Medical News Today: What to know about bipolar disorder and anger

Bipolar disorder is a long-term mental health condition that affects a person’s mood. Some people with the condition experience anger that is difficult to manage.

In this article, learn about the link between bipolar disorder and anger, as well as how to manage it.

Does bipolar disorder cause anger?

upset teenaged boy talking to father
Bipolar disorder affects mood and may lead to irritability and anger.

Anger is not a typical symptom of bipolar disorder. But people with bipolar disorder may become angry due to the shifts in mood they experience.

High, low, and mixed mood episodes are characteristic of bipolar disorder. Irritability is a common feature of high and mixed mood episodes.

If a person with bipolar does not have strategies to cope with irritability, it can lead to angry outbursts. Many people with bipolar experience anger, which can appear out of character for them.

One study suggests that people with bipolar may display more anger than others, especially during acute episodes of their condition.

Not everyone with bipolar disorder experiences irritability or may only experience mild irritability. Mild irritability may not impact their behavior or lead to anger.

Mood episodes affect each person with bipolar disorder differently, and research suggests bipolar symptoms may exist on a spectrum.

A person’s temperament and personality may affect the primary symptoms of their condition, including irritability that leads to anger.

Symptoms

During high periods or manic episodes, a person with bipolar may be excessively happy, have lots of energy, and feel confident.

They may feel like their thoughts are racing, they jump quickly between ideas or tasks and get irritated easily.

Hypomanic episodes are periods where high mood symptoms are present but are less severe than in a manic episode.

Irritability can be common in both manic and hypomanic episodes. Excessive energy and racing thoughts mean a person experiencing mania or hypomania may become frustrated easily. The fact that others are not able to match their pace may aggravate them. This frustration could lead to anger.

Doctors refer to periods of low mood as depressive episodes. During a depressive episode, a person with bipolar may feel deeply sad, hopeless, or worthless.

Low periods are less likely to cause irritability. One older study found that around a quarter of people with bipolar 1 experience substantial irritability during depressive episodes.

Unmanaged irritability may lead to anger. However, it is vital not to assume that all anger is due to a person’s condition.

Anger is not always a sign that someone is unwell. Anger is a natural human emotion that every person feels and has the right to express.

What to do to calm down

mature woman listening to music at home
Listening to music may help a person become calm.

When faced with anger, people can use many strategies to calm down.

These include:

  • breathing deeply from the diaphragm
  • repeating calming words or phrases
  • visualizing a relaxing experience
  • reframing a situation logically
  • listening actively to another person
  • making an action plan
  • using humor to defuse a situation
  • taking time out alone
  • going for a run or walk to redirect energy
  • listening to music to shift mood

Long-term management

There are many ways to manage bipolar anger and irritability, including the following strategies:

Sticking to a treatment plan

Effectively managing bipolar disorder is the best way to reduce irritability and anger.

Working with a doctor on a treatment plan that includes a combination of psychotherapy and medication is often the most effective way to manage bipolar disorder.

Once both parties agree on a treatment plan, consistency is key. Sticking to treatments in the long-term may reduce how frequent or severe mood episodes are.

Journaling to understand triggers

woman writing in journal
Keeping a journal can help a person recognize what triggers their anger.

Journaling can help a person with bipolar disorder understand what triggers anger and irritability. To use this strategy, a person can try:

  • writing down events that triggered shifts in mood
  • identifying what was happening when irritability last led to anger
  • planning ways to avoid these triggers or responding differently

This approach may reduce the likelihood of getting angry next time.

Planning with loved ones

Making a support plan with family and friends may help a person with bipolar disorder reduce the impact of irritability. A support plan can include:

  • sharing triggers of irritability and anger
  • listing calming strategies that help
  • agreeing on how family members and friends can best offer support

Managing stress

Managing the body’s physical response to stress may reduce the likelihood of mood episodes that cause irritability. Stress-reducing activities that can help include:

  • yoga
  • mindfulness
  • meditation

Trying cognitive behavioral therapy

According to research, cognitive behavioral therapy or CBT shows promise as a treatment for anger. It may also help people who have bipolar disorder manage irritability and other aspects of their condition.

Trying CBT may also support a person’s ability to manage bipolar disorder in the long-term.

Adjusting medication

If a person with bipolar disorder has long-term issues with irritability and anger, they should discuss it with their doctor. It may be a sign that their treatment plan needs adjustment.

One study suggests that taking citalopram in addition to a mood stabilizer may help to reduce anger, but “trait anger” (not related to bipolar symptoms) is also a predictor.

Takeaway

Anger is not a bipolar disorder symptom, but irritability is. Irritability can be part of hypomanic or manic episodes, and may also affect people during depressive episodes.

Without proper treatment or strategies to manage irritability, it may lead to anger. When a person is irritable, they may lose their temper.

Some research does link bipolar with increased anger, but it does not affect everyone with the condition.

If irritability affects a person with bipolar, following long-term management strategies may help reduce its impact. When anger does occur, many tactics can help a person calm down quickly.

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