Chapter 5: Managing Anger
Can Anger Cause Stress and Health Issues?
Could your personality kill you—or might it make you live longer? Could it give you heart disease, or protect you from illness? Could it push you toward or away from doctor appointments? Personality traits play a distinct role in determining how healthy we are, psychologists say. “Everything is related to everything else. How stressed or angry you are, and how you interact with the world, is contingent in large part on your personality style,” says Michael Miller, editor in chief of the Harvard Mental Health Letter. “And that is going to have an enormous impact on your health.”
Here’s a look at common personality types and traits and how each can help or hurt your health (sometimes both):
Hostile
One of the aspects of the impatient, hard-charging Type A personality that is known to increase heart disease risk is hostility. Hostile people eat and smoke more and exercise less than other personality types, says Redford Williams, head of behavioral medicine at Duke University Medical Center and author of Anger Kills.
They’re likelier to be overweight in middle age and have higher cholesterol and blood pressure. Williams’s past research suggests hostile people are also more likely to develop irregular heart rhythms, and to die before reaching their 50s. Most of these problems can be traced back to elevated levels of the stress hormone cortisol, as well as increased inflammation in the walls of the coronary arteries, which leads to a greater risk of heart attack.
No personality is set in stone, however, and Type A’s can be taught how to take the edge off their hostility. Hostile heart patients who attend workshops that teach coping skills, for instance, have a lower incidence of depression and healthier blood pressure than Type A’s who don’t go. The key, Williams says, is learning how to communicate more clearly and how to control anger and other negative emotions. He suggests asking yourself four questions when you get angry: Is this issue truly important? Is what I’m feeling appropriate to the facts? Can I modify the situation in a positive way? Is taking such action worth it? Meditation, deep breathing, and yoga can damp hostility with a layer of calm.
Impulsive
Because Type A personalities are defined by competitiveness, a drive to succeed, and a sense of urgency, they are prone to take risks and act without thinking, neither of which is likely to improve health. Non-Type A’s can be impulsive, too. Such people are often not as well-grounded as others, says Robin Belamaric, a clinical psychologist in Bethesda, Md.: “They’ll look at an opportunity that comes along and say, ‘Hmm, that sounds like fun,’ whereas another, more thoughtful person, will say, ‘I’m going to pass, because I’m not sure it’s the best idea.’ ”
Relaxed
If you’re a Type B, you roll with the punches. You’re relaxed, take life a day a time, and handle stress without cracking. That translates to a higher quality of life and lower likelihood of heart disease—less anxiety strengthens the immune system. The more we chill, the better off we are, says Miller: “You don’t want to get locked into a stressful, tense state of mind.” Over the long term, he adds, relaxing and managing stress effectively will lengthen your life, help your heart and gastrointestinal system, and just make you feel better overall.
Extrovert
People who are outgoing, involved in their communities, and have strong social connections reap health benefits. An analysis of 148 studies published in the online journal PLoS medicine in July found that on average, adults enrolled in a study with many close friendships were 50 percent likelier to survive until their study ended than were those with few friendships. And a 2009 study published in Perspectives in Psychological Science suggests that social support leads to improved coping skills, healthy behavior, and adherence to medical regimens. Bonding with others also reduces stress and improves the immune system—so making friends and getting involved becomes, in effect, a well-being tonic. What drives at least some of the health benefits goes beyond biology, Miller says. “It may have to do with the fact that when you’re around people, you think, ‘Oh, Martha has gone for her mammogram—that reminds me, I should, too.’ ”
Eager to please
People-pleasers—Type C’s—are conforming, passive, and want to accommodate. That can be a good thing when it comes to patient compliance: They’re more likely to take the right medicines in the right doses at the right times, for instance—once they see a doctor, that is. Making and following through on appointments can be challenging for Type C’s, who tend to accept their fate as inevitable and fall readily into hopelessness and helplessness. That means others must push them to take care of themselves. “They may be less likely to maintain their health on their own,” Belamaric says. “If they develop a problem, they may just complain about it, hoping somebody says, ‘I have a good doctor, I’ll make you an appointment.’ ” Some Type C’s may be so mired that they don’t seek medical attention—even when it’s clearly necessary—and slough off preventive behaviors, like watching what they eat. “If they get a serious diagnosis, they may be passive, throw their hands up, and say, ‘Well, there’s nothing I can do about it, anyway. If it’s my time, it’s my time,’ ” Belamaric says.
Stressed and distressed
Type D’s—D is for distressed—dwell on negative emotions and are afraid to express themselves in social situations. Compared to more optimistic sorts, a Type D may face three times the risk for future heart problems, according to a recent study in the journal Circulation: Cardiovascular Quality and Outcomes. Type D’s also face a higher likelihood of compulsive overeating and substance abuse. “If you’re a person who is prone to depression or anxiety, or if you’re overly self-critical, there’s more of a chance of turning to gratifying behavior to feel better,” Miller says.
Optimistic versus pessimistic
Optimism “heavily influences physical and mental health,” concluded a study published in May in the journal Clinical Practice & Epidemiology in Mental Health after researchers followed more than 500 males for 15 years. The rate of heart-related deaths was 50 percent lower among optimists than among pessimists. “Optimists have a higher quality of life, and they may be more resilient in the way they deal with stress,” Miller says. “So if a problem comes along, they’re able to handle it better, and they become less symptomatic.” Glass-half-empty types harbor little hope for the future and tend more toward depression and anxiety disorders. But there’s a catch for those at the extreme end of the optimism spectrum: They think of themselves as impervious to risks. Extreme optimists who smoke are the best examples. They believe they won’t develop lung cancer. Why give up smoking to prevent a nonexistent risk?
The “self-healing personality”
That is the name Howard Friedman, a professor of psychology at the University of California-Riverside, attaches to people who are curious, secure, constructive, responsive, and conscientious. These traits translate to enthusiasm for life, emotional balance, and strong social relationships. “Positive emotions buffer hormonal responses to stress,” says Friedman, who studies the relationship between personality and longevity. Self-healers, he says, “have healthier behavior patterns: more physical activity, a better diet, and less smoking and substance abuse.”
