Anger Kills

Studies in the U.S., Japan, Finland, England and other places, have shown that a high level of chronic anger, especially a high level of cynical mistrust of other people can lead to a lot of aggression. By itself that is not a surprise. The trouble is this anger also goes with high risk of heart disease and early death from many other causes. This seems to mean that people with this personality type are more likely to get all sorts of infections and diseases. In other words, anger kills.

People who have cynical mistrust of other people are the sort who get really angry in traffic jams. Or, when they are in the express check-out lines at supermarkets, they are always looking to see if the person in front of them at the checkout has got more items than they should. Then they get angry with them and might angrily say something about it.

American researcher, Redford Williams, wrote a book called “Anger Kills”. He explains that his ideas come out of research into Type A behaviour. The Type A research had looked at energised, driven workaholics who seemed at first to suffer more from cardiovascular problems. But there were studies that did not support the idea that always being on time for appointments and rushing and hurrying was a bad thing for you. So researchers, including Williams, began to focus on the hostility component of the Type A pattern. He says, perhaps a little jokingly, that it would be even better if the researchers could show that being a mean, nasty person was causing people to drop dead. But that is exactly what he found.

So getting angry at everyday little things all the time is not good for you. We are all going to get angry at major things, which is o.k. and may help you to change what is happening to you. But having a lot of anger kills you whether you hold it in or let it out. In some studies Williams found that men at age 25, who say "If I get angry, I show it. You're going to know about it", have high death rates by age 50. It's the anger itself that seems to be causing the problems.

This doesn't mean other negative emotions are out of the picture. A person who has a lot of hostility will also be more likely to have a lot of depression and very little social support. Each of those two, depression and social isolation, have been found to predict high death rates, in both healthy populations and patient groups who already have heart disease.

These effects are related to poverty. Michael Marmot at University College, London, has shown that as you go from the very highest socio-economic level down to the very lowest, at every step down there's an increase in mortality rate. Williams says that as you go down the socio-economic ladder, hostility goes up, depression goes up, and most likely, social support goes down. These factors may be the cause of the increased death rates from cancer, heart disease, minor respiratory infections and so on.

Williams and his group believe that there are two major reasons for this. First, poor health habits: more smoking, more alcohol use, more eating. Second, the bodies of hostile, depressed people react differently. Difficult life events lead to a greater chemical response in the body that goes with feelings of distress. Furthermore, the calming part of the nervous system is weaker in depressed and hostile individuals. So, Williams says, it's a double-whammy. They have more of the dangerous reaction, and less of the protective reaction.

A lot of this information comes from study of male behavior mostly because women are less hostile than men. All the same whenever there is a higher hostility within females, there is an increased risk for all the outcomes so far mentioned. All the bad effects of hostility on bodily reactions or smoking or drinking or eating seem to be present in women as much as men, but the women have a lower level of hostility to begin with. The bad news for women is that one of the other risk factors, depression, is much more common in women.

It is possible that the extreme stress reactions of highly hostile and depressed people may suppress their immune systems and this, together with their lowered resistance (e.g. through exposure to cancer causing agents such as cigarette smoke), is what does the damage.

Williams says there is no question about a genetic component with regard to the tendency to hostility and depression. If we compare identical and non-identical twins, the hostility scores are more similar in the identical twins than they are in the non-identical twins. Lower brain levels of the neurotransmitter serotonin, which has been shown to be significantly affected by genetic factors (at least in animal studies) may be a key factor.

However, some of the effects of hostility and depression may be created by unhappy life experiences. Animals deprived of normal nurturing in early life are more aggressive, more fearful, have higher stress hormone responses to stress and prefer alcohol when given a choice between a liquid containing alcohol or not. On the other hand, animals given extra attention for only the first seven days of life, are more resistant to stress, have smaller stress chemical responses, are less preferring of alcohol, less fearful and so forth as adults. We don't know if things work exactly the same way in humans but research evidence is pointing this way. In other words, we should aim to provide more nurturing, more love, more positive affirming communications in early life.

When it comes to doing something for the adult, other than drug therapy (which has only short term effects), patients who have had a heart attack show better progress when trained to control anger better, when given social support through weekly group meetings and when they are trained in identifying situations that make them angry and practise new ways of thinking about those situations. After this they don't become as angry, or act as aggressively.

Thus, learning to manage negative emotions like anger and depression and getting more social support, is likely to improve prognosis and not just with heart attacks. Williams says these kinds of treatments may help prevent return of cancer in cancer patients.

(Anger Kills. Williams Redford & Williams, Virginia, 1997. Times Books-Random House:New York)

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