Public Release: 

Chill out: Anger can give you a headache

Saint Louis University researcher says holding it in can make you hurt

Saint Louis University

ST. LOUIS -- Miffed that your daughter neglected to take out the trash -- again? Annoyed that a stranger cut you off in traffic? Ticked because your boss tagged you to work on a holiday?

Here's something else you can get mad about. Holding that anger in can give you a headache, according to new research from a Saint Louis University faculty member.

"We found that holding in anger is the biggest predictor of headaches, among the group of patients we studied," says Robert Nicholson, Ph.D., assistant professor of community and family medicine at Saint Louis University and principle investigator for a study recently published in the medical journal Headache. "Anger might be one of the many things that interact to trigger headaches."

Of the 422 adults Dr. Nicholson studied, 171 suffered from headaches. He looked at how angry a person is, how much he or she internalizes anger and how severe and frequent headaches are. He also considered whether the individual was anxious or depressed; both have been linked to headaches.

Dr. Nicholson found that bottling up anger made it more likely to have headaches -- even more so than depression or anxiety.

Does that mean Dr. Nicholson recommends expressing anger instead of letting it fester? Not exactly.

"There are times that expressing anger isn't the best thing. Yelling at your boss could cost you your job. Making an obscene gesture at a driver who cut you off in traffic could lead to road rage," he says.

"What I would hope to do is to help people learn ways to lengthen their fuses so they avoid becoming angry."

That in mind, Nicholson suggests these strategies to cope with anger.

  • Take three deep breaths. When you're angry, your body becomes tense. Breathing deeply will help lower your internal anger meter.
  • Know why you feel angry. Think like a detective and track down clues about the kinds of situations, people and events that trigger your anger.
  • Express yourself. . . but make sure it won't do you more harm than good in the long run. In many cases, you can tell others how you feel in an assertive, non-confrontational way, which makes you feel better and lets others know what they've done to tick you off. However, if expressing your anger could get you fired, divorced or killed, vent to a friend instead of the person who has wronged you.
  • Change your environment. Take a five-minute walking break to get some fresh air. Create a mental escape from a traffic jam by turning up the radio and singing at the top of your lungs.
  • Look at things in shades of gray instead of black and white. Acknowledge that sometimes life is unfair and sometimes the person who is making you angry does the wrong thing. But don't fuel the fires with phrases like "always disappoints" or "never comes through." It'll only make things worse.
  • Let go of the things that are beyond your control. You can only change yourself and your responses to others, not what others do to you. Getting angry doesn't fix the situation and makes you feel worse.
  • Forgive. This may be the most difficult coping strategy to master because it involves making a conscious choice not to hold something against someone.

"Whether the wound is from someone else or is self-inflicted, the greatest power you have is the ability to forgive and let it go," Nicholson says. "It won't change the past, but neither will being angry."


Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.

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