Home / Treating Alcoholism and Co-Occurring Disorders / Treating Anger Management & Alcoholism

Alcohol is often associated with increased aggression, anger, and violence. In fact, as published in a research article by the Association for Psychological Science, alcohol is a contributing factor in about half of all violent crimes committed in the United States. More than any other drug, alcohol is involved in many violent crimes, including rape, murder, spousal and child abuse, and assault, the National Council on Alcoholism and Drug Dependence (NCADD) publishes.

The journal Experimental and Clinical Psychopharmacology reports on studies showing that alcohol can increase aggression in both men and women, but more so in men. Alcohol impairs a person's executive functioning, making it harder for them to think clearly and make rational decisions. Impulse control is affected, and individuals under the influence of alcohol may have a shorter fuse than they otherwise would. This is not to say that alcohol causes aggression, or serves to makes someone angry, in and of itself; however, it may be a contributing factor when it comes to difficulties controlling these emotions. In addition, alcohol abuse and addiction can result in poor anger management skills.

Links between Anger, Aggression, and Alcohol Abuse

Some people are more prone to trouble controlling their anger while drinking than others. People who are more focused on the present than the future are more likely to become angry and aggressive under the influence of alcohol, for example, Science Daily publishes. Additionally, those who already have difficulties with executive functions and impulse control are more liable to become angry, aggressive, and violent when their self-regulatory skills are further impaired by alcohol, ABC warns.

Alcohol dependence can be closely tied to aggressive behaviors. The German journal Deutsches Artzeblatt International publishes that people who are dependent on alcohol also engage in violent behaviors around 16-50 percent of the time, and people who become significantly intoxicated at least once a year are twice as likely to be involved in violent behaviors over those who stick to moderate or low patterns of alcohol consumption.

There are several behavioral disorders that can involve anger management concerns that often co-occur with alcohol abuse and alcoholism. These include:

  • Bipolar disorder (BD): This mood disorder co-occurs with alcohol addiction around 30 percent of the time, the National Institute on Alcohol Abuse and Alcoholism(NIAAA) publishes.
  • Intermittent explosive disorder (IED): This mental health disorder affects around 7 percent of the population, as published by the National Institutes of Health (NIH), and it commonly co-occurs with alcohol abuse and addiction.
  • Oppositional defiant disorder (ODD): This behavioral disorder typically presents in childhood or adolescence, and may make a person more vulnerable to suffer from alcohol abuse and dependence later in life, the Asian Journal of Psychiatry
  • Antisocial personality disorder (ASPD): Individuals suffering from this disorder have a very high likelihood of also battling alcohol abuse and addiction. NIAAA publishes that those diagnosed with ASPD have a 20 times greater risk for also struggling with alcohol abuse and dependence than their peers without the disorder.

In addition to potential mental health disorders related to difficulties managing anger, there are several physical side effects of unchecked and chronic anger. When a person is angry, stress levels are high. This activates the stress response, which speeds up heart rate, respiration, and blood pressure, and increases body temperature. Stress also affects focus and attention abilities, and heightens energy while decreasing appetite and sleep functions.

A person may become very tense and have difficulty winding back down. Muscle tension, headaches, irregular heart rate and blood pressure, sleep difficulties, and the potential for heart problems or even stroke may be possible risk factors for chronic anger and emotional regulation issues. Add in alcohol abuse, and the multitude of possible social, emotional, physical, financial, and behavioral problems related to alcoholism and addiction, and the risk factors and potential for negative side effects go up exponentially.

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Co-Occurring Disorders Are Complexly Intertwined

Co-occurring disorders are common. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 8 million adults in the United States struggled with both a mental health disorder and addiction in 2014. When a person struggles with both alcoholism and anger management problems, the issues exacerbate each other. For example, drinking alcohol may escalate a situation, increase the likelihood of a worse outcome, and cause negative consequences of heightened anger and aggression, especially if a person already struggles with controlling their anger when they are not drinking.

The World Health Organization (WHO) warns that alcohol interferes with a person's cognitive and physical functioning, inhibiting self-control and making it more difficult for a person to recognize when things have gone too far. It can be harder for someone under the influence of alcohol to notice typical warning signs that emotions, especially anger, may be getting out of control.

Drinking may also be a method to self-medicate negative emotions, including anger. Alcohol is a depressant substance, meaning that it helps to suppress some of the "fight-or-flight" stress reactions that anger can induce. Repeated alcohol abuse as a coping mechanism increases the odds for developing problems related to alcohol, however. It also raises the risk for negative consequences of outbursts related to explosive and uncontrolled anger.

On the flip side, alcohol dependence commonly leads to significant withdrawal symptoms that are often side effects of alcohol addiction. Emotional withdrawal symptoms can include agitation, anxiety, depression, irritability, and tension as well as sleep disturbances, insomnia, and physical discomfort. When a person struggles with alcoholism and physical dependence on alcohol, these withdrawal symptoms can contribute to mood swings, trouble thinking clearly, and a feeling of being "on edge." All of these things can make it more difficult to regulate emotions, increasing issues related to anger management.

When someone battles alcoholism, they are also less likely to consistently take care of regular obligations, which can impact interpersonal relationships and their home environment. These issues can then lead to more anger and further difficulty controlling emotions and outbursts.

Getting Help for Co-Occurring Disorders

The connections between co-occurring mental health disorders and addiction can be complex; therefore, the disorders are optimally treated through a specialized and integrated treatment program that manages each disorder at the same time with the help of multiple providers working together. Anger management issues may be rooted in a specific mental health disorder in some cases. Regardless, treatment for emotional regulation is an important aspect of a specialized addiction care model, and someone prone to aggression, violence, or angry outbursts can benefit from an integrated program that focuses on controlling impulses and maintaining emotional balance.

Alcohol withdrawal can be potentially life-threatening, in the case of severe dependence. Medical detox is typically considered the optimal method for allowing alcohol to safely process out of the body while under continual medical supervision. When people have difficulty controlling impulses, trouble regulating their emotions, or may present a danger to themselves and/or others, medical detox is required. Medical detox programs are often the first stage in a comprehensive addiction treatment program. These programs usually last 5-7 days on average and commonly use medications to manage difficult physical and emotional withdrawal symptoms.

Mood stabilizers, antidepressants, or anti-anxiety medications can all help to regulate and control negative emotions, during both detox and treatment for anger management and alcoholism. After detox, individuals suffering from co-occurring disorders often proceed directly into a residential treatment program where structured around-the-clock programming can help to manage both disorders.

Clients can learn healthy stress management and coping skills to diffuse anger and other negative thoughts in group and individual therapy sessions. Emotional regulation skills and relapse prevention tools are also taught. Through behavioral therapy and counseling, a person is better able to recognize how their thoughts tie into their actions. They can learn to recognize potential triggers and how to safely manage them.

Meditation can help clients to relax physical tension, become more self-aware, and work toward creating a healthy mind-body balance. Other holistic methods are often used during a comprehensive addiction and anger management treatment program as adjunctive, or complementary, treatment methods. Massage therapy can help to relieve physical tension and therefore promote mental clarity. Expressive therapies provide healthy, and often nonverbal, outlets for the expression of negative and difficult emotions. Finally, support groups provide encouragement and hope for recovery.

As with all co-occurring disorders, it’s important to treat anger management issues and alcoholism at the same time as part of a comprehensive treatment program.