Addressing Anger In Addiction Recovery

Substance use disorders (SUD), also known as drug and alcohol addiction, can be an emotionally charged subject. People who have experienced an SUD and their loved ones often report tremendous guilt, shame, remorse, resentment, fear, and anger as part of their experience, all of which may be directed outwards, inwards, or both simultaneously. 

As part of SUD treatment and recovery, healthcare providers have a variety of different resources available to help people in recovery manage their emotions, with some treatment options also being available to loved ones to help restore trust, intimacy, and communication in relationships that have been damaged. In this way, SUD recovery programs can provide an important opportunity for emotional healing as well as behavioral healing in the lives of those who participate. 

This includes treatment provided for feelings of anger in recovery, as anger is a common emotion experienced by those receiving SUD treatment and can be intense and harmful if not addressed.

The Connection Between Anger And Addiction

Not everyone who suffers from intense anger will develop an unhealthy relationship with drugs or alcohol, and not everyone who experiences an SUD will also have problems with anger or other sometimes difficult emotions. However, research has shown that anger and addiction are deeply linked, as people with an SUD are much more likely to experience problems with anger and vice-versa, to the point that anger management is a common element included in personalized addiction treatment courses, and substance abuse is routinely covered in anger management programs. 

The relationship between anger and substance use runs deep, and each facet can interact with the other in a variety of different ways.

Common Risk Factors

Anger and addiction share numerous risk factors in common, making it more likely that people who develop a problem with one will also experience difficulty with the other.

These risk factors include a high level of personal or financial stress; childhood abuse, neglect, or unresolved trauma; poor impulse control; poor emotional intelligence and coping ability; certain personality traits or types; chronic pain; discrimination and disenfranchisement; genetics; lack of a strong support system/close relationships; and other mental health difficulties like depression, anxiety, bipolar disorder, and more. 

Emotional Dysregulation

When someone becomes dependent on alcohol or drugs, they may begin to lose the ability to properly experience, manage, and express emotions, while also experiencing significant changes to their brain function related to learning, inhibitory control, reward, motivation, and executive function. These effects can make it more difficult to experience pleasure from normal sources (anhedonia) while also making it more difficult for a person to regulate intense emotions like irritation and anger when they occur. 

As a result, people who use drugs and alcohol tend to experience anger more often and more intensely than those who do not, and periods of intense or chronic anger often predict relapse in people who are in recovery. Those with SUD may also be more prone to outbursts, physical violence, and suicide, whether or not they are currently under the influence or experiencing acute withdrawal symptoms like irritation and aggression. 

Self-Medication

Often, people who have endured extreme threat in the past find that their body and mind are always on guard, primed to respond to danger, including with anger, which provides a boost in energy, according to the National Center for PTSD. This makes them more apt to respond with aggression and overreaction when faced with normal day-to-day inconveniences. 

This constant state of readiness and fight-flight-freeze is both mentally and physically exhausting, as the body will continue to maintain high levels of stress hormones like cortisol, as well as increased blood pressure and physiological arousal. Many people experiencing these effects use drugs or alcohol to self-medicate and self-treat this state of tension. However, while self-medication may provide short-term relief, the long-term consequences can be severe, including SUD.

Cognitive Dissonance

Drug and alcohol addiction are heavily stigmatized, and a person living with an SUD may also struggle to fully process and come to terms with their present situation and identity. This can lead to a wide variety of reactions like denial that one needs help, deceit, defensiveness, blaming others, guilt and shame, frustration, self-isolation, paranoia, despair, self-loathing, and other complex and confused thoughts, feelings, and behavior. 

Until these beliefs and emotions are fully resolved and a person is able to accept the truth of their current situation and act accordingly, it can be easy to use others as an outlet, with one’s emotional stress and unease boiling over in the form of anger and irritability. In other cases, anger may be directed inwardly, which is just as destructive.

Treating Anger During Recovery

Treatment providers have a variety of different resources available to them to help treat anger as part of a personalized substance abuse treatment program. Treatment options for anger in recovery include the following.

Psychoeducation

During psychoeducation sessions, clients learn about the science of addiction and other related topics through readings, presentations, and videos. This can help people with SUDs learn more about what they are experiencing and what they will experience during recovery, helping them to be more aware of their internal state and understand their condition, thoughts, and feelings. 

Psychoeducation may also include education about addiction and emotions, especially anger. This can include learning about:

• physiological arousal and the physical changes that take place when one experiences anger
• the emotional and psychological side effects of prolonged substance abuse and addiction
• myths and truths about anger management 
• success stories from people who learned to manage and cope with anger in recovery

Cognitive Behavioral Therapy (CBT)

CBT is a proven option for anger management that focuses on identifying and exploring problematic patterns of thought, belief, and behavior that have contributed to one’s anger and addiction, and developing positive alternatives. 

Through one-on-one conversational sessions, CBT clients work closely with a therapist to identify the specific triggers that have created episodes of anger in the past and to build up new strategies and coping methods to avoid or work through similar experiences in the future, without relying on substance abuse or other harmful outlets like self-harm or isolation. Clients may visualize or simulate stressful experiences before practicing how to deal with them, work on thinking things out before acting, or focus on changing fundamental perspectives about themselves, others, and the world around them. 

Common coping mechanisms developed through CBT sessions include:

• taking timeouts or counting to 10
• deep-breathing exercises
• therapeutic physical activities
• developing healthy communication and improved problem-solving skills
• journaling
• practicing gratitude
• learning self-acceptance

Dialectical behavior therapy (DBT)

DBT is a variation of CBT that focuses on helping people who experience extreme emotions, including anger and pervasive feelings of being criticized, misunderstood, and invalidated in daily life.

During treatment, therapists help clients discover self-validation, accepting themselves and their feelings as they are. Simultaneously, clients explore the benefits and challenges that come with change and work to develop new, practical skills to improve emotional regulation, stress management, relationships, communication, and more. 

Family Therapy

Family therapy is a group-based form of psychotherapy that brings together couples or family members in the same space to work with a therapist and identify problem areas in these all-important relationships. Substance abuse and anger often disrupt intimacy and communication and can produce guilt, resentment, codependency, and other issues. During sessions, participants will have the opportunity to voice and discuss these issues, to learn more about anger and addiction, and to develop new solutions and strategies to improve relationships and support each other in daily living in the future. 

Peer Support 

Anger is a common topic in addiction treatment centers, and it’s common for there to be more than one person in treatment who struggles with intense, angry emotions. 

Through peer support groups, clients have the opportunity to talk about anger in their own life, to learn how anger has affected the lives of others in a similar situation, and to share support, affirmation, and information. This group-based approach can help reassure clients that others know what they are going through and that, together, they can work to control their anger and move past it in recovery. 

A variety of local and virtual peer support groups for anger are also available for clients to explore as aftercare once their time in treatment is complete, including 12-step groups like Rageaholics Anonymous (RA) and Emotions Anonymous (EA). 

Dual Diagnosis Treatment

Depending on the client, anger in recovery may relate to a co-occurring mental health disorder like bipolar disorder, an anxiety disorder, borderline personality disorder, PTSD, depression, ADHD, or others. 

Once a co-occurring disorder is detected and diagnosed, treatment professionals can provide personalized dual diagnosis treatment solutions for both a client’s SUD and their co-occurring mental health condition. This can help treat anger at the source, with medications and targeted forms of psychotherapy helping to restore one’s psychological health so their emotions can also settle. 

Alternative Treatment Options

Often, treatment centers will provide alternative forms of treatment to support the different forms of evidence-based therapy provided to clients dealing with anger and addiction. These alternative activities can meet a variety of different needs, helping clients to:

• break the cycle of anger and change their mindset by doing something relaxing or rewarding, e.g., animal therapy, nature therapy, music therapy, etc.
• learn a new skill and build self-confidence and optimism, e.g., sports, yoga, etc.
• express their emotions in a safe and constructive way, e.g., art therapy, exercise therapy, etc.
• connect with others in a low-pressure casual setting, e.g., sports, movie nights, game nights, etc.

Aftercare

Other professional anger management courses may also be arranged for clients to participate in after their residential treatment program is over as a form of personalized aftercare and relapse prevention. 

Risks Of Anger In Addiction

As with substance abuse, runaway feelings of anger can be harmful and dangerous, damaging both the person experiencing anger and/or those they love most. Without effective treatment and management, anger and addiction together are known to contribute to:

• domestic violence
• emotional or physical abuse/neglect
• other aggressive or violent activity and harm
• impulsive or high-risk behavior
• self-destruction, e.g., loss of one’s job, relationships, housing, etc.
• self-harm
• suicide

If you are concerned about your loved one, talk to them and encourage them to get help. However, if you experience violence or abuse or learn that violence or abuse has occurred, especially if it involves a child, call 911 for emergency response, the 988 Suicide and Crisis Lifeline, or Child Protective Services (CPS). You can also reach out to other family members or trusted adults like a spiritual leader or teacher if you don’t feel safe. 

Family support groups like Nar-Anon and Al-Anon are also available for you to connect with others who have family members struggling with drug or alcohol addiction. 

Other Behavioral And Psychological Signs And Symptoms Of Addiction

Irritability, defensiveness, anger, and aggression are all common signs that a person may be dealing with a major life issue, like substance abuse and addiction. But there are many other lasting and noticeable signs of an SUD that friends, family, colleagues, and the person who has developed the SUD may exhibit over time. 

These signs and effects include:

• using larger and larger amounts of a substance over time
• feeling urges or cravings to use a substance
• trying to cut back on drugs or alcohol but not being able to
• spending more and more time getting a substance, being under its effects, and recovering afterwards
• having trouble meeting normal responsibilities at home, in school, or at work due to substance use
• continuing to use a substance despite it causing problems with one’s relationships
• passing on social events, work opportunities, or hobbies because of drug or alcohol use
• using substances in risky ways or situations
• using drugs or alcohol even though one knows they are damaging one’s mental or physical health
• becoming more and more tolerant towards a substance’s particular effects

• experiencing withdrawal symptoms if too much time goes between doses
• neglecting self-care, including meals, showers, exercise, and appearance
• worsening mental clarity, memory problems, confusion, and emotional volatility
• withdrawal from friends and family
• lying to loved ones or becoming secretive
• difficulty experiencing pleasure or expressing positive emotions without substance use
• using substances at odd hours, such as mornings, or when alone

Find Recovery At Ark Behavioral Health

The truth is, substance use disorders are common, as is not knowing how to handle intense anger in recovery, and both can be deeply harmful. Fortunately, effective treatment services are available to help you and those you care about build a long-lasting and healthy recovery from both anger and addiction. 

At Ark Behavioral Health, we offer comprehensive SUD treatment services for all forms of drug and alcohol addiction as well as co-occurring mental health disorders. Using evidence-based treatment solutions, our staff can help support and restore your behavioral health, mental health, and emotional health.

To learn more about treatment for both addiction and anger at one of our behavioral health facilities in Ohio or Massachusetts, or to enroll in a personalized addiction treatment program, please reach out today.