Charlie Sheen’s Anger Management Problem

What’s the line between normal anger and anger as a psychological disorder?

We recently read a headline saying that Charlie Sheen’s behavior as a marriage partner makes Tiger Woods look like an OK spouse. Sadly, Mr. Sheen has a well-known history of substance abuse and domestic violence. Because some forms of antisocial behavior have been classified as psychiatric disorders, we wondered whether anger in some forms could constitute a bona fide mental disease and so we did some research.

According to the “bible” of mental illnesses (DSM-IV), anger is not a stand-alone diagnosis but is often associated with other mental disorders, particularly GAD — generalized anxiety disorder. (Some anger cases are diagnosed as a mental illness called Intermittent Explosive Disorder according to another classification system (ICD-10).)

According to recent articles in medical journals, some authorities believe that diagnostic criteria can and should be developed to distinguish the normal emotion of anger from repeated episodes of anger so severe that it can result in physical or emotional harm to the patient himself or those around him. One of these authorities, Professor Raymond DiGiuseppe of St. John’s University, has a 165-page presentation that describes many aspects of anger as a psychiatric disorder.  According to Dr. DiGiuseppe, some people are opposed to making anger a mental disease and he cites the example of feminists who believe that if anger is a disease, domestic violence offenders will be held less culpable for their antisocial and aggressive behaviors, in other words they’ll be off the hook. Other people think anger should be considered a mental illness because they cannot get research grants to study anger from the U.S. National Institutes of Health (NIH) because NIH only funds research on “real diseases.”

For many celebrities, whether their problems are substance abuse, sex addiction or something else, treatment and rehabilitation are often seen (maybe cynically in some cases) as a route to redemption in the public mind. What do you think?

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

3 Comments

  1. pete

    January 4, 2010 at 9:14 pm

    Focusing on “anger management” may not be ignoring other aspects of the pathology. Might “anger management” problems be symptomatic of a generalized disregard for others and perhaps be a component of antisocial personality disorder? Several other criteria are there — it includes a bunch of traits commonly associated with celebrity (superficial charm, grandiose sense of self worth, no sense of remorse or guilt, shallow emotional affect, impulsive, promiscuous, early onset, short relationships).

    • Dr B

      January 4, 2010 at 9:58 pm

      We didn’t go into all of the points made in Dr. DiGiuseppe’s work, but it’s unclear among psychiatrists whether pathological anger should be an Axis I or Axis II (personality disorder as you describe). Unfortunately, treating personality disorders is very difficult particularly because of the lack of self-awareness in these patients that they even have a problem.

  2. Michal Wiemann

    February 4, 2011 at 5:15 am

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