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The Road and Your Health: Is Stress All the Rage?

You're probably guilty of it. You start the day off by hitting snooze three or four times, already running 10 minutes late on your morning routine...

You’re probably guilty of it. You start the day off by hitting snooze three or four times, already running 10 minutes late on your morning routine. By the time you get in the car and crawl your way through 30 minutes of bumper-to-bumper traffic, you’re in no mood for the Miata that just edged its way into your lane, nearly running you off the road. With 21 patients visits already scheduled for today, it’s sure to be a long one.

If you’re anything like the 16 million Americans whose immediate reaction is to curse, honk the horn, or even make an obscene gesture at the jerk who just cut you off in traffic, you may have intermittent explosive disorder (IED). In laymen’s terms? Road rage. In fact, road rage is more prevalent among driving-age Americans than schizophrenia or related mental disorders.

Travel Temperaments

Defined by “temper outbursts that involve throwing or breaking objects” including “threats, aggressive actions, and property damage,” IED is attributed to inadequate production or functioning of serotonin, a mood-regulating and behavior-inhibiting brain chemical, treatable only with antidepressants and anger management.

Just how common is road rage? More than 1,500 people are killed or injured in road rage incidents each year. The Transportation Research Board (TRB) warns that the increasing traffic congestion in the US is becoming a serious problem for commuters. A February 2007 poll substantiated this claim, with more than one-third of adults saying traffic congestion is “a serious problem in their community.” Additionally, the US Department of Transportation Federal Highway Administration released a report last year that stated the estimated percentage of travel occurring under congested conditions rose from 27.4 percent to 31.6 percent between 1997 and 2004. The average duration of congested conditions has also risen—from 6.2 hours per day in 1997 to 6.6 hours per day in 2004. The math is simple, really: more drivers on the road = more angry drivers on the road.

Humans are territorial by nature. According to Matthew Joint, MSc, BSc, MCIT, our cars are an extension of our personal space or territory, and if a “vehicle threatens [our] territory by cutting in, [we] will probably carry out a defensive maneuver. This may be backed up by an attempt to re-establish territory” in the form of flashing headlights, or tailgating, for example.

Excuses, Excuses

Road rage has become such a part of modern life that it has become a common subject for movies and TV shows. Take, for instance, Michael Douglas’ character, William Foster, in the 1993 flick Falling Down. A divorced engineer for the defense industry, Foster gets stuck in LA traffic and finally snaps. He gets out of his car and begins walking through the city, where he acquires various weapons along the way and takes out his rage and frustration on any of his fellow citizens unfortunate enough to cross his path that day (see our list at the end of this article for more movies that prominently feature road rage). This may be an extreme reaction to the daily grind, but aggressive driving incidents have risen about seven percent every year since 1990, according to the AAA Foundation for Traffic Safety.

Some reported excuses (or “triggers” as the AAA labels them) for this kind of severe behavior:

“He cut me off ...”

“She wouldn’t let me pass ...”

“It was an argument over a parking space ...”

The AAA study revealed that one of the main factors influencing driver behavior was mood. “Being in a bad mood appears to have an adverse effect on driving behavior and this effect appears to be most pronounced among unsafe drivers.” People with IED have “poor impulse control, explode in anger far out of proportion to the stress they’re experiencing, and usually suffer from anxiety, as well.” It usually follows a stressful situation such as divorce, losing a job, or an argument with a spouse.

According to a May 2007 report released by the Associated Press (AP), for the second straight year, Miami drivers have earned the city the title of having the worst road rage in the country. New York, Boston, and LA were close contenders, with Portland, Oregon, ranking the lowest. The data comes from a survey conducted between January and March of this year of more than 2,500 drivers who regularly commute in 25 major metropolitan areas.

So now you’re on your way home from work on a Friday evening, after putting in a 10-hour workday, and having seen 24 patients. You’re sitting through 40 minutes of bumper-to-bumper traffic, when a cement truck comes clambering in front of you. Feeling your face burning redder by the second, you remember the tips you read in the Caremark Special Report and try to avoid flipping him the bird. Instead, you attempt to relax by taking deep breaths, unclenching your teeth, and loosening your grip on the steering wheel…or taking it personally and cursing the driver under your breath. The choice is yours.

Other Road Rage-inspired Flicks:


Changing Lanes



Gone in 60 Seconds

The Italian Job