Road Rage: When Stress Hits the Highway

In Truckee, California, 25-year-old Timothy Brooks flew into a rage after another car cut him off on the highway. He followed the offending car to a bagel shop where the driver, 47-year-old Robert Ash, had stopped to eat. After yelling at the older man, Brooks attacked him, stabbing him to death with a knife. Brooks was convicted of second-degree murder.

In Little Falls, New Jersey, May Lee and her two children were run off the road by Milton Aganon, 25, who'd been tailgating her at 80 miles an hour and gesticulating at Lee to get out of the way. When Aganon finally passed Lee, he cut her off so suddenly that she was forced to swerve to the shoulder lane, flipped over a median and landed in a ditch. Both of Lee's legs were broken, and the children suffered minor injuries. Aganon served nine months in jail.

These may sound like unusually violent or rare incidents. However, studies from the AAA research arm show that at least 1,700 people are injured or killed in road rage incidents each year.

So who are these lunatics on the road? Are they normal people in their daily lives who convert to maniacs behind the wheel? Or is there a certain type of person who is more prone to go ballistic on the beltway?

Psychiatrists have an actual name for the kind of seething rage that goes beyond the speeding, tailgating, honking, or passing on the right that many aggressive drivers regularly do when they drive. People who experience road rage so violent that it leads to an assault against another driver, passenger, or car may be suffering from "intermittent explosive disorder" (IED), according to a report in the Archives of General Psychiatry. This disorder could affect up to 7 percent of the population, or about 16 million Americans over their lifetimes, according to the authors. This disease -- the psychiatric disorder most closely linked to impulsive violence -- usually begins in childhood or adolescence and includes repeated aggressive outbursts involving property destruction and/or injury over many years.

That's not great news for those of us on the road. Although no agency keeps official statistics on road rage events across the country, reports of so-called "aggressive driving" incidents have increased by about 30 percent since 2010, according to the AAA Foundation for Traffic Safety. The "reasons" given for violent disputes that ended in injury or death include:

• "He cut me off ..."
• "She wouldn't let me pass ..."
• "It was an argument over a parking space ..."
• "Nobody gives me the finger ..."

"The so-called 'reasons' for disputes are actually triggers," an AAA Foundation for Traffic Safety report observes. "While the event that sparks the incident may be trivial, in every case there exists some reservoir of anger, hostility, or frustration."

Candidates for road rage

The majority of aggressive drivers, according to the AAA foundation report, are relatively young, poorly educated men between 16 and 26 who have a history of crime or violence and who also have problems with drugs or alcohol. (The Archives of General Psychiatry report on IED, in contrast, found that the disorder didn't distinguish greatly between people with low or high income and/or education.)

Many cases of road rage occur when these perpetrators are going through some kind of emotional crisis, such as losing a job or girlfriend, going through a divorce, or suffering from an injury or illness, according to the AAA foundation.

Certainly, there are cases of mild-mannered people who fly off the handle on the highway after a particularly bad day at the office, however. (Remember Michael Douglas in the movie Falling Down?). Hundreds of motorists who have abruptly snapped and attacked other drivers, in fact, are successful men and women with no prior history of crime, violence, or alcohol or drug abuse. They come from all classes, races, religions, and ages, and some are women and older men. Oscar winner Jack Nicholson, for example, was 57 when he jumped out of his car at a red light in a Los Angeles suburb and used his 3-iron golf club to bash in the windshield of a Mercedes that he said had cut him off.

Still, although anyone can become an aggressive driver, some character traits appear to make a person more prone to road rage. According to the Archives of General Psychiatry report, people with intermittent explosive disorder have poor impulse control, explode in anger far out of proportion to the stress they're experiencing, and usually suffer from mood, anxiety, or substance abuse problems as well. The disorder doesn't stem from another psychiatric illness or the physiological effect of a drug or medical condition, such as head trauma. Significantly, most people with IED have been treated for emotional or substance problems at some point, but only 28.8 percent have ever received treatment for their anger.

John Casada, a psychiatrist in Abilene, Texas, who specializes in treating patients with anger issues, says that people with the classic "Type A" or competitive personality are more likely to rage. "These types -- the driven types who always have to have everything their way -- are the kinds of people who have a harder time tolerating the frustrations of driving," says Casada, who is also an associate professor at Abilene Christian University.

Unlike normal drivers, who get stressed in traffic but don't flip out, road ragers tend to take another driver's poor road manners or bad driving maneuvers as a personal slight. "They're certain, for example, any time anyone cuts them off, that that person did it just to make them late," says Casada. "They don't consider that maybe that person is having some sort of emergency, or that what they did was a mistake."

Another key to the mentality of road ragers and aggressive drivers may be their desire to punish the other driver or to "teach them a lesson." The act of driving forces us to pay close attention to the movements and behaviors of strangers, far more than we would if we were just walking down the street. This dynamic, experts say, has a tendency to make drivers feel that it's their responsibility to make sure that the mistakes of others drivers don't cause accidents. While calmer drivers might let another motorist's stupid maneuver roll off their backs with an "At least no one got hurt" type of attitude, ragers tend to work themselves up about how dangerous the driver is and how they must be corrected.

Is there a road rager inside you?

The AAA Foundation for Traffic Safety asks these questions:

Are you the type that hits your brakes suddenly to "teach a lesson" to a tailgater? Do you leave yourself 30 minutes to make a 40-minute drive and then become enraged when the cars before you are going too slow? Have you ever blocked a car that was trying to pass you just because you didn't think it should go so fast or get to pass you? Do you curse at other drivers? Do you compete with other drivers in a traffic jam or in toll booth lines?

If you answered yes to any of these questions, you could stand to calm your inner provocateur, at least on the road.

Sitting in traffic all boxed up your car, running late and feeling powerless to improve your situation, is a perfect recipe for stress. Add to the mix some guy weaving in out of lanes trying to push his way in front of you and everyone else who wants to get home too, and your road rage tiger just might rear up.

Unfortunately, this scenario is common during the rush hours of most major cities in the United States at least five days a week. As our society spends more time commuting amid more and more traffic, it's no surprise that rates of aggressive driving and road rage are on the rise as well, Casada says. Certainly, the longer you sit in traffic, the more likely you are to rage, he says. Even if you never actually rage, you might notice the physiological effects of driving stress, such as increased heart rate, headache, muscle tension, and upset stomach. Stress prepares your body for danger and flight, but when you're stuck in a traffic jam with nowhere to run, Casada says, those physiological effects end up doing your body harm instead of good.

Even if you're not likely to engage in road rage, the following tips can make driving less stressful for you:

• Listen to music or books on tape while you drive.
• Don't have unreasonable expectations about how long it will take you to get somewhere. Give yourself plenty of time, and try to plan your route to avoid major congestion.
• Consider changing your schedule to avoid the worst traffic.
• Before going somewhere, check to make sure you have water, a window cloth, and sunglasses accessible.
• Don't get into your car when you are angry or overtired. If you're upset about something, take a few minutes to wind down before hitting the road.
• If you're taking a long trip, get out and stretch your legs when you take a break.
• Try to relax and make yourself comfortable when stuck in traffic. Roll down the windows or turn up the air conditioning, unclench your teeth, and breathe deeply. Finally, relax your grip on the steering wheel.
• If it's out of your control, just resign yourself to being late.
• Use public transportation! If it's available where you live, why not relax and read a book on the bus, train, or streetcar instead of fighting traffic?

And finally, experts at the Harvard School of Public Health have one more piece of advice: Don't carry a gun in your car. A study conducted by the university found that Americans with guns in their cars are more likely to engage in road rage than unarmed drivers. Of 2,400 people surveyed, 23 percent of those who admitted to making obscene gestures to other drivers while driving carried guns in their cars, while only 16 percent of those who don't pack weapons made gestures. Similarly, 14 percent of gun packers said they "aggressively follow" other motorists, compared to 8 percent of those without firearms.

Tips to avoid being a victim of road rage

If you've read this far and you're not a road rager yourself, you're probably wondering how you can avoid a confrontation with these types of people on the road. The National Highway Transportation and Safety Agency recommends the following:

• Make every attempt to get out of the way of an aggressive driver.
• Put your pride in the back seat. Do not challenge drivers by speeding up or trying to prevent them from getting in your lane.
• Wear your seat belt.
• Avoid eye contact. Eye contact can sometimes enrage an aggressive driver.
• Ignore obscene gestures from other drivers, and never respond in kind. According to the AAA Foundation, "Obscene gestures have gotten people shot, stabbed, or beaten in every state."
• Use your horn sparingly. Stressed-out motorists are often sent over the edge by a supposedly rude honk, an event that has been linked to scores of shootings.
• Lock your car doors and, when in town, keep the windows and sunroof only partially open.
• Report aggressive drivers to the police or highway patrol.
• If an aggressive driver gets in an accident, stop at a safe distance from the scene, wait for police, and report the driving behavior that you witnessed.
• If you're pursued by an angry motorist, never go home -- drive to a police station or another place where you can get help.

Aside from steering clear of hostile drivers, the AAA Foundation suggests avoiding the kind of mistakes that have provoked mentally and emotionally disturbed drivers -- and others -- to attack hapless motorists. Here are steps the foundation suggests to avoid drawing the wrath of bullies:

• Don't block the passing lane.
• Stay a safe distance behind the car in front of you -- don't tailgate.
• Always signal before you switch lanes, and make sure you don't cut anyone off.
• Avoid the right-hand lane if you're not turning right.
• Park with care -- don't take up more than one space, and look behind you before backing up.
• Don't park in the handicapped zone unless you're disabled.
• Keep your headlights on "low." If it's dark and you need high beams, dim them for oncoming traffic.
• Don't flash your high beams at other motorists to punish them.
• Don't block the road while talking to someone. As the AAA Foundation observes dryly, "Dozens of shootings suggest that this behavior irritates a lot of people."
• Don't get distracted by your cell phone.
• Refrain from displaying bumper stickers, flags, and other messages that might easily infuriate someone, such as an "IM RICH" license plate.

As tempting as it may be, avoid the urge to engage in any exchange with road ragers or, worse yet, teach them a lesson. "Meeting road rage with road rage is the worst thing you could do," says Casada. "If you look at them and respond, it will only make them madder and you more stressed. If someone pulls up to you and starts yelling or gesturing, just let them blow off steam."

References

Cleave, Kris V. Trying to Put the Brakes on Road Rage http://www.cbsnews.com/news/trying-to-put-the-brakes-on-road-rage/

Interview with John Casada MD, PhD, a psychiatrist in Abilene, Texas.

AAA Foundation for Traffic Safety. Aggressive Driving: Three Studies.

AAA Foundation for Traffic Safety. Are you an aggressive driver?

Kessler, Ronald C., et al. The Prevalence and Correlates of DSM-IV Intermittent Explosive Disorder in the National Comorbidity Survey Replication. Archives of General Psychiatry, Vol. 63

Attila Henry Hegeduus and Olga Kharitonovich v. Jack Nicholson and Sally Boyle, EOnline.

He'll go to jail at night for road rage; Woman and kids got flipped in SUV. The Record. Bergen County, New Jersey.

Man convicted in road-rage stabbing death. Sacramento Bee.

Stop Aggressive Driving Primer, National Highway Traffic and Safety Agency.

Study: Armed drivers more prone to road rage, Chicago Sun Times.

Smart, Reginald G., PhD, Mann, Robert E, PhD, and Goldbloom, David S., MD. Road Rage: Are Our Patients Driving Angry? Psychiatric Times.

National Highway Transportation Safety Administration. Aggressive Drivers.

American College of Emergency Physicians. Aggressive Driving.

National Conference of State Legislatures. Aggressive driving: Background and overview report.

Harvard School of Public Health. Press release: Survey finds association between presence of gun in vehicle and aggressive driver behavior.

Kessler, Ronald C. et al. The Prevalence and Correlates of DSM-IV Intermittent Explosive Disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry; 63:669-678.