Check Yourself Before You Wreck Yourself: The Anger/Autoimmune Connection

Have you seen the Pixar film Inside Out? While it may be a cartoon, I love how it shows the interplay among our emotions, and how they all get to have their moment in the sun. It’s no coincidence to me that the character “Anger” in the movie is modeled after a fire brick. When he gets wound up, flames literally shoot out of his head! In my case, the faces of anger look a little different:

• It can be rageful — like an out-of-control monster mommy when my kids are pushing my buttons during a day that I just can’t possibly take anymore.
• It can look like giving the stink eye to my husband and being irritated at everything he does (even how he chews his food!) because he said something that hurt my feelings or was insensitive. Often, he hasn’t even done anything wrong, but he is a convenient target when I’m angry at life. In fact, I sometimes feel like I’ve kind of developed a superhero level of anger repression that comes in the form of passive aggressiveness. I learned growing up that I should choose gratitude over anger, that no one wanted to feel my anger, and that I should get over it and put on a happy face.
• It can look like a smiling face and, “Everything is just fine!” as I commit to ignoring and suppressing the things that really hurt and bother me.

Anger is a pretty loaded emotion. Culturally, we tend to try to suppress anger and oftentimes don’t allow ourselves to experience it. I have found that my autoimmune clients frequently experience SIGNIFICANT anger — at their disease, at their body for not functioning properly, at themselves for being the way that they are, and even at past events that continue to bother and haunt them — but they often also tell themselves that they shouldn’t outwardly express their frustrations. Instead, they ignore them or bottle them up, only adding to their body’s stress response, and, you guessed it, exacerbating their autoimmune systems (more on that in a minute.)

It’s okay to be angry!

Here’s the thing: it’s okay to be angry! One more time for the folks in the back: it’s okay to be angry. Anger is natural, it is useful, and we ALL experience it. Autoimmune disease (like many other things in life, which are also okay to get angry about) is frustrating, perplexing, painful, and often unpredictable. That’s enough to make anyone mad! We get to learn to navigate it like we do all of our other uncomfortable emotions. The key is to express your anger and move through it, rather than stewing in it.

Admittedly, this can be tough. If you’re like me, you judge yourself when you get mad: “I should be better than this.” “Why does this bug me so much?!” “My emotions are so out of control!” “I’m an angry person — who the heck could love such ugliness?” and so on.

Anger can wreak havoc on our immune systems

Unaddressed anger often creates problems in relationships both at home and in the workplace. But beyond that, it can have devastating physical consequences. Both types of anger expression are associated with heart disease, stroke, cancer and even autoimmune disease. It can not only exacerbate autoimmune symptoms but it can also stand in the way of the healing process.

In my private practice as a nurse and health coach, I spend a lot of focus with clients working with the connection between the psyche, the nervous system, and the immune system. Psychoneuroimmunology is a growing field that attempts to understand the interaction between these complex systems of our minds and bodies. We are learning more and more about the profound connection of our thoughts and emotions to and on our immune system. Research has shown that our immune systems and our brains are actually wired together and that they communicate with each other.

When anger is driving the bus, our bodies produce a stress response which directly affects the endocrine system (think thyroid and adrenals here as well as sex hormones and even the GI tract, to name a few of interest to the autoimmune community.) Before you are even aware you are angry, your amygdala in your brainstem is activated. The amygdala signals the hypothalamus — and we know what happens from here — the hypothalamus releases corticotropin-releasing hormone (CRH) to the pituitary gland. The pituitary sends a message to the adrenals via adrenocorticotropic-releasing hormones (ACTH) triggering the release of adrenaline, cortisol and norepinephrine.

In chronic doses, these hormones impact microbial diversity, immune function, hormone balance, thyroid functioning, blood flow to digestive system, cardiovascular function and health, and cause inflammation in the body. So, the image of the “Anger” character with flames shooting out of his head is actually pretty accurate!

• Increased pressure inside the eyes
• More frequent headaches and migraines
• Vision issues — blurred vision, tunnel vision, and sensitivity to light
• Dry mouth
• Increased heart rate, blood pressure, blood glucose levels, which means increased risk of stroke and heart attack
• Decreased bone density
• Reduced immune system function (elevated numbers of virus-infected cells with decreased numbers of natural killer cells)
• Slowed metabolism
• Decreased blood flow to the digestive system
• Reduced thyroid function

Even after the feeling of anger passes, its impact lingers in the body. The more often we experience unaddressed anger, the more these hormones show up in the body and wreak havoc on the environment we are working so hard to heal.

On the other hand, when we constructively express our anger — because, again, it’s okay to be angry! — we mitigate these health risks. One study showed that individuals who disclosed a tragic event seemed to have an elevated immune response and generally were healthier than those who inhibited expression of those emotions. There is considerable evidence that expressing emotions such as anger, frustration, and disappointment in a constructive fashion decreases the number of sick days employees use, and lowers health costs for these individuals.

Healthy strategies to navigate anger

Proactively handling (rather than suppressing, or losing control over) our anger can alleviate the constant activation of the endocrine system, which in turn increases the effectiveness of the immune system.

Here are some great ways to shift your approach:

• Be honest with yourself. Are there ways that you suppress your anger, or avoid dealing with it in a healthy fashion? Take some time to reflect on the role modeling you saw growing up and the patterns you may have picked up along the way.
• Get closer to your anger. Anger can be scary, and sometimes it can be hard to look at the root cause. But the only way out is through!
• Dig deep. Anger is usually a surface-level reaction to a much deeper feeling. I like to think of it as a red flag that there is something within me that is calling to be seen. Ask yourself what you feel underneath the anger. For me, it’s usually a combination of sadness, insecurity, embarrassment, disappointment, or frustration. For you it might be guilt or some other emotion. Getting clear about the layers of emotion you’re experiencing will help you to address your anger with the offending party—or just share it with someone else.
• Choose courage. Address the issue! I watch clients, friends, family, and even myself do everything we can to avoid it: we numb, ignore, or dismiss our anger all the time. We exercise it away (we’ve even been taught that this is an effective stress management tool!), mindlessly eat, isolate ourselves, and keep ourselves “busy” so we don’t have to feel and address that which is hard to see. Challenge yourself to have vulnerable conversations with folks to help process your emotions.
• Use your body as a guide. I’ve found that even if my clients haven’t explored the root cause of their anger, they know what it feels like in their body. I have one client whose back acts up whenever he is actively avoiding processing something he’s angry about. Sit with the feelings and ask yourself where they show up in your body. You will likely get some clues that you can watch out for in the future.
• Your process is yours—and it doesn’t have to look rational. While uncontrolled rage that harms us or hurts someone else (think punching a wall, losing it on your kid, etc.) is not constructive, sometimes we need to give ourselves a safe space to express our anger. Here’s the thing: you can love someone with your whole being AND still need to shut yourself in a closet so you can scream into a pillow because they make you so mad. Maybe you need to go out into a field and just holler at the sky. Getting the feelings out of your body in a wild, unconventional way can lead to a euphoric feeling—it’s just the emotion living out its life cycle. Think of a kid throwing a tantrum. Give yourself permission to throw your own tantrum!

I’m curious: do you find anger to be a big part of navigating your disease process? What makes you most angry? How do you express it, and what are some ways you could be more constructive about it? Please share in the comments!