Living With Chronic Pain

Pent Up Anger Worsens Pain

Anger is a normal emotion. But when it’s a daily event or shoved so deep inside it festers and causes harm to yourself and others it’s not healthy. As discussed in last week’s post it also worsens pain. That’s why recognizing when it’s a constant part of your life and learning productive ways to deal with it is so important.

We all know the signs:

  • Irritability
  • Restlessness
  • Frustration
  • Anxiety
  • Depression
  • Quick to criticize.
  • Poor sleep.
  • Hurting others.
  • Persistent negative thoughts.
  • Throwing or damaging things.
  • Impatient.

Common causes for pent up anger include:

  • Feeling you’re not heard or understood.
  • Felling unappreciated.
  • Inability to accept a situation.
  • Needs aren’t met.
  • Feeling vulnerable and hurt (this can then turn to wanting to lash out and hurt others).

Whatever the reasons, pent up anger can turn to rage quickly, leading to catastrophic consequences. But even a simmering, low level chronic anger can have devastating impacts to our physical and mental health.

The first step is acknowledging it exists. Then understanding the source. Once that’s done you can appropriately express your concerns in the moment or accept when you don’t have control over a situation and move on if needed.

Like the famous quote says,

“Give me the courage to change the things I can. Accept the things I cannot charge. And the wisdom to know the difference.”

Here are a few ways to deal with pent up anger,

Work it out

Exercise helps us to decompress, release tension and built-up hormones waiting to flee or fight in a productive and healthy way. Plus, it releases feel good hormones to encourage positive energy.

As a medical student you have no control over anything- your time, your job or who you interact with daily. Being a low person on the totem pole we were often treated poorly by everyone. One of the professors acknowledged early on that pent up anger and frustration was common. He recommended we all find acceptable ways to release it so patients, nurses and attending doctors weren’t affected. Back then I would run a couple of miles a day and he suggested visualizing the face of whoever was driving me crazy under my feet as I pounded the pavement. For another it was seeing their faces on bowling pins as he threw the ball. Sounded pretty gruesome and harsh for those of us starting in a field to help others. But it worked. It helped us deal with the anger we could never express to the actual people involved, in healthy ways.

Later, I used a similar means to help my little girl deal with all the anger and fears she was feeling at having her home life uprooted when my ex and I divorced. Every night we’d hit a punching bag while making it clear who we were mad at. She could direct it at me, her dad, or her lack of control without hurting herself or others in a safe and productive way.

Take a moment

Before you say or do something you’ll regret, take a moment. Go into the bedroom. Take a walk. By allowing space between you and who’s triggering your anger you’ll have time to calm down and assess the best way forward. Can’t leave? The old adage count to ten is a good one. It’ll allow your heart rate and breathing to normalize which will help you to think clearer. Really angry? Count to 100.

When we’re angry we want to get the last word in. Instead, just stop talking. No matter what don’t say a word. Just listen. You’ll be surprised at how quickly this can diffuse a situation.

Challenge your thinking

Put yourself in the other’s shoes. This often allows us to see more clearly where they are coming from and hear their views more openly. Or it can help us see the anger is coming from our own issues, not theirs. From our feelings of vulnerability, hurt, or sadness. Cognitive behavioral therapy is another way to help change negative thoughts that incite anger, depression, frustration to positive ones.

At the very least change the negative to positives. From, “You’re always criticizing me.” To, “I know you mean well and want to help but I need to deal with this issue my way.”

Just breathe

When situations start to escalate take a moment to calm yourself down.

Breathe in to the count of five. Hold to the count of five. Breathe out to the count of five. Hold to the count of five. It can work anywhere at any time. No one even has to know you’re doing it.

Or breathe in deeply through your nose and exhale through your mouth several times.

Practice relaxation techniques

Whether it’s meditation, visualization, guided imagery, massage, deep breathing, long hot baths, scented candles, or progressive muscle relaxation techniques, take the time to decompress and let go of the worries and stressors of the day.

Talk it out

Whether it’s to the person you’re angry at or a friend. Let it out. Expressing yourself can help release the pent-up emotions. Even if you’re not heard or understood, just saying the words can often help.

Not able to speak to the person directly because they’re no longer in your life, dead, or a person you don’t feel you can share with (e.g. a boss), write that proverbial letter. The one that spills your heart and soul, then put it away. Next time those feelings rise read it or even add to it. Too tempted to send it? Ripping it into pieces can feel empowering as well.

Creative arts

Play or listen to music, write in a journal, color, draw, paint, dance, or sing… whatever makes you happy. They can help us to feel more in control, give us a safe means to let it out or break the cycle by letting us focus on something beyond the anger.


Watch a funny show. Laughter can break the anger cycle and release feel good hormones. Even a sad show can bring up emotions that allow productive conversations or a cathartic release.

Get a good night’s sleep

There’s no question poor sleep increases our levels of anger. Studies show people who lose just a few hours of sleep a night are angrier and less capable of adapting to frustrating situations. This may be because lack of sleep inhibits the brain’s ability to regulate fear, alarm, anger regulated by the prefrontal cortex and amygdala, leading to emotional instability. It can even make other people’s faces look less happy and more hostile!


Isolation breeds loneliness, isolation and anger. These last few years with COVID shutdowns, masking and social distancing have taken a human toll. Humans require touch, interaction and socializing to survive, Get out more. Stay safe when necessary but studies have shown getting together with friends can be as powerful as morphine.

Seek professional help when the above mechanisms stop working or you’re experiencing these concerns:

  • Harming yourself
  • Harming others
  • Threatening or taking it out on strangers, those you see as weaker or less powerful.
  • You can’t control your outbursts.
  • You can’t let the anger go or accept a situation.
  • It’s affecting your relationships and ability to get close to others or your happiness. can’t stop negative thoughts.

Anger is a normal, healthy emotion. But holding on to it, turning it inward or taking it out on others, isn’t. It leads to higher levels of pain, decreased physical abilities, poor sleep, impaired coping skills and ultimately loss of support and social connections. The angrier we get the more we hurt and push people away. It may feel like a shield or fuel to keep the fight going, but the opposite is true. Dealing with and letting go of our anger at the world, ourselves and others is one more way we can lessen pain.

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