Lowdown on Adult Tantrums, Meltdowns, and Rage Attacks

Hearing the word “tantrum” might inspire visions of a small child flailing on the floor, red-faced, screaming, “I want it, I want it!”

Young children often throw temper tantrums because they haven’t yet learned to control their emotions or vocalize their needs.

But what about this kind of behavior in an adult friend, partner, or co-worker? It might actually be something a little different.

Adult meltdowns and rage attacks can resemble tantrums, but they tend to happen when someone can no longer cope with tension or painful emotions (not because they want or need something).

Below, you’ll find information on potential causes of tantrums and meltdowns in adults, tips for coping with your own distress or supporting a loved one, and guidance on when it might be time to get professional help.

What might be going on

Angry outbursts in adults can happen for a number of reasons.

Trouble managing emotions

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It’s normal to feel angry and sad when things don’t turn out how you hoped. But without good emotional regulation skills, some people have a hard time navigating those emotions in appropriate ways.

Say you meet with your boss to discuss a promotion. Your boss explains that while the company recognizes your dedication and effort, they want you to get more experience before you take on more responsibility. “Let’s talk again in 6 months,” they say.

Consider these two possible reactions:

• You’re disappointed, but you quietly return to your office where you slam out a frustrated text to your partner.
• “That’s ridiculous,” you exclaim, shoving back your chair so hard it topples over. “I’ve worked harder than anyone else, and you’ll regret passing me over.” You snatch up the documents you brought, ball them up, and throw them into the wastebasket with force, slamming the door on your way out.

Not everyone learns to express emotions in healthy ways. People who learned to suppress emotions often experience outbursts when they can no longer push them back.

Imagine a pot left to boil with the lid on. Eventually, the contents will bubble up and spill over, right? Emotions follow a similar pattern.

Depression

People most commonly associate depression with extreme sadness, low moods, and feelings of hopelessness. But depression can also involve uncharacteristic irritability and anger.

Someone dealing with depression-related anger might:

• feel extreme rage in response to smaller-scale triggers
• become angry and “blow up” when things go wrong
• have trouble managing their anger response

Intermittent explosive disorder (IED)

IED involves repeated aggressive and angry outbursts that can resemble temper tantrums. Someone with IED might lose their temper while driving, scream at others, throw things, or even punch a hole in the wall.

The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lays out two separate key criteria for diagnosis:

• Uncontrollable tantrum-like behavior, like verbal or physical outbursts of anger or rage, about twice a week for at least 3 months. These tantrums won’t involve property destruction or damage or harm to anyone else.
• At least three physical outbursts in the space of 1 year. These explosions of anger will involve harm to other people or pets, or damage to property and belongings.

Someone only needs to experience one of the above to meet the diagnostic criteria for IED.

These eruptions generally come and go fairly quickly. They can happen anywhere, and you might feel exhausted or guilty afterward.

Autism

Autism spectrum disorder can also involve meltdowns that seem like tantrums.

Meltdowns can happen in just about any situation. They might involve crying, screaming, throwing or breaking things, or other physical expressions of distress. Some people also withdraw or zone out.

Unlike temper tantrums, meltdowns don’t happen because someone is trying to get what they want. They happen in response to extreme overwhelm caused by:

• stress
• sensory overload
• changes in routine

You might think of them as a loss of control that happens when you can no longer cope with a situation.

Tourette syndrome

This neurological tic disorder involves uncontrollable muscle spasms, but anywhere from 20 to 67 percent of people with Tourette syndrome may also have rage attacks, according to a 2020 research review.

These attacks generally happen in response to a specific situation, and they usually don’t last long. They tend to be more severe than the trigger would usually warrant. For example, shouting at a co-worker when you catch them using the coffee creamer you brought from home.

While someone might recognize their response as extreme and feel embarrassed and upset afterward, they still can’t help their reaction.

How to cope

Experiencing meltdowns and rage attacks can be pretty upsetting. Even when you realize your reaction doesn’t really match the situation, you might feel powerless to calm down or react differently.

You might even notice physical symptoms, like:

• a racing heart
• tremors and shaking
• tightness in your chest

While rage attacks and meltdowns may not necessarily be your fault, they can still harm you, as well as the people you love. These tips can help you begin taking back control.

Know your triggers

You can’t plan for every circumstance that triggers a meltdown or rage attack. Still, knowing what types of situations tend to make you angry or upset can help you come up with strategies to prevent outbursts.

Start by listing situations when you’ve lost control in the past, or tracking outbursts for several weeks to identify any patterns.

Maybe you notice you have the most difficulty controlling emotions:

• after a long day
• when spending too much time in social settings
• when under a lot of stress
• after something alters your routine

Once you’ve identified potential triggers, you can develop strategies to handle them:

• If things in your environment upset you, you might try getting a cool drink, taking a walk, or finding a quiet place to be alone.
• Outline a few ways to politely refuse changes in your routine that trigger distress.
• Prepare a list of calming activities, like meditation or music.
• Look for other ways you can express your anger, like drawing, writing in a journal, or playing music.

Practice relaxation techniques

While relaxation exercises can’t replace therapy and other professional treatment, they can help you manage anger and outbursts.

The key to success lies in practicing these techniques regularly. When they become part of your routine, it’s easier to reach for them when you become upset.

Helpful relaxation strategies for anger include:

• visualization or guided imagery
• progressive muscle relaxation
• deep breathing
• meditation

Find more anger management exercises here.

Practice good communication

When you’re really upset, it might feel satisfying to scream or kick furniture, but these actions don’t let other people know why you’re angry. These actions usually won’t do much to resolve the problem, either. You could also hurt yourself or someone else.

Improved communication can help you express anger in healthier ways. If you can name and describe specific emotions and feelings, other people have a better chance of understanding the problem and helping you resolve it.

Therapists can offer support with strengthening communication skills, but self- help books can also have benefit.

Here are a few titles to consider, all available for purchase online:

• “Improve Your Social Skills” by Daniel Wendler
• “Big Talk, Small Talk (and Everything in Between): Effective Communication Skills for All Parts of Your Life” by Shola Kaye
• “Simply Said: Communicating Better at Work and Beyond” by Jay Sullivan
• “Better Conversations: Coaching Ourselves and Each Other to Be More Credible, Caring, and Connected” by Jim Knight

Talk with a professional

It’s not always possible to manage rage attacks or tantrums yourself.

A therapist can teach you relaxation techniques and skills to better manage your feelings. These can help with any kind of tantrum or rage attack, regardless of the underlying cause.

Cognitive behavioral therapy (CBT), an approach that helps many people improve their ability to manage distress, may have particular benefit for IED.

Therapy also offers a safe space to get support with identifying and processing difficult feelings if you struggle with emotional regulation.

Very occasionally, uncontrollable rage could have an underlying medical or psychiatric cause. If you don’t see improvement after working with a therapist, you may want to make an appointment with your healthcare provider.

Dealing with someone else’s tantrum

When someone you care about has tantrums or meltdowns, you might wonder how to best offer support or de-escalate the situation.

First, try to keep calm. This might be difficult if they seem to want to provoke you. If they say unkind things, you might begin to feel hurt and angry yourself.

Maybe they show their rage with the silent treatment; adult tantrums don’t always involve kicking and screaming.

Though being ignored might infuriate you, resist the temptation to blow up at them. Instead, take a few deep breaths, even a short break, before you try to respond.

Make sure you’re safe

Someone having a rage attack or meltdown might express anger and frustration physically. Maybe they don’t normally kick, hit, or throw things, but someone in the grips of rage may react differently than they ordinarily would.

Someone who knocks over furniture or punches holes in walls when angry isn’t necessarily abusive. Still, you want to avoid putting yourself at risk.

If you have any doubts as to whether someone might become physically aggressive or violent, it’s best to leave the room and give them some space to regain their calm.

Offer empathy

Tantrums, rage attacks, and meltdowns are usually linked in some way to overwhelming situations or difficulty regulating emotions.

If you don’t know what upset your friend or loved one, ask. They may not respond until they feel calmer, but when they do, hear them out. Knowing someone cares can make it easier to explore solutions.

Showing understanding and compassion also helps validate their feelings:

It can also help to consider the language you use. Calling the outburst a “tantrum” may make sense, but it’s also somewhat demeaning and could frustrate them even more.

Many people find it difficult enough to cope with rage attacks or meltdowns without also worrying what others think about them. In any case, outbursts related to mental health or neurological conditions generally aren’t considered tantrums.

Set boundaries

It can feel exhausting to cope with a friend or partner’s regular outbursts or meltdowns. Setting clear boundaries — and sticking to them — can help you protect your emotional well-being while still offering support.

Some examples:

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