Alcohol and Rage: What You Need to Know

If you’ve ever noticed that you — or friends or family — have intense feelings or express extreme emotions or behavior while buzzed or drunk, you’re not imagining it.

“One of the acute effects alcohol can have on the brain is causing rage, anger, and aggression,” says Brent Metcalf, LCSW, a specialist in trauma treatment and clinical alcohol and drug counseling at Tri-Star Counseling.

Alcohol has a closer association with aggressive behavior than any other mind-altering substance, according to the World Health Organization (WHO). It plays a role in half of violent crimes globally. Violent behavior may occur in as much as 50% of people with alcohol use disorder (AUD).

Alcohol factors into nearly a third of all murders in the United States. Plus, alcohol-related rage and aggression are tied to intimate partner violence, verbal and physical abuse, sexual assault, violent crimes, verbal and physical altercations, and more (1).

So, what influences a tendency toward rage or aggression while under the influence? 

Research suggests several factors may be involved, including personality, genetics, social considerations, brain chemistry, and brain changes. And the reasons may be different from one person to the next.

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Disinhibition, alcohol, and rage

Alcohol causes changes in the prefrontal cortex (PFC), leading to disinhibition. 

“It can be difficult to be aware of the impact of your emotions due to alcohol’s effect on the brain,” Metcalf explains. 

This impact can begin to take place after just one drink, depending on the person and other factors, he adds (2).

Impaired judgment

The PFC region of the brain is where we make judgment calls about potential behavior before acting on it. When alcohol impairs this area, a person may be more likely to behave in a way they wouldn’t while sober, including getting confrontational (2). 

Reduced consideration for consequences

Alcohol’s ability to temporarily reduce anxiety can also intensify the urge to act on impulse. If you’re less worried about what others will think, or of any consequences, you could be more likely to have a strong reaction when something upsets you (2).

Disruption to emotional regulation

Additionally, the amygdala area of the human brain is where we process emotions. And our orbitofrontal cortex (OFC), which is part of the PFC, helps calm feelings of rage and aggression. 

Alcohol can impair the OFC, and disrupt communication between the OFC and the amygdala. Without the OFC doing its job of calming those intense emotions, a person can have a strong reaction (2).

Narrowed focus

Alcohol also narrows our focus or attention. So, someone may not be able to grasp the bigger picture of a situation. Instead, they may zoom in on a particularly small thing and have an overly aggressive response (2).

Brain chemistry, alcohol, and rage

Some people may become more angry or aggressive when they drink, in part because of alcohol’s effects on brain chemistry.

“It’s a combination of their genetics, their environment, and how alcohol impacts serotonin levels,” suggests Gillian Tietz, a biochemist and host of the podcast “Sober Powered.”

But effects to other neurotransmitters, including gamma-aminobutyric acid (GABA) and glutamine, may also be involved. 

Here’s a look at alcohol’s effects on various neurotransmitters and their impact on mood and emotional regulation.

1. Dopamine increases, causing euphoria

Drinking, or even the anticipation of consuming alcohol, causes the production of dopamine.  At first, drinking can often make someone feel giddy or euphoric. But that can quickly change (3).

2. Serotonin decreases, reducing the ability to regulate emotion

“Later on in the night, you may find someone crying or becoming overly emotional, and this is because, as the alcohol wears off, there is a big drop in serotonin below baseline,” Tietz explains. 

Studies have shown that serotonin levels may begin decreasing within 30 minutes of that first drink (4). Plummeting serotonin levels hinder the brain’s ability to regulate anger and are linked to impulsive aggression (5).

3. The chill-out effects of GABA give over to the excitatory effects of glutamine

Drinking can have a relaxing or anxiety-relieving effect by mimicking the "chill-out" effects of GABA. At the same time, alcohol hinders the neurotransmitter glutamine, which has a stimulating effect. So, drinking may provide a sense of stress relief at first. But once GABA is metabolized, it mostly converts to glutamine, causing excitement (6). 

In rodent studies, glutamine is linked to heightened agitation and aggression during alcohol withdrawal (7). Additionally, repeated drinking may alter GABA receptors and even damage cells, causing reduced sensitivity to the body’s own relaxing neurotransmitter (8).

In summary, heavy drinking or chronic drinking alters brain chemistry in the short and long term. For these reasons, some people may exhibit nervousness, outbursts, aggression, and even violence while intoxicated or during withdrawal.

Impulsivity, alcohol, and rage

The tendency to avoid looking ahead and assessing consequences for one’s actions is a risk factor for aggressive behavior while drinking. That may sound obvious, and it’s a theory backed by a small, interesting 2012 study from Ohio State University (9). 

In the study, nearly 500 participants completed a questionnaire about their inclination to consider future outcomes. Afterward, they either drank an alcoholic beverage (orange juice mixed with alcohol) or a placebo (the same concoction but with minimal alcohol).

They were then told they were competing with an unseen opponent in a computer-based speed-reaction test for 34 rounds. The winner of the game would deliver a safe electric shock to the loser, with the winner determining the shock’s length and intensity. 

But there was no real opponent. Instead, each participant randomly lost the game about half the time and was led to believe another person was delivering shocks to them during each loss. In turn, some retaliated when they won the game.

Researchers found that participants who were less inclined to think about the future were more inclined to deliver shocks longer and harder, but especially if they were drunk. Alcohol had minimal impact on aggression for those who thought about future consequences.

Genetics, alcohol, and rage

Impulsivity and rage with alcohol may also be a result of genetics. Some people have a genetic variation of the serotonin 2B receptor gene HTR2B. The variation is called HTR2B Q20. 

A small 2015 study published in Translational Psychology investigated the role of this variation in impulsive and aggressive behavior while intoxicated (10).

Using a personality questionnaire, an aggression scale, and alcohol use and history assessments, researchers compared 156 people without the gene with 14 people who have it.  Researchers were studying people in the Finnish population, of which more than 100,000 people have the genetic variation.

They found that people with HTR2B Q20 tended to be more impulsive and aggressive under the influence of alcohol. They were more likely than those without the variation to have a history of outbursts and fights while drinking, as well as to have been arrested for driving under the influence. 

Additionally, more than three-quarters of study participants with the gene had mood disorders, personality disorders, and mood swings (10).

Social factors of alcohol and rage

Alcohol consumption may also lead to a rage response because of expectations, according to researchers (1). For example, if a person goes into a drinking experience with the expectation of alcohol helping them pick a fight with a partner later, that’s then likely to happen. 

Those expectations can also arise from what we’ve learned about alcohol from family members and peers. If you had a parent who was frequently enraged while drunk, you may expect that response in yourself when drinking and therefore exhibit it.

How to prevent alcohol-fueled rage

With some insight into factors that can cause rage or aggression while drinking, you can take steps to avoid certain behaviors.

“Understanding the effect that alcohol has on our emotions helps disconnect them from being personality flaws or something that is wrong with us,” Tietz says. “Anyone who struggles with aggression or anger when they’re drinking would benefit from either not drinking, drinking less, or learning to manage their emotions with the help of a therapist.”

“Look for patterns,” suggests John M. O’Brien, PhD, a psychologist and executive wellness coach in Maine. “Have you found that you and your spouse fight more frequently when you drink? Only when you drink?” 

"Become familiar with how alcohol impacts you," he adds. Do you experience a difference depending on how much you drink? Pay attention to your thoughts and emotions.

"Keep in mind that any amount of drinking can influence emotions and behavior," O’Brien says. Alcohol can fuel rage or aggressive behaviors even when a person isn’t intoxicated. 

For that reason, abstaining from alcohol altogether may be the best way to prevent undesirable effects, such as relationship issues or legal trouble. Alternative solutions may involve setting drink limits, avoiding alcohol when you’re already having intense emotions, or opting to have emotional conversations when you’re sober.

Takeaway

Alcohol consumption is strongly associated with rage and aggressive behavior for a variety of reasons, including brain changes, genetics, learned behavior, and a tendency toward impulsive action. 

To curb alcohol-fueled rage, it helps to know how you respond to drinking. And you may need to take steps to stop or limit alcohol consumption.