In the summer of 2015, I went off Zoloft, a selective serotonin reuptake inhibitor (SSRI) used to treat depression and, in my case, anxiety. I got a bit more anxious, but the main side effect was one I didn’t expect: sudden outbursts of anger. I wasn’t angry about anything, though just about everything seemed infuriating when these hit. I'd clench my jaw, run, or punch pillows as I waited for this unbearable fury overtaking my body to pass. It was years before I learned that SSRI withdrawal can cause rage attacks.
Rage attacks are just what I described — sudden bouts of anger for no apparent reason. Sometimes, they’re accompanied by anxiety and feel a bit like panic attacks, Richard C. Shelton, M.D., a psychiatry professor at the University of Alabama School of Medicine, tells Bustle. But SSRI withdrawal is actually not a common cause, he says. “Rage attacks can occur as part of a range of mental disorders, including schizophrenia, bipolar disorder, major depression, and borderline personality disorder. There are people who are prone to rage attacks without other psychiatric illness.”
If you find yourself furious about nothing in particular at random times, it’s not your fault and it doesn’t make you a bad person. But it could mean you’re dealing with some underlying physical or mental condition. Here are some of the most common explanations behind rage attacks.
Rage attacks aren’t always pathological. Even if there’s no immediate trigger for your anger, it could stem from something in the past that you’re not aware of. “Anger is not a socially accepted emotion,” psychotherapist Vladimir Musicki tells Bustle. “Because of that, we start to negate and suppress anger, trying to push it away from our consciousness. By doing that for years, we harm ourselves and it can become quite detrimental to our well-being, because the neglected feelings are still there and they want to 'come out' from the basement. This is perhaps the reason why rage attacks are almost by definition so strong and out of control. The feelings which were unconscious are finally free in all their 'glory' and they are starting to create havoc.”
You can explore what feelings could be underlying your rage by talking to a therapist or trusted friend about what has made you angry in the past, perhaps when you didn’t have the chance to express it. Be compassionate with yourself and validate your reasons for being angry. Anger gets stronger when you try to push it away or delegitimize it.
2Intermittent Explosive Disorder
When your rage attacks don’t coexist with any other symptoms and aren’t linked to any life occurrences, intermittent explosive disorder could be the culprit, says Shelton. People with this disorder have out-of-the-blue anger outbursts accompanied by racing thoughts and sometimes physical aggression. Intermittent explosive disorder can be treated with therapy and sometimes psychiatric drugs.
4Borderline Personality Disorder
Borderline Personality Disorder is characterized by mood swings, difficulty with relationships, depersonalization, and sometimes self-harm or suicide attempts. Many people with BPD experience “borderline rage” due to abandonment issues, according to The Mighty. They tend to blow up at people close to them because they’re expressing anger rooted in childhood, when a parent or someone else they were close to abandoned them.
5Premenstrual Dysphoric Disorder
Rage can be a symptom of hormone fluctuations, which can occur with Premenstrual Dysphoric Disorder (PMDD). PMDD is essentially extreme PMS, so it can come with intense mood swings. Healthy habits like exercising and eating a balanced diet can curb PMDD, but sometimes psychiatric drugs and hormone therapy are necessary. If you suffer from rage attacks around your period, don't assume that what you're experiencing is just normal PMS. Talk to a doctor if it's significantly impacting your life.
Anger and irritability are lesser-known signs of depression. Less than one percent of people with depression have rage attacks, but about 10 percent get irritable during episodes, and 40 percent have outbursts of anger, says Shelton.
Schizophrenia, a disorder characterized by a number of symptoms including hallucinations and delusions, is sometimes associated with anger due to the perception that others are out out to get the person or just the pain of having schizophrenia. In the case of paranoid schizophrenia, this can sometimes lead to violence. Treatments for schizophrenia include medication, therapy, and help with employment, education, and other tasks.
The bottom line: Don't view your outbursts of anger as signs of a character flaw. You're suffering, and you deserve compassion and help.