Bipolar Rage

In this episode, Wendy examines explosive and unpredictable Bipolar Rage.


Be sure to check out Wendy's debut novel, Involuntary Hold. It's a story of self-discovery set on the psych ward. It's available on Amazon and Audible. 

** Remember if you, or a loved one, is in emotional crisis... Help is just a phone call away. Simply dial 9-8-8 for the Suicide and Crisis Hotline, or text "HOME" to 741741 to chat with someone via text 24/7 across the United States. **

Please contact us at bipolarforlife@myyahoo.com with any questions, suggestions, or comments.

Transcript

Bipolar for Life
Ep 9/S2-Bipolar Rage

Good evening and welcome to “Bipolar for Life.” I’m your host, Wendy Foard, and I’ve managed to live with bipolar disorder for 44 years now. It hasn’t always been pretty, but I’ve survived several suicide attempts, four psychiatric hospitalizations, and one disastrous trip to rehab. Yet, I’m still here!

Let me say up front that I am NOT a medical doctor. I am simply a seasoned manic-depressive trying to help others survive this deadly mental illness through shared information and experiences.  

As we discuss issues, please remember that I am speaking from my own experience; your bipolar experiences may be entirely different. Yet, I suspect highly that we have more in common than not.

Tonight, I thought we’d talk about the hidden Hulk in the back of the room… Bipolar rage. This rage is a waking nightmare for the person in its grip and for those in its path. It’s uncontrollable, unstable, and unpredictable. 

With regular anger, there is usually a trigger, something you can pinpoint as setting someone off. However, with bipolar rage, there does not necessarily need to be a trigger. It can show up without warning and is always absent of reason. Rage chooses chaos; it’s not the individual choosing to lose control. If anything, control is something we’re desperate to have, and that desperation only makes our anger more chaotic.

When in the throes of bipolar rage, the individual loses all control. The rage is in control, and it has no conscience, nor remorse. My greatest shame comes from what I’ve done while under the influence of bipolar rage. But I literally had no control over myself. I could see what I was doing, knew it was horrible and wrong, but was helpless to stop it! 

The range of anger in bipolar disorder can be broad, stretching from mild annoyance to overwhelming, explosive rage. It stands as one of the most challenging elements to manage in bipolar disorder. The anger can emerge seemingly out of nowhere or be triggered by events that typically wouldn’t bother most people, leading to a wide spectrum of responses, from subtle to extremely intense. 

Bipolar anger and rage can significantly impact a person’s mental health and relationships with others. Violent outbursts, such as physical aggression and verbal abuse, are common for individuals with bipolar disorder who experience heightened aggression. These outbursts can cause significant harm to the individual and those around them, leading to feelings of guilt, shame, and isolation. 

Symptoms of bipolar anger and rage can also result in blaming others for problems and difficulties, further straining relationships and exacerbating frustration. People with bipolar disorder who experience rage attacks or outbursts may have an increased risk of self-harm and suicidal ideation. 

Bipolar anger or rage can be a symptom of a mood swing. Uncontrolled, intense and unpredictable the anger seems to begin without a trigger, such as a threat or frustration. People in the middle of bipolar anger can scream at and verbally abuse others just because they are there—and sometimes the bipolar person has no memory of doing so.

The three hallmarks of bipolar disorder that are correlated with bipolar rage include anxiety, irritability and agitation. Two controlled trials showed that these symptoms were present in approximately two-thirds to three-fourths of people with bipolar I mania, and can be observed during depressive, manic and mixed episodes. 

A number of researchers and clinicians theorize that some people with bipolar disorder may also have Borderline Personality Disorder (BPD), the most frequently co-occurring personality disorder. This disorder is characterized by features including inappropriate, intense anger or difficulty in controlling anger, as well as anxiety and irritability. When a person with Borderline Personality Disorder is also experiencing a bipolar mixed episode or severe mania, this can generate a massive amount of anger or rage.

Signs of uncontrollable bipolar anger or rage are similar to those of normal anger, only more intensified and explosive. There are common warning signs that an episode of bipolar anger is nearing, which can provide an opportunity to enact adaptive skills. Some signs of uncontrollable bipolar anger may include:

·     Temper tantrums

·     Heated arguments

·     Shouting at others

·     Being avoided by friends and family

·     Slapping, shoving, or pushing others

·     Physical fights

·     Property damage

·     Threatening or assaulting people or animals

While mood swings are a hallmark of bipolar disorder, anger and irritability are commonly observed symptoms especially during manic episodes. 

One study examined the occurrence of anger in diagnosed individuals and found that anger symptoms were present in 66% of participants, with higher rates observed during manic episodes than in depressive episodes. 

Further research explored manic rage in bipolar disorder and findings indicated that manic anger was associated with a more severe course of the illness, increased hospital rates, and higher risk of substance abuse. Additional investigations demonstrated that people with both bipolar disorder and anger issues experienced elevated functional impairment and suicide risk.

Bipolar rage is not a typical symptom of a bipolar diagnosis, but paying attention to warning signs can help people prepare and use coping skills. Coupled with bipolar treatment, strategies for anger management and methods to control anger can help minimize the risk of rage episodes. 

     12 Tips for Coping with Bipolar Rage

1.  Be mindful of the warning signs. When warning signs of bipolar anger occur, take a step back and consider what is happening. Ask yourself, “What is making me angry? What sensations am I experiencing?” Doing this can help you develop a plan to work through a conflict or stressful situation.

2.  Identify your triggers. Identifying potential anger and rage triggers is important when living with bipolar disorder. Write down known stressors for future reference and add new triggers to the list as they occur. This self-awareness can help you notice potential issues before they become a big problem.

3.  Take a time-out.  If you begin experiencing bipolar anger symptoms, take a time-out. If rage is imminent, remove yourself from the situation. During this time-out, engage in adaptive coping skills and deep breathing. Continue to practice these skills to remain calm when you cannot take a break.

4.  Harness your anger into something productive. This is the advice my mother always gave me. While anger can be a challenging symptom to manage in bipolar disorder, it is possible to harness that energy into something productive. One way to do this is by engaging in physical activity, such as exercise or sports, this can help release pent-up energy and reduce feelings of anger and frustration. Creative activities, such as writing, painting or music, can also be beneficial when managing bipolar rage.Creating art allows you to express and process difficult emotions constructively and in a healthy way.

5.  Stick to a medication regimen. Medication is a necessary component for the treatment of bipolar disorder, and not taking them as scheduled may aggravate bipolar cycles. Discontinuing your medication when symptoms go away is a common mistake. The alleviation of symptoms means your meds are working. Most people with bipolar disorder take medications throughout their lives, but the type and dose may fluctuate depending on their symptoms. Medications should be combined with talk therapy, such as Cognitive Behavioral Therapy (CBT), to maximize effectiveness for bipolar disorder.

6.  Seek therapy. Seeking therapy can be an effective way to cope with bipolar anger. A therapist can help people with bipolar disorder develop coping strategies and tools to manage manic anger or rage. Therapy can also provide a safe and supportive space to explore and process difficult emotions, which can help reduce the risk of a bipolar meltdown. 

7.  Boost your support network. Reaching out to friends and family for support, joining a support group, or connecting with a mental health professional can make a monumental difference in your life. A strong support system can provide stability and help you feel less alone in your struggles with bipolar disorder and rage.

8.  Start a mindfulness or meditation routine. Consider trying these techniques. They can help you become more aware of your emotions and learn to manage bipolar aggression more constructively. Remaining grounded and present in the moment can also reduce stress and promote a sense of calm and relaxation.

9.  Keep track of your moods. A mood journal is an effective tool when managing bipolar anger. Tracking your mood changes can help you identify triggers for anger and develop an action plan to manage and prevent future episodes of rage.

10. Get your body moving. Physical activity can help release pent up energy and negative feelings like anger and frustration. Regular exercise may also improve overall mood stability and reduce the risk of manic anger.

11. Develop an action plan. Preparing for and managing episodes of bipolar rage starts with creating an action plan. Your plan would list your triggers for anger and helpful coping strategies to engage when symptoms become overwhelming.

 12. Live a healthy lifestyle. Maintaining a healthy lifestyle by eating a balanced diet, getting enough sleep, and avoiding drugs and alcohol can help improve your overall wellbeing. If you have bipolar disorder, it is important to prioritize self-care and make choices that support good mental health. 

 According to the Substance Abuse and Mental Health Services Administration (SAMHSA), signs that you may have chronic anger management problems, or the kind of uncontrollable anger associated with bipolar episodes include: 

·      You are constantly angry or annoyed and are quick to overreact

·     You have gotten in trouble at work or with the law

·     The way you express your anger at loved ones, friends, neighbors, or coworkers has caused serious relationship problems

·     You frequently lash out verbally or physically, such as punching walls or hurting someone else

·     You’ve been told you have anger issues and need to get help, or

·     People are afraid of your anger and try to avoid you when you’re in a “bad mood”

 While bipolar rage seems to appear out of nowhere, there are sometimes underlying triggers that can exacerbate or even initiate these intense emotional responses. Recognizing these triggers can be a crucial step in managing bipolar anger effectively.

                          Possible Triggers 

·     Stress—High-stress situations or feeling overwhelmed can act as a catalyst for bipolar rage. This might include work pressure, relationship conflicts, or financial worries

 ·     Sleep disturbances—Lack of sleep or irregular sleep patterns can significantly impact mood regulation, potentially leading to heightened anger or irritability

 ·     Substance Abuse—Excessive alcohol or drug use can interfere with emotional control and may trigger or intensify episodes of bipolar rage

 ·     Perceived slights or rejections—People with bipolar disorder may have heightened sensitivity to rejection or criticism, which can trigger intense anger responses

 ·     Disruption in routine—People with bipolar disorder often benefit from a structured routine. Disruptions to this routine, whether minor or significant, can serve as a trigger for anger

 ·     Sensory Overload—Overstimulation from loud noises, bright lights, or crowded environments can overwhelm the senses and contribute to anger outbursts

 It is important to note that while triggers can increase the likelihood of bipolar rage episodes, they are not always necessary for such episodes to occur. The nature of bipolar disorder means that mood swings can sometimes happen independently of external factors.

 For those dealing with a loved one with bipolar disorder, arguing or debating with someone exhibiting rage is futile. However, try to remember that their behavior is a product of the condition. Those with bipolar disorder may say hateful, hurtful things when upset, throw objects, or cause property damage, but there are ways to help them calm their rage.  

1.  Remain Calm—When people become angry, reacting with anger may only worsen the situation. Take deep breaths or engage in coping skills. Arguing with irrational thoughts, going on the attack, or using defense mechanisms is not helpful.

 2.  Provide some space—When someone is experiencing bipolar rage, give them space. Crowding the person, pressing the issue, and minimizing the opportunity for them to step away prevents them from enacting their own coping skills.   

  Remember, those experiencing bipolar rage are encouraged to make their own space to calm down. Not affording them this option minimizes their ability to cope. Therefore, you are now invading their space.

 3.  Set and maintain boundaries—Setting healthy boundaries in any relationship is important, but may be especially so when a loved one has bipolar disorder. During a calm moment, state and explain your limits on what you will and will not accept when your loved one is angry. These boundaries should be clearly defined and collaborative. Once set, make sure you are consistent with their maintenance. 

 4.  Become educated—Understanding bipolar disorder can help you make informed decisions. Possessing a robust knowledge of the condition can facilitate healthy, judgement-free communication that does not minimize your loved one's feelings or behaviors.

 5.  Be patient and empathetic—Remember that your loved one is dealing with a mental health condition that can cause mood swings, depression, and other challenging symptoms. Showing patience and understanding can help you create a supportive environment that promotes healing and recovery.

6.  Don’t let them avoid responsibility—It is important to encourage a person with bipolar disorder to take responsibility for their actions and behaviors. While this can be challenging, especially when dealing with bipolar rage symptoms, your loved one should understand the impact of their actions. Try not to see their rage as a “bipolar tantrum,” but rather, as a way of offering support and guidance while they try to navigate one of the most difficult bipolar challenges. 

 7.  Use healthy communication skills—Healthy communication can involve active listening, using “I” statements, and avoiding blame or criticism. Constructively interacting with your loved one may help reduce the risk of bipolar rage or verbal abuse. It also shows them that you are sympathetic with their experience.

 8. Remember, it’s not your fault—It is common for people with bipolar disorder to direct their anger and frustration towards loved ones. However, remind yourself that their symptoms are not your fault. By separating the person from their illness, you can avoid taking their behavior personally, and focus on providing support and understanding. 

 9.  Don’t back down—When dealing with someone experiencing bipolar rage, set your boundaries and communicate your needs calmly and constructively. Utilize healthy communication skills and approach the topic patiently and empathetically. If necessary, revisit the topic after the person has calmed down. It is important to prioritize safety for everyone!

 10. Seek support and therapy for yourself—Seeing a counselor provides a safe space to discuss your experience and devise adaptive coping skills. In-person or online support groups are also helpful, as you can meet others in similar situations, find common ground, provide mutual support, and share resources. 

 For those of us with the disorder, talking to a therapist or a trusted loved one can help you deal with bipolar anger and rage. Coping strategies are different for everyone, and mastering them can take some time, but they do actually work!  

 Bipolar rage can last anywhere from a few hours to several days, typically resolving once the mood episode passes. 

 Medications for treating bipolar disorder, such as mood stabilizers, aim to manage symptoms and stabilize the fluctuations between mania and depression. While these medications are generally effective in reducing symptoms of bipolar disorder, their impact on anger and irritability can vary among individuals. Studies examining the effects of these medications indicated that participants experienced a reduction in anger after treatment with mood stabilizers, such as Lithium, Lamictal, and Depakote. 

 If the person in your life with bipolar disorder frequently becomes verbally abusive or threatening, you need to have your own source of support; either through working with a therapist, or in a support group for people who take care of individuals with mental health issues. These can help you understand when the illness is “talking” rather than the person. 

 It is also important to know how to seek safety as needed or call emergency services if physical danger becomes a concern. If medical, fire or police services are needed, 9-1-1 is your best bet. Otherwise, some mental health crisis hotlines can help. For example, the National Alliance on Mental Health Helpline is 1-800-950-6264 or text “Helpline” to 62640.

 The National Domestic Violence Hotline number is 1-800-799-7233.

 If you, or a loved one, find yourself in immediate need of emotional help due to a crisis in your life, or a mental health condition, call 9-8-8 and talk to someone at the Suicide and Crisis Lifeline. Or, if you’d rather not get that personal, you can chat with a crisis counselor via text. Just text H-O-M-E to 741741. Or, if the person is in danger of physical harm, please go to your local emergency room. 

 For those living outside the United States, here is some useful information. The International Association for Suicide Prevention has a directory of crisis centers and helplines for over 50 countries! 

Just go to the internet and type in, all lowercase:

      findahelpline.com/i/iasp

 And it will bring you to a drop-down menu where you can input your country and region, and it will give you the information for your location. Granted, it doesn’t cover everywhere, but it’s a start!

Again, that’s:

       findahelpline.com/i/iasp

Thank you so much for joining me this evening. It has been a pleasure. As always, please stay safe in all your travels. Until we meet again, this is Wendy wishing you and yours, good night.