Quick Facts

    • Anger is a very common emotional response following a brain injury
    • Anger is an emotion triggered by something and may not always lead to aggression
    • Aggression is what others can see, hear, or feel as a result of anger and may require medication to control
    • An increase in aggression following an injury may be related to an increase in the individual’s behaviour from before the injury, or it could be a change in personality as a result of the injury

Possible Causes and Complications

    • Irritability
    • Having a short fuse or trouble controlling temper
    • Verbal aggression which may include swearing, yelling and/or judgmental and abusive comments
    • Rapid breathing and heart rate, tense muscles, sweating, and/or a flushed face
    • Physical self-harm
    • Threatening behaviours (e.g. raising voice, standing to closely, staring, shaking a fist, or treats to harm others)

What does it
look like?

    • The individual may have been irritable or angry person prior to their injury and these tendencies could be increased/amplified as a result of the injury
    • May experience “impulsive anger” which occurs when there is damage to parts of the brain that normally control anger and behaviour. This type of anger is characterized by:
      • Anger begins with injury or is much worse since the injury
      • Feelings of anger come and go quite suddenly
      • Minor events trigger anger
      • Following the episode of anger, the individual with a brain injury is surprised, embarrassed and possibly upset with their behaviour
      • Anger is made worse by physical stress such as fatigue, pain, or low blood sugar.
    • Loud noises, high levels of activity in the environment, and unexpected events may contribute to anger
    • Medical factors such as fatigue, pain, low blood sugar, medications, alcohol or drugs can contribute to anger.
    • Changes in ability, grief, and isolation following a brain injury may contribute to anger as well
    • As a result of anger, individuals with a brain injury may experience a loss of friendships or relationships, withdrawal and isolation, and embarrassment, frustration and sadness.

What can we do?

    • Keep a record of events and factors that increase anger
    • Use positive ways to manage and respond to behaviour (see Ways to Manage Challenging Behaviours)
    • Do not take anger personally and recognize that is may be an impairment in the ability to control anger
    • Avoid the increase and escalation of anger and aggression by using prevention strategies
    • Develop behaviour intervention and management strategies and support the development of self-control strategies.
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