Bipolar Disorder and Anger: Why It Happens and How to Cope
People with bipolar disorder often experience irritability. This emotion is common during manic episodes, but it can occur at other times too.
Bipolar disorder is a brain disorder that causes unexpected and often dramatic shifts in mood.
During what’s known as a manic period, these moods can be intense and euphoric. During a depressive period, they may leave you feeling sad and despairing. That’s why bipolar disorder is also sometimes called manic-depressive disorder.
The changes in mood associated with bipolar disorder cause changes in energy too. People experiencing a bipolar disorder episode often have different behaviors, activity levels, and more. This includes irritability.
A person who’s irritable is easily upset and often bristles at others’ attempts to help them. They may be easily annoyed or aggravated with someone’s requests to talk. If the requests become persistent or other factors come into play, the person may anger easily and often.
Keep reading to learn more about what may be behind this emotion and what you can do about it.
Anger isn’t a symptom of bipolar disorder, but many people who have the disorder, as well as their family and friends, may report frequent bouts with the emotion.
For some people with bipolar disorder, irritability is perceived as anger and may become as severe as rage.
A 2012 study and a 2014 study by some members of the same research team found that people with bipolar disorder show greater episodes of aggression than people without bipolar disorder.
People with bipolar disorder who aren’t receiving treatment or those experiencing a rapid change in mood, or rapid cycling between moods, are more likely to experience periods of irritability too. Anger and rage may follow.
A 2017 analysis of two clinical trials focused in part on remission during bipolar disorder I treatment. Researchers discovered that 62.4 percent of the study participants experienced irritability before starting treatment. An even larger percentage of people (76.4 percent) experienced agitation.
Overall, 34 percent of people experienced severe anxiety, irritability, and agitation.
The research included 960 people in total: 665 people who’d experienced a depressive episode within the past 3 months and 295 people who’d experienced a mixed, or manic-depressive, episode.
Prescription medication is one of the primary ways doctors treat bipolar disorder. Doctors often prescribe a variety of medications for the disorder. Mood stabilizers such as lithium (Lithobid) are usually part of the mix.
Lithium can help treat symptoms of bipolar disorder. It can also improve the brain chemical imbalances believed to be responsible for the disorder in the first place.
Although there are anecdotal reports of people experiencing increased episodes of irritability and anger after taking lithium, they aren’t considered side effects of the medication.
Side effects of mood stabilizers such as lithium include:
- restlessness
- constipation
- loss of appetite
- dry mouth
Changes in emotions are often the result of your body learning to adjust to the new chemicals. That’s why it’s important that you continue to take your medication as prescribed by your doctor.
Even if new symptoms crop up, don’t stop taking your medication without first discussing it with your doctor. If you do, it may cause an unexpected shift in your emotions and increase your risk of side effects.
Everyone gets upset from time to time. Anger can be a normal, healthy reaction to something that’s happened in your life.
However, anger that’s uncontrollable or prevents you from interacting with another person is a problem.
If you think this strong emotion is preventing you from having a healthy relationship with friends, loved ones, and colleagues, it may be time to see a doctor.
Here are some signs that irritability or anger may be affecting your life:
- Your friends avoid you. An angry run-in with a friend or two too many times may discourage your friends from inviting you to future events.
- Your family and loved ones back down. Arguments are common, even within the most secure relationships. However, if you find your loved ones aren’t willing to have an intense discussion with you, your behavior may be the reason why.
- You’re reprimanded at work. Irritability or anger at work may create a difficult work environment with your colleagues. If you’ve been reprimanded or counseled recently about your attitude, the way you handle your emotions may be an issue.
If this sounds like something you’ve experienced, don’t be afraid to ask for help.
If you need honest feedback about your behavior, ask someone you can trust. Tell them you understand how uncomfortable it may be, but you need to know how your behavior is affecting your relationships.
If you’re experiencing anger or irritability, learning to cope and manage the emotions can help improve your relationships with others and your overall quality of life.
The following steps may help you manage any shifts in emotions.
Identify your triggers
Some events, people, or requests can be really upsetting and turn a good day into a bad one.
As you experience these triggers, make a list. Try to recognize what triggers your anger or makes you most upset, and learn to ignore or cope with them.
Take your medications
Well-managed bipolar disorder may cause fewer severe emotional shifts. Once you and your doctor decide on a treatment plan, stick to it. It can help you maintain even emotional states.
Talk with a therapist
In addition to medications, doctors often suggest people with bipolar disorder take part in cognitive behavioral therapy (CBT).
CBT is a type of therapy that can help people with bipolar disorder express their thoughts, feelings, and concerns.
The end goal is for you to learn to be productive despite the disorder, and to find ways to cope with any lingering side effects or complications, whether from medication or the condition itself.
Harness the energy
When you sense yourself getting upset or frustrated, look for creative outlets that can help you harness the energy while avoiding a negative interaction with another person.
This could include exercise, meditation, reading, or any other activity that lets you manage emotions in a more productive way.
Lean in to your support team
When you’re having a bad day or week, you need people you can turn to. Explain to your friends and family members that you’re working through the symptoms of bipolar disorder and need accountability.
Together, you can learn to manage this mood disorder.
When a person has bipolar disorder, their emotional shifts may seem very unexpected to you. The highs and lows may take a toll.
Learning to anticipate and react to these changes can help people with bipolar disorder, as well as their loved ones, cope with the emotional changes.
Here are a few strategies to keep in mind.
Don’t back down
If you’ve been dealing with your loved one’s bursts of anger and irritability for a long time, you may be tired and unwilling to put up a fight.
Instead, ask your loved one to visit a therapist with you so the two of you can learn ways to communicate more clearly when emotions are high.
Remember, they’re not necessarily angry at you
It can be easy to feel that the anger attack is about something you did or said. If you can’t pinpoint a reason for their anger, take a step back. Ask them what they’re upset about, and go from there.
Engage positively
Ask your loved one about their experiences. Be willing to listen and be open.
Sometimes explaining what they’re experiencing can help your loved one cope better with their shifts in mood, and communicate better through them.
Look for a community of support
Ask your loved one’s doctor or therapist for recommendations for groups you could join or professionals you could see. You need support too.
Help them stick to treatment
The key to treatment for bipolar disorder is consistency.
Help ensure that your loved one is taking their medication and following through with other treatments when and how they’re supposed to. If they’re not, encourage them to talk with their doctor about finding a treatment that works better for them.
Last medically reviewed on January 31, 2021