Managing Anger With Bipolar Disorder

Bipolar disorder can look different for everyone. Every person may have different symptoms. Anger is not typically considered an official symptom of bipolar disorder. But, for many, anger is often linked to bipolar disorder.¹

Anger and aggression with bipolar disorder

Bipolar disorder is a mental health condition. It involves cycling between times of feeling high and times of feeling low. This is also called cycling between mania and depression.^1-3

During mania, a person will have an elevated mood. But this mood can be uncontrolled and lead to reckless or risky behavior. During depression, a person will usually have a low mood. It may be hard to get tasks done or even get out of bed.^1-3

Both mania and depression may cause anger. For some, irritability and anger may be symptoms of depression. Manic episodes can also go past a happy high and lead to unpredictable and agitated behavior. This can show up as anger and irritability.^1-3

Research on anger and bipolar disorder

Anger is not usually considered an official symptom of bipolar disorder. But research shows a link between anger and bipolar disorder. Studies show people with bipolar disorder are more likely to experience anger. Many studies use anger questionnaires to study this relationship. People with bipolar disorder tend to score higher on these questionnaires. This means they tend to experience more anger. But, at this time, we do not understand the exact reasons for this.^2,4

One study focused on people with bipolar disorder and regular depression. This study found that those with bipolar disorder tended to have more angry or aggressive traits. It also found that those with depression and symptoms of reactive anger were more likely to develop bipolar disorder compared with those having other types of depressive symptoms. This may mean depression with abnormal anger could be an early warning sign of bipolar disorder.²

Could time of day be a factor?

Another study that used anger questionnaires found additional links. This study focused on people with bipolar disorder who were more active at night versus in the morning. You might think of this as "night owls" versus "morning people." The study found that people with bipolar disorder who were active at night were much more likely to have high anger scores. These results suggest that adjusting your schedule might help manage anger with bipolar.⁴

Tips on managing anger

Anger can be a scary feeling. It impacts you and the people around you. But there are steps you can take to help manage your anger:^1,5,6

• Try to identify triggers that spark your anger. These could be people, places, or tasks. Plan to manage these triggers. You cannot always avoid them. But you can plan on how to prepare for them.
• Learn from past anger. Try to recognize your internal warning signs that anger is coming. These could be thoughts, emotions, or physical sensations. Practice ways to address these warning signs. You could try deep breathing or leaving a situation to take a break.
• Avoid illegal drugs and alcohol. They can both cause bipolar depression to worsen and can impact your other medications. Even though those with bipolar disorder can struggle with anger, they are not more likely to become violent. But violent actions for people with bipolar disorder are linked with the use of illegal drugs and alcohol.

Managing bipolar treatment

Most importantly, talk to your doctor about your symptoms. Persistent issues with anger could be a sign that your treatment needs adjustment. For example, your doctor may recommend a different medicine or dose. You can also talk with a counselor or therapist on how to manage these emotions.^1,5