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Anger and Aggression

Anger is an emotional response to any perceived threatening stimuli (situation, event) that can be physical or psychological.

Aggressiveness is the behavioural manifestation of an angry emotional response. When anger is centered around hurting self or others – verbally, emotionally, physically it is termed as aggression.

Anger is not always a bad thing. Sometimes it may also lead to feelings of doing better, striving for greater opportunities. However, if the anger is pervasive or extreme it may also be symptom of underlying mental health conditions, substance use disorder or any other medical issue.

Adjustment Disorder
Nirvan Hospital

Symptoms of aggressiveness:

Symptoms are characterized as behavioural, physical, cognitive and psychosocial.

Behavioural symptoms:

Behavioral symptoms include biting another person or an object, bullying, hitting, pinching, pushing someone, spitting, spreading rumors, teasing, yelling etc.

Physical symptoms:

Physical symptoms include accelerated breathing, clenched fists, flushed skin, increased body temperature, increased heart rate, palpitations, sweating, teeth grinding, tense muscles etc.

Cognitive symptoms:

Cognitive symptoms include feeling as if you “black out” when angry, inability to think clearly, poor decision making, problems focusing, problems with concentration etc.

Psychosocial symptoms:

Psychosocial symptoms include abrupt mood changes, angry mood, feeling agitated, low tolerance threshold etc

Aggressive behavior could be co-occurring with:

Substance use disorders, Schizophrenia and other psychotic disorders, Personality disorders, Oppositional defiant disorder (ODD), Intermittent explosive disorder (IED), Dementia, Conduct disorder, Bipolar disorder, Autism spectrum disorder, Attention-deficit/hyperactivity disorder (ADHD), Alzheimer’s disease.

Management of Aggression:

Treatment regime for adjustment disorder includes psychotherapy, medications or both. Individual psychotherapy offers the opportunity to explore the meaning of the stressor to the patient so that earlier traumas can be worked through. Psychotherapy can help persons adapt to stressors that are not reversible or time limited and can serve as a preventive intervention if the stressor does remit.

Crisis intervention and case management are short term treatment regime aimed at helping persons with adjustment disorders resolve their situations quickly by supportive techniques, suggestions, reassurance, environmental modification, and even hospitalization, if necessary.

Medicines are also used to help patients with adjustment disorder depending on the type of adjustment disorder. A patient may response to an anti-anxiety agent or to an anti-depressant. Anti-psychotic drugs can also be used if there is sign of impeding psychosis.

Nirvan Hospital – Centre of excellence in Behavioral and Addiction Medicine has very efficient team of Psychiatrists and Clinical Psychologists to manage adjustment disorders.

An adjustment disorder is precipitated by one or more stressors. Personality organization and cultural or group norms and values contribute to the disproportionate responses to stressors. Stressors may be single like divorce or job loss; or multiple like death of near or dear one which coincides with the person’s own physical illness or job loss. Stressors can be recurrent, such as seasonal business difficulties or it could be chronic like poverty, chronic illness. Sometimes, adjustment disorders occur in a group or community setting, and the stressors affect several persons, as in a natural disaster or in racial, social, or religious persecution. Specific developmental stages, such as beginning school, leaving home, getting married, becoming a parent, failing to achieve occupational goals, having the last child leave home, and retiring, are often associated with adjustment disorders.