Dr Thomas Stuttaford's next online forum will be live after 1pm on April 2. The topic is: anger and how to manage it. To ask the doctor your question on this topic and to read other recent topics he has answered click here

Long before John Osborne wrote Look Back in Anger in 1956, young men were angered by being constrained by their class and education. Just as Philip Larkin's light-hearted conclusion that sexual intercourse “began in 1963, between the end of the Chatterley ban and the Beatles' first LP” drew attention to the Sixties sexual revolution, so did Osborne's angry young men merely emphasise the influence of social conditions and restrictions on hostility, anger and even hate.

Angry young men and women suffering from arrogant bosses, rigid, oppressive class systems or sexual inadequacy, or labouring under thwarted ambitions, even if these have been inspired by grandiosity and unrealistic expectations rather than ability, have been destroying self-esteem and engendering fury since the Roman Empire. Anger is a basic emotion that is often useful, even lifesaving, for it can be a response to danger. It has the advantage of triggering the body's fight-or-flight mechanism.

The Bible encourages us to be slow to anger but doesn't condemn it outright. Even Jesus displayed commendable rage in the temple when he overturned the moneylenders' tables and doubtless showed the physical symptoms of aggression. Theologians used to accept, and probably still do, the concept of righteous anger - after all, even the God of the Old Testament toppled the Tower of Babel just as surely as His son scattered Temple traders.

Anyone who has recently witnessed rather less righteous anger will feel support for the recent appeal by the Mental Health Foundation that aims to draw more attention to anger as a symptom of psychological or psychiatric troubles and the underlying social problems that may encourage them. The foundation recently published the findings of a survey of 2,000 adults. This suggested that people have become angrier and that now one in three from time to time fails to control his or her temper. It is all too easy to attribute this to overcrowding, lack of a stable family, a crumbling community life and the absence of a settled career structure and job security, together with increasing disparity between the rich and the poor - all factors that contribute to feelings of deprivation, personal inadequacy and low self-esteem.

Neither God nor psychiatrists would consider the behaviour of the road-rage lout righteous as he wreaks his wrath on a grey-haired Mr Pooter who has touched his back bumper. The psychologists would, however, be even more interested if the enraged lout repressed his anger until he had the chance to displace it once he was home by taking it out on even feebler people than Mr Pooter. Perhaps he habitually does so by giving vent to his bottled-up rage by kicking the dog, striking his wife or finishing the bottle of whisky. The Mental Health Foundation rightly emphasises that uncontrollable rage isn't a disease. It isn't even the marker for any single personality disorder or psychiatric disease, but can be the symptom of any one of a number of disorders. It can be a symptom of a host of psychological, psychiatric and physical troubles. Although it is tempting to suppose that uncontrollable anger is always the hallmark of either an antisocial personality disorder (psychopathy) or psychiatric disease, in fact any stress, including stress caused by constant pain, can cause previously well-balanced personalities to crack and tempers to fray.

Stress may have been induced by any of the notorious Ds: divorce, desertion, destitution, death, depression or drink. Rage may also be a symptom of problems ranging from the all-too-common dementias to neuro-degenerative disease such as multiple sclerosis or Parkinson's to small strokes, epilepsy, infection or physical injury.

An uncontrollable temper is especially important if it is a new finding. As well as exploring changes in the patient's social background, the doctor will want to exclude the possibility of recently manifest physical or psychiatric disease. Uncontrolled anger can be a feature of a previously unrecognised depressive state, or, paradoxically, evidence of over- elation, hypomania or mania. Bipolar disorder (manic depression) may therefore give rise to rages in patients in either the depressive or the overexuberant phases of the disease. Physical diseases, including damage to the central nervous system, may equally result in an uncertain temper, and some alcoholics - even heavy social drinkers - may get aggressive if they become disinhibited when drinking.

The Mental Health Foundation's call for more attention to anger as a symptom is timely. Unstable and volatile temperaments characterised by bursts of inappropriate rage destroy everyday life for many people and their families. They interfere with employment, make domestic life a misery, and corrode everyday relationships. It is easy to recommend distraction therapy whether by taking a brisk walk, a vigorous run or an hour's gardening, easy to suggest planned chats, but discussion can reveal how thin the ice on which the whole relationship rests has become - so thin so that one false word may crack it irretrievably. Specialist help is needed.

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