Why are you so angry?

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London -Feeling cantankerous? While anger is a normal reaction to certain events, it can be due to something more serious.

“There are surprisingly numerous medical conditions that are reported to have anger and irritability as a side-effect,” says Dr Helen Stokes-Lampard, of the Royal College of General Practitioners.

“Certain medications can also lead to this personality trait.”

Here, we look at the health conditions and drugs that can lead to rage.

OVERACTIVE THYROID

Your anger - shouting at the children or your partner - could be triggered by an overactive thyroid, also known as hyperthyroidism. Most commonly affecting women (about one in every 100), this trait comes on gradually when the gland makes too much thyroid hormone.

“This hormone affects everything to do with the body’s metabolism, including heart rate and body temperature,” says Dr Neil Gittoes, an endocrinologist at University Hospitals Birmingham and BMI The Priory Hospital, Birmingham.

“Circulating hormones affect every tissue, including the brain.”

Other symptoms may include weight loss, tremors and sweats.

“This is easy to rectify with medication such as Carbimazole, which stops the gland producing excess hormones.”

CHOLESTEROL

Around seven million Britons take statins to help lower their blood cholesterol levels and reduce the risk of heart disease, but one side-effect is bad temper.

In a study at the University of California, six patients suffering from irritability improved almost immediately once they had given up statins.

“One theory is that low cholesterol levels also lower levels of serotonin [the happiness hormone] in the brain, making the response to anger harder to control,” says Steve Bazire, honorary professor, School of Pharmacy, University of East Anglia and consultant pharmacist at Hellesdon Hospital, Norfolk.

Lower levels of serotonin mean statins have also been associated with depression and even a raised risk of suicide.

“The risk of depression is highest with low and high levels of cholesterol, so being in the low to middle range seems the safest place to be,” says Professor Bazire. “The best way to avoid this side-effect is to bring levels down slowly.”

So ask your doctor about reviewing your statin dose.

DIABETES

Low blood sugar levels can cause sudden bursts of anger. Hypoglycaemia, caused by lower than normal blood glucose levels, can happen in type 1 and type 2 diabetes. Low sugar levels affect all body tissue, including the brain, and can lead to an imbalance of chemicals, including serotonin.

Within minutes this can lead to aggression, anger, confusion, restlessness and panic attacks.

Treatment involves drinking or eating something sugary as soon as possible and, fortunately, you should feel better within 20 minutes.

“While diabetes is a common cause of low blood sugar levels and hence a tendency to fly off the handle, this same effect can be experienced simply by being hungry,” adds Dr Stokes-Lampard.

DEPRESSION

Depression is not only expressed as lethargy and sadness. “It can also leave you feeling angry, agitated and irritable,” says Paul Blenkiron, a psychiatrist at Bootham Park Hospital, York.

This is particularly the case in men, as they are less likely to experience the feelings of hopelessness and self-loathing women often suffer. Dr Stokes-Lampard says:

“One extreme form, agitated depression, is thought to affect five percent of people with depression. Symptoms can also include restlessness, insomnia and racing thoughts.”

It is thought depression is linked to levels of serotonin. Treatments such as antidepressants, or talking therapy such as Cognitive Behavioural Therapy (which helps you think less negatively), can help.

“Why one person is more likely to turn aggressive than another is often down to personality,” adds Dr Stokes-Lampard. “Some people are simply more angry and aggressive in the first place and the medication or conditions enhance this.”

ALZHEIMER’S

As Alzheimer’s progresses, a range of behavioural and psychological symptoms may occur in up to 90 percent of sufferers, says a report commissioned by the Department of Health.

“These can include irritability and uncharacteristic outbursts of anger, which occur several years after the onset of the disease,” says Dr Michael Gross, a neurologist at Spire Bushey Hospital. “The disease increasingly affects various parts of the brain including the frontal lobe, the area responsible for personality.”

INFLAMED LIVER

The liver was linked to the emotion anger in ancient medicine - and rightly so. Several conditions affecting the liver - such as cirrhosis (usually brought on by excessive alcohol) and hepatitis (as a result of viral disease such as glandular fever and severe bacterial infections) can lead to a condition called hepatic encephalopathy. This can bring on personality changes, including surly behaviour and aggression.

“When all’s going well, the liver ensures any toxic substances made by either the body or taken into the body (such as medicines) are made harmless,” says Dr Stokes-Lampard. “However, when the liver is damaged these poisons can gradually build up in the bloodstream, affecting the brain.”

EPILEPSY

Patients can sometimes experience anger immediately after a seizure. “Seizures themselves are caused by a sudden burst of electrical activity in the brain,” says Dr Hannah Cock, a neurologist at St George’s Hospital, London.

“This causes a temporary disruption in the normal message passing between brain cells.

“If the seizure is major, outbursts of anger, sometimes delusional, may occur afterwards.”

While exceedingly rare, symptoms may last from minutes to days after the seizure. In this situation treating the cause - the epilepsy itself - is the key, generally with anti-epileptic drugs.

BEING A WOMAN

The mere mention of a grumpy demeanour during the “time of the month” is enough to incur the wrath of most women - but there is a genuine reason for it. Premenstrual Syndrome (PMS) is believed to happen when levels of hormones such as oestrogen and progesterone fall at the end of the cycle - the week before menstruation.

“Although the mechanism isn’t understood, it’s thought this may have a knock-on effect on serotonin,” says Dr Stokes-Lampard, who has a specialist interest in women’s health. The same can occur during the menopause, because of the drop oestrogen.

SLEEPING TABLETS

A lack of sleep is enough to make anyone overwrought - but one of the drugs supposed to ease the insomnia may also add to your anger, says Professor Bazire.

The group of drugs, known as benzodiazepines, also sometimes prescribed for anxiety, work by slowing down brain function. While affecting only one percent of users, for those with an aggressive personality, this could make them even more prone to irrational outbursts. Ask your doctor to change to another type of sleeping tablet such as Zolpidem or Zaleplon.

WILSON’S DISEASE

Your angry outbursts could be a result of Wilson’s disease. This genetic disorder, which affects about one in 30,000, causes copper to accumulate in the liver or brain.

“Small amounts are as essential as vitamins (it maintains the health of bones and tissues, among other things) and we get it from the food we eat,” says Dr Stokes-Lampard. “However, while healthy people excrete any copper they don’t need, in Wilson’s disease, patients can’t.”

This build-up of copper attacks the brain damaging brain tissue, including the frontal lobe, which is responsible for personality.

STROKE

“Flying off the handle after a stroke is relatively common,” says Dr Gross. “Stroke occurs when blood supply to the brain is cut off - either as a result of a blood clot, or a damaged blood vessel - leading to brain cell death.

“If the part of the brain affected is the underside of the frontal lobe, which deals with our ability to feel empathy and controlling our emotion, aggression can occur.” - Daily Mail

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