Anger problems: what is behind them, what helps and when to get support

NHS inform describes anger as a normal emotion that alerts you to a problem and, if expressed constructively, can help you resolve it. It can be a natural response to being threatened or attacked, and can motivate you to stand up for yourself. Problems arise when you cannot properly express or manage it. It says that while some people lash out, having problems with anger can also mean not expressing it at all, and some people bottle up feelings, which can lead to stress and unhappiness, or turn anger on themselves in the form of self-harm.

The NHS says most people feel angry sometimes, but if it is affecting your life there are things you can try that may help. The NHS also notes it is not always easy to recognise when anger is the reason you are behaving differently.

The NHS groups the symptoms of anger into physical, mental and behavioural ones.

• Physical: a faster heartbeat, tense muscles, clenching your fists, tightness in your chest and feeling hot.

• Mental: feeling tense or nervous, being unable to relax, being easily irritated, feeling humiliated and resenting other people.

• Behavioural: shouting, ignoring people or sulking, starting fights, breaking things and self-harming.

The NHS says there are many different causes and that it is different for everyone. Common things that make people feel angry include being treated unfairly and feeling powerless, feeling threatened or attacked, other people not respecting you, your feelings or your property, and being interrupted when you are trying to achieve a goal. It says how you react can depend on the situation you are in (if you are dealing with lots of problems or stress you may find it harder to control anger), your family history, past events including traumatic experiences that can lead to post-traumatic stress disorder (PTSD), and substances such as drugs and alcohol that make some people act more aggressively.

NHS inform says a combination of biological, psychological and social factors is likely involved. Biological factors include the brain's fight, flight or freeze response; psychological factors include personality traits, beliefs, values and thinking patterns. It also says people dealing with anxiety and depression commonly experience anger, and that people who have experienced trauma or loss can have issues with managing it. When people are stressed, tired or dealing with other problems, they are more sensitive to triggers.

NHS inform explains that avoiding anger, or being rewarded for aggressive behaviour in the short term, can keep problems going, as can not having learned healthy ways to cope. These patterns can become a cycle.

The NHS suggests trying mindfulness techniques to recognise when you start to feel angry so you can take steps to calm down early, giving yourself time to think before reacting (counting to 10 and doing calming breathing exercises), talking to someone who is not connected to the situation such as a friend or a GP, exercise such as running, walking, swimming and yoga, considering peer support and trying self-help cognitive behavioural therapy (CBT) techniques to manage unhelpful thoughts and solve problems.

It also advises not trying to do everything at once, not focusing on things you cannot change and trying not to use alcohol, cigarettes, gambling or drugs to relieve anger, because these can all contribute to poor mental health.

NHS inform offers a CBT-based self-help guide for mild-to-moderate problems with anger, which takes about an hour to work through and covers understanding anger, triggers, the body, unhelpful thinking, coping strategies, assertiveness and problem solving. It says the guide will not stop you getting angry, because anger is a normal emotion, but helps you manage it and express your feelings in a healthy way.

The NHS says you may need medical help if you are struggling to cope with anger and what you are doing to help yourself is not working. It advises seeing a GP if you are struggling to cope with anger, things you are doing to help yourself are not working, you are acting in an abusive or violent way, you are struggling with stress, anxiety or depression, or you have had a low mood for more than 2 weeks. Your GP may be able to refer you to a local anger-management programme or counselling.

The NHS describes a typical anger management programme as involving one-to-one counselling and working in a group, over a 1-day or weekend course or a couple of months, and that most programmes include CBT as well as counselling. You can refer yourself directly to an NHS talking therapies service for free therapies such as CBT. There are also private courses and therapists, and the NHS advises making sure any therapist you see is registered with a professional organisation such as the British Association for Counselling and Psychotherapy.

The NHS says that if uncontrolled anger leads to domestic violence and abuse there are places that offer help and support, and it lists Refuge, Women's Aid and Respect (Men's Advice Line). NHS inform says that if your anger has caused you to harm other people, or yourself, you should visit your GP or explore local services, and that if someone close to you is causing you harm or making you afraid because of their anger it is important to reach out for help.

If you feel distressed, in despair or suicidal, NHS inform says to phone 111 in Scotland (NHS 24), and the NHS says to find out where to get urgent help for mental health. In an emergency, call 999.