Alcoholic Rage Syndrome: What It Is and How To Overcome It

Imagine this: everyone is sitting around the table, having a pleasant conversation, passing around platters of nachos and sipping on salt-rimmed margaritas. Everyone is acting presentable, and the atmosphere is, as they say “classy.” Then, a few margaritas in, the conversation gets a bit louder. You look over and see your friend’s face getting red, and, before you know it, voices are raised and you’re wondering if you’ll have to duck when that plate of nachos goes flying across the table. Yikes!

We’ve heard of the “raging alcoholic” or “angry drunk” stereotype, but is there any truth to the idea? Is alcohol really the culprit? Let’s explore what alcoholic rage syndrome is all about.

What Is Alcoholic Rage Syndrome?

If you follow true crime, you’ve heard about the notorious Murdaugh trials in South Carolina, with the latest being the trial of Alec Murdaugh convicted for killing his son and wife. And although nothing justifies murder, the son Paul Murdaugh was quite a character (and not in a good way). And much of it came down to his drinking. Those close to him would talk about his personality under the influence — a character prominent enough to be seen as his alter-ego, “Timmy.” What was Timmy like? Well, let’s just say you wouldn’t want to get in Timmy’s way. Timmy would get angry. Timmy would get abusive. Ultimately, Timmy would lead to the death of Paul’s girlfriend who drowned in a boating accident that Paul (in drunken Timmy mode) was responsible for.

The truth is, while this case may be extreme, many of us might recognize signs of an inner Timmy in ourselves or in someone we know. Alcoholic rage syndrome, also known as alcohol-induced aggression or alcohol-related aggression, refers to a pattern of intense anger and aggression that occurs in people under the influence of alcohol. Ranging from verbal outbursts to physical violence, this behavior can pose a serious risk to our health and safety, as well as to the well-being of those around us. (For more information, check out “Why Do I Get Angry When I Drink?”)

A Link To ASPD

Those who do seem prone to get angry under the influence might have some characteristic brain activity patterns going on. These neurochemical changes are correlated to some behavioral symptoms, such as disinhibition, and also relate to some psychological factors.

1. Neurochemical Changes

Part of the story has to do with neurotransmitters. From the first sip, alcohol sends our brain chemistry into disarray, altering the delicate balance of neurochemicals in charge of impulse control and mood regulation. Here’s the gist:

• Alcohol boosts the reward chemical, dopamine. The flood of dopamine causes temporary euphoria, making us feel chatty (sometimes too much so) and a bit “uplifted.” (But remember, what goes up must come down — sometimes way, way down).
• It also boosts GABA while suppressing glutamate. At the same time, alcohol acts as a depressant by boosting the inhibitory neurotransmitter, GABA and putting the breaks on glutamate, its excitatory “partner.” The result? A “devil-may-care” attitude that can make it easier for us to exercise self control (more on this later).
• There’s a seesaw effect as the brain tries to balance itself. While in the short run the inhibitory effects of alcohol “win out” (although aggression can still be part of the overall picture), the brain likes equilibrium and shifts to balance out the depressant effects. The result? Rebound agitation and anxiety, sometimes dubbed “hangxiety.” That unease we often feel the next day, in turn, can also come out as irritability and possible aggression.
• Alcohol increases cortisol levels. Another link between alcohol and negative emotions, which can show up as anger, is stress. Yes, many of us think that drinking “relieves stress.” But that’s largely an illusion! In fact, alcohol has a neurochemical “dark side” — it raises the levels of the stress hormone cortisol, leading to increased anxiety as we’re drinking and adding to next-day unease.

Although the effects of alcohol on our brain chemistry kick in right away, over time the situation gets more and more complex. The brain gets used to the “new normal” and can lead to more pronounced long-term changes in our personality (read: our alter ego sets up camp and can become a permanent fixture). (For more information, check out  “How Alcohol Affects the Brain: A Look Into the Science” and “Alcohol and Emotions: How Alcohol Plays With Your Feelings.”)

2. Disinhibition

By acting as a central nervous system depressant, alcohol also takes our prefrontal cortex — the hub of logic, and reasoning — temporarily “offline.” Without our decision-making powerhouse running the show, we have less control over our behavior and are more prone to impulsivity and aggression.

In other words, we’re likely to do things — including giving others an earful as soon as we feel irked — without thinking about the potential fallout. We might also misread social cues and lash out in response to perceived slights, nonexistent threats, or frustrations.

3. Psychological “Baggage” and Social Influence

The past has a sneaky way of making a less-than-pleasant appearance when we’re drinking. It might be something small that nagged us recently — the way our partner never makes the bed or the way our mother-in-law said the paella we tried to impress her with needed more salt. On the other hand, something deeper and more traumatic could also resurface: we might be dealing with unresolved trauma, an illness of a close relative, or financial problems. Either way, mixing any type of psychological “baggage” with booze is trouble waiting to happen — our anger is that much more likely to erupt if there’s already trouble brewing in the background. 

In a similar way, our present surroundings can play a role. If we hang out with people who throw digs at each other (or at us) or normalize alcohol-induced aggression, it’s more likely to make an appearance. Perhaps our friends play it off as funny, or maybe they downplay it due to their own insecurities — whatever the reason is, if our environment makes our “inner Timmy” feel welcome, he’s more likely to show up.

Cause of Effect?

While alcohol can induce rage, sometimes the tables are switched: we might also crave alcohol when we’re already angry. Why? The answer has to do with the nature of all cravings — they’re misguided attempts to feel better in the moment by silencing an emotion or external circumstance we don’t want to experience. The problem is, when booze becomes the answer, it backfires — big time. (To dive into the details, check out “Why Do I Crave Alcohol When I'm Angry?”)

Symptoms of Alcoholic Rage Syndrome

Symptoms of alcoholic rage syndrome run the gamut from verbal tiffs to outright violence. Here’s an overview:

• We might become verbally aggressive. Science shows that alcohol brings out our aggressive side. With loosened inhibitions and heightened emotions, we’re likely to say what’s on our mind — for better or worse. What our sober self would have phrased more delicately suddenly slips right out.  
• Things might even get physical. There’s a reason bar fights tend to get ugly. The “angry drunk” can start throwing punches (or plates, or furniture). Needless to say, physical violence is never okay and can quickly make an unpleasant situation outright dangerous. 
• We could get irritable or hostile. You know how Seinfeld’s George Costanza gets riled up about perceived slights (for example, thinking that the waitress in the coffee shop is covertly flicking him off or that a driver, who ends up having a cast on his middle finger, is doing the same)? George doesn’t need alcohol to get hostile at the drop of our hat, but for many of us these heightened responses happen under the influence.  
• Our impulses might be harder to control. Alcohol-induced aggression is often characterized by impulsive and reckless behavior with little regard for the consequences of one's actions.
• Memory impairment. One of the most serious and often devastating aspects of “raging under the influence” is that sometimes we forget that we do it. Booze can get in the way of memory formation and retrieval, leading to memory gaps around the outbursts or violent confrontations. (These days, if things get really ugly and we’re in a public place, chances are someone will tape it, and we’ll end up seeing a visual reminder. But that doesn’t necessarily make things any better.) For more information, check out “What Happens When You Black Out From Drinking?”

How To Overcome Alcoholic Rage Syndrome

Now that we know what alcoholic rage syndrome is, can we do anything about it? In other words, can we make our inner “Tammy” or “Jimmy” (or whatever name your boozy alter-ego might have) stay away for good? Absolutely.

1. Consider cutting back. Now, this one’s obvious, but we’ll say it anyway — if your angry alter-ego insists on showing up over and over again, it might be time to cut back or take a break from booze altogether. 
2. Know your triggers. What tends to rub you the wrong way or get under your skin, especially when you drink? Is it a certain subject of conversation? Global politics, the upcoming elections, or whether pineapple really does belong on pizza — whatever it is, steer clear of it before things escalate.
3. Breathe out the stress. A lot of times, our anger (especially under the influence) gets ignited by underlying stress. Meditation and mindfulness can work wonders to ease the burden! Besides, a regular mindfulness practice is a science-backed way to reduce impulsivity by changing pathways in the brain while keeping alcohol cravings at bay. A double win!
4. Set clear boundaries. If others’ aggression under the influence is the problem, communicate what behaviors are acceptable and which aren't. If aggression does occur, have a plan for enforcing consequences, such as stepping away from the situation to cool down.

If you do decide to take a break from booze, know that you’re in for a treat. In addition to helping your relationships, a life with less alcohol will leave you healthier and happier in myriad ways: your sleep will improve, your heart and liver will heal, you’ll find yourself getting sick less frequently, and you might even lose weight. And that’s just the beginning! If you need help starting, Reframe is here to help with science-backed strategies and tools to make the journey easy and fun.