Anger and the city: Doctors share expert strategies to manage road rage

In fastpaced densely populated metropolitans the daily grind often involves navigating a complex web of environmental and digital stressors While a fleeting moment of irritation in traffic is completely normalmdasheveryday frustrationmdasha more intense chronic reaction is taking a significant toll on mental and physical healthThis pervasive issue often manifesting as road rage or chronic urban stress is more than just a bad mood its a fullbody stress reaction that over time can lead to serious health risks This Anger Awareness Week mental health experts delve into the clinical physiological environmental and digital roots of urban rage and offer actionable strategies to reclaim your calmUnderstanding the clinical shift From frustration to rageMehezabin Dordi clinical psychologist at Sir HN Reliance Foundation Hospital Mumbai clearly delineates the clinical difference between normal frustration and genuine road rage ldquoMost of us sigh mutter under our breath or feel our shoulders tighten and then we move on Thatrsquos just everyday frustrationrdquo she explainsRoad rage however is fundamentally different It shows up as1 Anger that feels too intense for the situation2 A sense of being ldquohijackedrdquo by emotion3 Behaviours that feel unsafe like shouting chasing honking aggressively4 Struggling to calm down even long after the trigger has passedAccording to Dordi when someone notices that these reactions happen often feel out of control or spill over into the rest of their life thatrsquos usually when a psychologist should step in It may point to something deeper like chronic stress poor emotional regulation or even a condition such as intermittent explosive disorder The crucial rule of thumb is If your anger feels bigger than the moment itrsquos worth getting helpPhysiological impact The fullbody stress reactionldquoRoad rage isnrsquot lsquojust angerrsquo itrsquos a fullbody stress reaction The moment something feels threatening on the road the brain hits the panic button The amygdala fires adrenaline surges the heart races breathing gets faster and cortisol floods your system Your body thinks youre in danger even though yoursquore actually stuck in trafficrdquo shares DordiThe longterm health risks of repeated exposure to this stress response are significant Dordi notes that over time repeated bursts of this reaction can take a real toll leading to1 Higher blood pressure2 Increased risk of heart problems3 Sleep issues4 Constant fatigue or irritability5 Lowered immunityldquoItrsquos like running a marathon on the inside every time someone cuts you off Your body isnrsquot designed to stay in ldquofightorflight moderdquo during daily commutes and yet thatrsquos exactly what happens for many people living with chronic urban stressrdquo she concludesComorbidity Chronic anger rarely exists in a vacuumFrequent road rage can sometimes be a sign that something else is going on emotionally Dordi highlights how often chronic anger issues are linked to underlying mental health conditions1 People with anxiety often feel on edge so a small traffic error can feel like a real threat2 Depression can show up as irritability making anger quicker to surface3 Individuals with trauma histories or PTSD may react strongly to situations that feel unpredictable or out of their controlShe also mentions that some people use substances to cope with stress and that lowers impulse control even further ldquoWhile not everyone with anger issues has a diagnosable mental health condition chronic anger rarely exists in a vacuum When someone starts noticing that theyrsquore more reactive more easily triggered or less patient than before itrsquos often a sign that their emotional reserves are running lowrdquo Dordi emphasisesHow traffic anger rewires the brainldquoWithout realising it our mood in cities like this is often influenced by our commutes In traffic many people feel irritation and carry it into meetings conversations and even their homes This happens because the repeated anger of being lsquoblockedrsquo becomes a learned emotional responserdquo explains Bhavya Shah consultant psychologist at Saifee Hospital MumbaildquoEvery time we get stuck in a traffic jam and feel annoyed our brain creates a strong neural pathway Over time this pattern turns into a habit The amygdala the part of the brain that handles quick emotional reactions activates even before we fully grasp the situation Meanwhile the rational prefrontal cortex takes a backseat making it harder to calm ourselves at that momentrdquo she explainsWhen asked for a way to break this harmful habit she says ldquoThe solution is to create new responses that compete with the old ones When you practice a calmer responsemdashlike taking deep breaths as your car stops relaxing your shoulders or changing the radio station to distract from the trafficmdashyou signal to your brain that there is no real threat With regular practice most people notice real changes in about 4 to 8 weeks which is often how long it takes to rewire emotional habitsrdquoThe lasting effect of attention residueThe stress from driving doesnrsquot go away as soon as your car stops or you get off the bus Shah introduces the concept of attention residue to shed light on this lingering mental load ldquoAfter a near miss a clash with another driver or just from being in a noisy environment the brain keeps replaying the event This means your focus stays partially stuck on that past experience This lingering mental load weakens working memory and slows down full attention even on simple tasks Many people say that the first 20 to 45 minutes after they get home or to work can feel muddled or tense which is what attention residue looks like in practicerdquoShah suggests designing a healthier transition ldquoFollowing simple rituals can help the brain shift between different states A few minutes of deep breathing before starting the workday stepping outside for fresh air or listening to something calming as you finish your commute can help These mini resets clear away residue reduce emotional carryover and prepare you for a more balanced dayrdquo she saysEnvironmental and digital triggers The microstressors that break the camels backHyperlocal and environmental factors The cumulative effectWe know major events cause stress but the cumulative effect of constant lowlevel irritants microstressors like poorly designed queues repetitive minor honking lack of timely information is equally corrosiveDr Ajit Dandekar head of mental health psychology and psychiatry at Nanavati Max Super Speciality Hospital in Mumbai observes ldquoLongterm exposure to such irritants may cause annoyance sleep problems tiredness headaches and generally higher stress levels Individuals who develop ongoing irritation with honking engine sounds or loud neighbours can potentially experience some psychological problemsrdquoThe core issue is that the brain has a limited tolerance level ldquoEvery badly managed queue loud neighbour or heavy traffic laden with continuous honking makes one more likely to snap even though such an incident in isolation may be a minor one Especially those who live with anxiety or depression may experience the effects even strongly and the link between irritants and poor mental health becomes strongerrdquo he explainsDandekar warns ldquoDonrsquot ignore these minor irritants that make you lsquoa bit grumpyrsquo repeatedly because over a period of time they lower the anger threshold especially in densely packed metropolitans such as Mumbai where there are little or no quiet places or time to recoverrdquoEnvironmental triggers Beyond the obviousBesides the obvious traffic noise subtle environmental factors contribute significantly to increased irritability and rage Dandekar poses ldquoOur expectations of the world around us and the real time overall quality and design of our surroundings can strongly influence the stress levels of an individualrdquoHe notes studies have proved that greener streets with proper pedestrians can offer much higher levels of relaxation as compared to cardominated noisy and polluted urban streets This is why each one of us craves holidays to much quieter greener and natural spaces after every two to three months to reset our stress levelsThe subtle environmental factors he sees contributing to irritability or the buildup of rage are1 Air quality Most major irritant is poor air quality laden with vehicular or industrial fumes and dust Several people develop visible signs of discomfort and their bodies show more signs of stress with higher levels of air pollution2 Lack of green space Trees plants and open sky have a major lsquorestorativersquo effect on people helping their brain to recover from stress On the contrary concrete jungles with no tree in sight and traffic can undo the sense of restoration3 Ambient environment Noise combined with heat overcrowding stench and visual clutter are major ambient stress factors4 Badly designed public spaces Pedestrians hijacked by street vendors or used as parking spaces lack of open spaces confusing crossings densely stacked buildings with little space for manoeuvring are some of the many issues associated with higher stressDigital stressors Instant gratification vs realworld delayThe constant expectation of instant gratification driven by the digital world fuels anger when faced with realworld delays ldquoPeople living all their life in a fastpaced metropolitan like Mumbai are used to instant responses We digitally track our cabs food and even messages all the time and have conditioned our brains to expect speed and predictability Annoyance irritability and rage build up in some of us when situations become unpredictable uncontrollable and repetitiverdquo explains DandekarDigital screens have taught people to expect instant feedback but the real world is slow and thus becomes stressful ldquoEspecially those exposed to constant urban stressors like noise pollution or overcrowding with limited or no recovery time such extra frustration can quickly tip into road rage shouting abusing aggressive honking or at times even a physical altercation We live in environments surrounded by smartphones and digital screens that keep triggering our stress systems A factor of unpredictability and loss of control such as a sudden horn or a buffering app can amplify angerrdquoSeven oneminute strategies for reclaiming controlTo combat the physiological and neurological cascade of urban stress the experts recommend building practical immediate strategies into the daily routine Dandekar shares seven practical strategies to follow when you feel irritated or experience the rage building1 Create a lsquoquiet zonersquo Cut the noise Roll up the window switch to softer music or simply use earplugs Such even smaller reduction in honking and engine sound can help the nervous system settle2 Use a destressor Studies have shown that a green line of trees can potentially reduce stress Spot a tree small garden even a potted plant spend a minute just looking at it Use this as a lsquorestorative breakrsquo to help your brain shift out of fightmode3 Breath Fastest way to calm down is to slow your breathing Inhale through your nose count till 4 exhale gently while counting till 6 and repeat 6ndash8 times4 Reset your body Use the sudden stoppage in your activity to pause and move your body within your space Roll the shoulders stretch the neck unclench the jaw and loosen your grip from the steering wheel This helps to release the pentup energy into movement instead of aggression5 Identify the feeling not the people When you are surrounded with noise and overcrowding avoid blaming the whole environment and instead try to silently label your feeling Naming the emotion help the brain to regain control and reduces the urge to react impulsively6 The glass half full Deliberately reframe an irritating situation into an ordinary one Tune into your favourite song when stuck in a traffic jam observe people and their quirks when stuck in a queue donrsquot deny the problem but donrsquot let it own you emotionally7 Planning selfcare Plan your routine in a way that it offers you a realistic and healthy lsquoresetrsquo for later A short walk in the park after dinner a quiet cup of tea without screens or going to bed ten minutes early for a longer peaceful sleep Plan a recovery point to reduce the sense of helplessness and calm down the chronic rageBy understanding the distinct clinical markers of road rage recognising the physiological and neurological damage caused by chronic stress and implementing these actionable oneminute resets individuals can begin the essential process of healing their brains and reclaiming their emotional wellbeing amidst the chaos of urban life