Working Smarter

Are You Mad? The Link Between Irritability, Anger and Clogged Arteries

Posted by Joe Robinson

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We all know certain lifestyle behaviors can be hazardous to the old lifespan. High cholesterol and heart disease, smoking and lung cancer, obesity and diabetes. Yet there is an under-the-radar behavior that can be just as deadly: irritability.

It seems innocuous. You’re just in a bad mood, grouchy. You woke up on the wrong side of bed. Yet a pattern of chronic irritability can lead to the same blowback as that caused by cholesterol—heart attack. The danger is that it is a very short distance from irritability to anger, hostility, and clogged arteries. When you are ticked off, seething, simmering inside, any little spark can set off a burst of anger, which has been shown to be a major risk factor for cardiovascular issues.


One study of 1305 men with no history of heart problems (Kawachi, Sparrow et al) found that anger can triple the risk of developing heart disease. A huge metastudy on anger as a heart attack trigger (Mostofsky, Penner, Mittleman) found that an anger outburst two hours before the episode can more than quadruple the risk of myocardial infarction.

Anger can also take a cumulative toll. A study of medical students found that the angriest were five times more likely to have an early heart attack and three times more likely to get cardiovascular disease (Finney, Stoney, Engebretson).

Anger and particularly hostility do their damage through activation of the stress response, which jacks up heart rate and blood pressure and suppresses the immune system. The flood of adrenaline to help you fight or run from danger can cause heart spasms and arrhythmias, and the velocity with which the blood is pouring through arteries can wear down their lining, causing craters that attract platelets and clogs.

Hostility has been linked to increased levels of C-reactive protein, which can form plaque and restrict blood flow. It’s such a red flag that one study by the Boston University School of Public Health suggested hostility is a better predictor of coronary disease than high cholesterol or smoking.


The real threat of anger is its staying power. It keeps us in a prolonged state of emergency and high blood pressure after even a minor event. Five minutes of anger can suppress the immune system for five hours (Rein, Atkinson, McCraty). The longer stress lasts, putting strain on your cardiovascular system and compromising the immune system, the greater the health risk.

Irritability keeps the prospect of anger close, amping up impatience, annoyance, and aggravation. Irritability is defined as a proneness to anger. It is both an enabler of anger and a low-grade form of it. It is the famed short fuse that some have temperamentally and others have conditionally. The more irritable we get, the better the odds that anger will erupt.

Researchers have connected irritability to the frustration that comes with a blocked goal. We can see this with the cause of much of the irritability in the workplace: time urgency, the frenzy of hurry-worry that most of us work with today that comes from a lack of patience.

Time frenzy is rampant in a digital world as is the impatience that trips it off. Digital devices have conditioned us to expect immediate gratification. Everyone wants the product, report, the email response yesterday. The Internet page won’t load fast enough, so it’s apocalypse now.


Traffic, coworkers, and progress not moving swiftly enough all fill the blocked goal thesis. In fact, time urgency makes every event in the day a potential source of frustration, because little in real life happens as quickly as we want it to. It sets an impossible standard on turnaround time, while locking us into self-inflicted irritation. Some of the most prone to impatience: Type A’s, whose defining trait is a fixation with the passage of time and annoyance with those moving in slow motion.

Chronic impatience fuels rushing, which jacks up aggravation and stress. It also drives crisis mentality and the belief that whatever I’m doing is an emergency, so I have the right to interrupt anyone at any time. Rushing and time urgency put everyone on edge and set off bad judgment and decision-making, since they rely on the irrational lower brain unfiltered by the analysis of the higher brain.

Researchers studying time urgency have identified the irritability/anger nexus as the danger zone. This is where on-edge tips over-the-edge at any slight aggravation, and triggers reflex emotional reaction and the stress response.


Whether the source of the irritability is impatience, something somebody said, a low-value assignment, lack of progress, stressful life events, setbacks, or generalized grouchiness, most of it comes on unconsciously. It’s part of the cloud of negative emotions and moods that can waylay the productive day or mind.

Moods ebb and flow constantly. They rise and fall depending on the time of the day (morning up, night down), the day of the week (Friday up, Monday down, for some strange reason), and multiple other swings throughout the day.

Most of the time we get swept downstream by the automaticity of irritability, and, like with most deeply felt emotion, it’s hard to let go of the mood once it takes hold. It’s as if we want to be irritated, because it allows us to feel justifiably up in arms about something.

If we could opt out of this prelude to anger, we could do a big solid for our heart and mind, not to mention the people around us on the receiving end of our funks. To do that, though, we would have to first become aware of the mood when we are in the middle of it—not easy to do—and then have the willpower and presence of mind to shut it down, and not let it spiral to fight-or-flight meltdowns.


Irritability is essentially a loss of patience with others, ourselves, the world. We’re mad but don’t want to come out with it directly, so it’s kind of passive-aggressive. It’s a grumbling in the brain of unexpressed, unprocessed annoyances, frustrations, resentments, and anxieties. It doesn’t serve any purpose, other than to make others want to give us a wide berth.

How do we off this reflex behavior? Get the triggers into the open. Ask where the irritability is coming from. Did you not get enough sleep (lack of sleep can drive irritability)? Are your efforts not being rewarded? Are there obstacles in the way? If so, what are they? Who are they? Did someone push your buttons?

Often, irritability is generalized and as long as it stays that way, we can’t resolve it. As with all stressors, the way forward is shining the light on the trigger, so that we can see that it is not life-and-death, and then turning off the danger signal. We can do that by having a conversation about the issue, changing the way we think about it, and identifying a more productive way forward.


Irritability is one of the ways that humans excel at getting in their own way. It pushes others away, entrenches negative emotions, sets off anger and stress, keeps you in a bunker of me-against-the-world, makes you unhealthy, and hands over the keys to your life to your ego.

One way to keep this self-inflicting behavior at bay is to treat yourself as the enemy, or at least your ego. Make it a competition between you and your ego. When irritability starts up, making you the most important person in the world, aggrieved by everyone, tell yourself, no, I’m not going there.

Make it a game. If you’re impatient, for instance, deliberately walk slower or get in the longer line at the market. You’re not going to take the bait. You act the opposite, using the extra time to take deep breaths to restore your higher faculties and step off the runaway train. You are in charge, not your ego.

Another approach is to identify the issues that set off irritability and create scenarios you will use to defeat it the next time that trigger pops up. You can use an implementation intention, an if-then statement that seeds a new behavior in the future. You tell yourself: If I get irritable, then I won’t take the bait. You solve the issue, let it go, and refuse to be a breeding ground for anger and assorted cardiovascular havoc.

If you would like to control anger and stress on your team, click the button below for details on my stress management training programs. If you are interested personally, please click on the coaching page above.

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Tags: Stress and anger, anger and heart risk, irritability and stress, negative mood and productivity

Road Rage to Office Meltdowns: Why Stress Makes Us Take It Out on Others

Posted by Joe Robinson

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As if we don’t have enough stress of our own, we also have to contend with the impact of other people's stress—the triggered colleague who has a meltdown over some minor delay on a project, the driver with road rage, or the spouse who comes home after a bad day at the office and lashes out at anyone in sight, including the dog.

Stress is more than a personal health hazard. It’s a menace to the planet, since it aggravates a part of the brain responsible for aggression, and does so with zero awareness on the part of the reflex reactor.


Misery definitely loves company. Stress makes you take your frustration or anger out on others. Hormones released by the fight-or-flight response, not surprisingly, make it easy to go into fight mode. We see the cascade of pass-along stress at the office. The supervisor gets chewed out, then he or she jumps on you, then you look for someone else or, smarter, the stress ball to take your frustration out on.

It’s known as stress-induced displacement aggression, the practice of dishing out to others what you just got served up, and, believe it or not, it actually reduces stress for the person acting out as it increases it for others. No doubt, it's a prime suspect in why humans have such a hard time getting along.

As primate expert Robert Sapolsky reports in his book, Behave, “Shock a rat and it’s likely to bite the smaller guy nearby; a beta-ranking baboon loses a fight to the alpha, and he chases the omega male; when unemployment rises, so do rates of domestic violence."

If we want to reduce the volume of mindless violence and aggression in the world and at the office, I’d suggest a Marshall Plan for the psyche, giving people stress management tools to turn off the stress that drives reflex hostile aggression. When you switch off the false danger signal of the stress response, the emotional cyclone that can wreak damage on anyone nearby stops in four minutes.


Stress and aggression are linked together in a chemical dance in which each feeds off the other in a way that prolongs aggressive feelings and removes inhibitions that would normally keep irrational and violent acts at bay. The dynamic is neatly summed up in a study led by Menno Kruk of the University of Leiden in Holland, where researchers investigated the connection between stress and aggressive behavior. 

Scientists removed the adrenal glands of rats that produce stress hormones, and then injected them with corticosterone, similar to the cortisol that surges in humans during stress. Stimulating the aggression hub of the hypothalamus set off attack mode, bona fide rat rage even without another rat in sight.

Kruk’s research showed that the stress response sets off a swift feedback loop of hormones that contribute to aggressive behavior. Stimulating the hypothalamus produced more stress hormones, adrenocorticoids, and those in turn ratcheted up overall stress and more aggravation.

It all happens very quickly and can set off violent behavior even in tranquil settings. Kruk reports that there seems to be a threshold of stress that sets off aggressive behavior.


A study of road rage (Lipaz Shamoa-Nir, Meni Koslowsky) found that aggressive driving style predicted high levels of stress. The more aggressive the driving style, the higher the stress. Drivers with high stress perceived other drivers as the cause, and this made them act more aggressive towards them.

No doubt, driving is stressful. It involves what is known as “threat vigilance,” having to be on guard for hazardous conditions and potential life-threatening incidents. Taxi drivers and bus drivers are at the top of the list for jobs with the highest stress levels.

Yet the road rage study showed there is an alternative to stress-induced, aggressive or hostile driving. It depends on the stress coping style of the driver. People who respond to stress with emotional, reactive behavior are prone to drive aggressively. Drivers who use a problem-solving approach to stress, focusing on the task at hand with their modern analytical faculties, don’t plunge off the aggression deep end.

Problem-solving is the course we want to take in stressful moments, because it keeps the emotions down and reasoning in charge. It's a challenge, not life-or-death. This allows us to weigh pro and con before acting and analyze the situation, instead of default to reflexive action and what’s known as System 1 thinking—rash, impulsive, get-out-of-the-car-and-fight-the-other-driver mode. This is the Cro-Magnon state we are reduced to when stress uncorks the aggression equipment. 


Knee-jerk, irrational emotions set off by the stress response make us do incredibly stupid things without thinking, and when combined with the aggression-turbocharge of the fight part of the survival instinct, incredibly stupid, violent things. In this state inhibitions vanish as if you were stone drunk.

The sad part of the story is that displacement aggression actually helps reduce stress hormones. Sapolsky says that when a baboon loses a fight, picking on someone further down the chain results in a drop in glucocorticoid levels.

A study on the connection between family violence and pro football (David Card, Gordon Dahl) uncovered a similar dynamic in humans. When a local pro team unexpectedly loses, violence by men against female partners increases 10%. There’s no increase in violence if the supported team wins or is expected to lose. The violence increased 13% if the team was in the playoffs.

Another study (Ganz, Bradley, Wang) connected police reports of home violence to NFL football games. Game days, it turns out, have more domestic violence. As the authors put it, “emotional cues based on the outcomes of professional football games exert a relatively strong effect on the occurrence of family violence. The estimated impact of an upset loss, for example, is about one-third as large as the jump in violence on a major holiday like Independence Day.”


The central theme connecting stress and aggression is anger. It's a short distance from anger and hostility to the stress response and cardiovascular heart disease, studies show. We have to be mindful of the stages of anger to keep it and aggressive acting-out at bay.

It's a building process. Frustration and impatience lead to irritability and then the slightest spark can tip it over into anger. We have to catch ourselves before that tipping point. Ongoing anger can morph into hostility, which is a better predictor of cardiovascular disease than high cholesterol, drinking, or smoking.

The impatience/irritability threshold in time urgency, for instance, or the stress of time pressure, is the most dangerous part of a process that can lead to hostility and clogged arteries. Studies show that the risk of heart attack in men in the first two hours after a bout of anger is five times greater and the risk of stroke three times higher.

Are you thinking what I’m thinking? It’s kind of a miracle that humans are still around, considering the built-in self-destruction buttons we have. For a species designed to feel better by taking out frustration on other humans, it could be a lot worse.

We’d be doing a lot better, though, if we could get as many people as possible into stress management training—to get out of their own way, and ours, by learning how to turn off the stress response and make the world safer for those around us.

If you would like to help your team manage stress and not take their stress out on colleagues, customers, or patients, click the button below for more information on our stress management training programs.

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Tags: office stress, road rage, Stress and anger, stress and aggression

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