment plan made with the therapist.6,7,8
Group Therapy
Other options for therapy exist as well, including group therapy, which focuses on these goals with a number of people instead of individuals. Group therapy tends to occur for about ten to twelve sessions, depending on the program, and assists in providing a place for feedback.
Medication
Although therapy is one of the most commonly provided interventions for individuals with rage outbursts, medication can also help them reduce their outbursts, increase mood stability, and reduce other potential symptoms that may be influencing the rage.
Medication can only be prescribed by a psychiatrist, primary care physician (PCP), or advanced practice nurse. Broadly, medications to manage emotions and anger include anti-anxiety meds, antidepressants, mood stabilizers, antipsychotics, and anti-seizure medications.7,8,9
7 Techniques to Use at Home
There are a number of interventions that exist for individuals with rage outbursts, including CBT, group therapy, and medication; however, individuals can also manage their rage outbursts with at-home techniques like meditation and relaxation practices.
Seven techniques to use at home are:1,10
- Relaxation and breathing techniques: Grounding exercises, deep breathing, meditation, or imagery can help slow the heart rate and lower reaction time in rage
- Complete a body check: Scan yourself for warning signs that anger or other intense emotions are rising; once this is done, try applying relaxation techniques or walking away
- Walking away and changing the environment: If anger and rage cues are visible, walking away can help reduce stress and anger and allow for a moment to de-escalate emotions
- Challenging negative or stressful thoughts: Before reacting, practice countering angry urges with rational thoughts about the situation
- Practice communication skills: Especially when emotions start to increase, try to listen to the other person and take a moment to respond without reacting
- Work out or do something active: This can help lower stress levels, get rid of tension in the body, and help people to process their emotions
- Reduce or avoid the use of substances: Limit intake of alcohol or drugs, especially if a history of angry reactions tends to coincide with their use
How to Get Help for a Rageaholic
Options to help a rageaholic include encouraging them to enroll in therapy and explore self-help or support groups, helping them practice coping techniques, and urging them to consider and maintain therapy or medications.
It can be helpful to explore whether there are triggers or warning signs to their outbursts. If you’re in the same household, you may be able to help guide the individual to a calmer state of mind if these warning signs begin to show. It’s also helpful for everyone to practice their communication skills to reduce misunderstandings and increase healthy interactions.
How to Get Help For a Teen
Because teenagers may not recognize their rage as easily and have difficulty keeping themselves and others safe, risk may be increased. Try enrolling them in therapy or support groups to help them manage their emotions and anger in a safe and healthy way.
Other ways to help teenagers to express their emotions and anger are:
- Encourage active behavior: This could include going for a walk, hitting a punching bag, or getting involved in sports
- Encourage personal time: Especially if the teen is becoming aware of their warning signs, help them calm down and de-escalate
- Help them identify triggers to their emotions: This way, they can learn how to identify when they need to calm down
- Explore ways to express anger: Expression could be through music, art, or some other activity
Final Thoughts on Rageaholics
Whether you are a rageaholic or your loved one is a rageaholic, you are not alone. There are options for help like therapy, medication, support groups, practicing techniques, or even talking with family and friends to figure out options to increase everyone’s quality of life.
Additional Resources
- Rageaholics Anonymous: A support group that is provided via phone at this time and is accessible to anybody. It is similar to other 12-step programs and may be helpful to you or your family
- Band Back Together: A great mental health website that focuses on destigmatizing the experiences of mental health, including anger and rage
- Online Therapist Directory: Sort therapists by specialty, cost, availability and more. Watch intro videos and see articles written by the therapists you’re considering working with. When you’ve found a good match, book an online therapy appointment with them directly.
Are you ready to connect with a therapist but feel a little overwhelmed by all your options? Speak with one of Choosing Therapy’s Client Navigators. Client Navigators are mental health professionals who will listen to what you’re looking for in a therapist and help pair you with the best possible fit. Getting started is free, easy, and confidential.
