Bipolar disorder leads to depressive and manic phases that are often associated with anger. Here are 10 tips for learning how to better manage your anger.
In manic/delirious phases we can quickly get annoyed, especially more than average. Controlling your anger is crucial, not only for you but also for your loved ones. Each situation is different but here are some ideas for thoughts with exercises to control your bipolar tantrum.
It's a nuanced skill, according to Brock Schludecker of Columbus, Ohio (in the United States). But it is important to “protect one's time, space and autonomy so as not to feel exploited or used.” Each of these feelings can trigger anger. Dr. Schludecker suggests discussing the details with your therapist or psychiatrist. First and foremost, you need to understand what is putting you off. You can also write in your diary what is not acceptable for you in order to say no more often, especially at work.
An important step in mitigating “tantrums” 😖 is to identify the source. When you are in a quiet, private location, take time to reflect and record. Ask yourself questions like: What types of interactions always make you angry? Are there “little things” that tend to add up until you feel like you're about to lose your cool? If yes, what are they? Does your anger occur at certain times of the year, in certain seasons, or at certain times in your daily life? (sometimes more often in winter than in summer for example). Write down your answers so you can dig a bit deeper. Often these phases of intense anger are linked to a manic phase, which is why it is important that your loved ones be aware of your bipolarity so as not to misinterpret your anger.
After thinking about and recording your answers to the trigger questions, look for patterns in your answers. Are they associated with certain emotional states, such as feelings of rejection, criticism, or abandonment? Are they linked or limited to certain mood episodes or to certain times of the year? Finding the roots of your triggers can help you reduce future regrets.
Search for guided imagery programs on Spotify or YouTube (15 minutes to let go) that will help lower your heart rate ☺️ and regulate your breathing when you feel like you're in an exacerbated state. “There are scripts you can follow that will say, 'Contract this muscle first, 'or they'll help you visualize a forest or beach scene,” explains music therapist Meegan Hussain. “They help change that narrative in the spirit of rumination and restlessness — that negative space — into something positive.”
“Few of us have to do everything we think we should do,” notes psychiatrist Ben Christenson, MD. He advises giving greater priority to restorative activities like reading a book, going for a walk, or watching a movie while balancing non-negotiable responsibilities. When you feel like you're exhausted, it's important to pause some high school projects to focus on what's most important.
“Anger should not endanger your relationships and your relationship, so it is essential to learn how to manage it.”
Shaley Hoogendoorn, co-host of a blog/podcast called “This is Bipolar” (English), is trying to unleash her rage in a healthy way by taking off her shoes and socks — preferably outside — and by focusing on the ground under her feet. Sometimes I close my eyes and say to myself, “You are safe. You are safe, you have your feet on the ground. There's an emotion behind it all, and it's not going to last forever.” It's a great podcast that I recommend.
Once you've found the roots of your anger response and a way to de-stress, it's important to become proactive rather than reactive, says Michael Pipich, LMFT, a psychotherapist in Denver and author of “Owning Bipolar”: “How Patients and Families Can Take Control of Bipolar Disorder.” (How patients and their families can take control of bipolar disorder.) He also suggests asking the following questions: What should I say to the people I care about so they don't trigger me? What would be a good thing to hear if they're worried that I'm having a manic episode? How can they support me — and how can I support them? “And then, he adds, take the quieter moments, not the hotter moments, to talk about these things with your loved ones.”
There's nothing like doing a sport like going for a jog or signing up for a boxing class to let off steam. Your body being tired will help you manage your anger. In addition to all the benefits of sport 😊
Meditation allows you to calm yourself and limit these phases of intense anger. When you feel anger coming on, don't hesitate to take a few minutes to breathe deeply for a few seconds either.
Writing is a good way to write down your anger on paper rather than expressing it orally at the risk of hurting your loved ones. This does not replace speech but it allows you to relieve yourself without hurting your loved ones.
In a bipolar disorder, a tantrum is normal in the manic or hypomanic phase, the most important thing to say it and especially to apologize if necessary.
The irritability and anger of people who are bipolar can hurt relationships and hurt you at work. It is helpful to learn how to prevent and defuse angry outbursts.
As a bipolar person, we are more irritable 😡 than most people. We must therefore take this into account in our way of life by explaining our bipolar disorder to our loved ones. Why is accepting your bipolar disorder essential to manage your bipolarity?
It starts with a classic annoyance, the living room is still a mess, or another driver is cutting you off. Irritation sets in, and then quickly turns into a nuclear explosion. The cheeks are blushing, the pulse is getting faster, and... boom. Welcome to bipolar rage.
For Paul, from Paris, an innocuous comment from his wife during dinner can trigger his internal switch.
“I was going crazy,” said the 45-year-old architect. “It went wrong.”
Paul realized that something was wrong with his changing moods, but the stigma kept him from seeking treatment for bipolarity until about a year ago. So, periodically, “for most of the last 20 years: “I got mad about nothing,” he says.
Work stress was affecting her sleep, which affected her balance. He contained himself in the office, but lashed out at home with harsh words. His wife paid the price for his verbal attacks before their marriage unfortunately ended.
“That's 100% the reason for my divorce,” Paul says.
Irritation and anger can be a normal and even healthy response to certain provocations. However, as with many emotions, people with bipolar disorder seem to be more vulnerable to extreme reactions.
“Anyone can be frustrated or angry, but losing control can be an integral part of the rage of bipolar disorder,” says Dr. Jeffrey Borenstein, president and CEO of the Behavior and Brain Research Foundation.Brain & Behavior Research Foundation ”.
Having a particularly irritable mood is one of the main criteria for diagnosing mania and hypomania, and there is growing understanding that anger and irritability can also characterize depression.
If left unchecked, irritability and its cousins, anger and rage, can have dramatic and devastating effects. Family life and friendships suffer as a result. There can be serious repercussions at work and, at times, with the justice system.
At a minimum, guilt and regret after an outburst have corrosive emotional consequences.
“Five seconds later, there's some relief,” Paul admits. “And then there's the, 'Oh my God, what did I just do? “And remorse was sending me into a depressed state.”
In addition to inflicting damage on relationships, anger can have devastating physiological effects, says Redford Williams, the director of the “Behavioral Medicine Research Center at Duke University School of Medicine.”
“Anger activates our body's fight or flight response, which involves the release of stress hormones like adrenaline and cortisol,” explains Redford Williams, the writer of the very good book (Anger Kills: Seventeen Strategies for Controlling the Hostility That Can Harm Your Health).
Over time, high levels of stress hormones cause wear and tear on all body systems. And when people who are irritable and easily frustrated by temperament go into anger mode, Williams says, “all the components of that response [to anger] appear at higher levels.”
“We know that people with a hostile personality type develop a hardening of their coronary arteries at an earlier age than their less hostile counterparts,” Williams says, and this heightened response may be the reason.
“It's unclear whether people whose anger is a component of bipolar disorder have the same exaggerated fight and flight response, but anger is certainly bad for the heart and can contribute to heart disease and high blood pressure,” he adds.
Controlling bipolar mood swings can reduce the pressure to explode, but that doesn't mean volatile emotions will go away entirely. That's where anger management techniques come in, like counting to 10, taking a deep breath, and finding a positive outlet instead of letting the pressure build up.
It is also important to learn to recognize triggers such as mental and physical signs of an impending eruption. Paul says that over the past year, he has learned to better recognize his warning signs.
“I feel that my blood pressure is starting to rise and that means I need to calm down.”
Learning to distinguish appropriate emotional responses from those associated with a change in mood in one direction or the other requires insight developed over time.
“Take a break
When emotions start to boil, you can bring the temperature down by giving yourself a long breath of time and/or space.”
“It's important to know if your anger goes hand in hand with symptoms of mania, like lack of sleep, or with symptoms of depression, like losing interest in things,” explains Elizabeth Brondolo, professor of psychology at St. John's University in New York and co-author of Break the Bipolar Cycle: A Day-to-Day Guide to Living with Bipolar Disorder.
It's easy to detect changes when a normally easy-going person starts to get cranky. For people whose temperament is marked by “hostile personality traits” impatience, frustration, rudeness (such as interrupting when others are talking) there may be a subtler crescendo nuance.
A 2012 study of more than 500 people found that people with bipolar disorders (type I or II) are more likely to argue, to be hostile to others than people who do not have this disorder, especially during a manic or depressive episode. It is also more likely that anger will escalate quickly and result in more sudden and explosive crises.
However, there could be underlying differences in disposition between people who feel “surly” and those who feel “happy” during the hypomanic and manic phases. A study published in the March 15, 2015 issue of the Journal of Affective Disorders found that on a temperament scale, the “snarky” group was more irritable, more self-centered, and less cooperative. They were also more likely to report higher levels of irritability during depression and to have a comorbid anxiety disorder.
According to Dr. Brondolo, the symptoms inherent in bipolarity can also fuel a propensity for an outbreak. For example, when your mind is racing, “you push your thoughts forward and can rush to catastrophic or unfair conclusions that can make you angry,” she says.
Brondolo recommends monitoring various aspects of your feelings and behaviors on a regular basis, although she notes that it's not easy to have such self-awareness once your brain starts to fail.
Her checklist starts with the essentials: Am I upset about something? If yes, what and why?
Also, ask yourself if you are anxious, if you sleep normally, if you drink alcohol, if you have symptoms of mania or depression, and if you are taking prescribed medications.
“The answers to these questions may prompt you to call your doctor,” she says.
If you manage to avoid the episodes of mania and depression, “the angry reactions that result from them will also decrease,” says Dr. Norman Sussman, professor of psychiatry at the Langone Medical Center at New York University.
“Sleep is one of the most sensitive early markers of mood swings — even a single lost night's sleep can be a trigger for anger,” he adds.
According to Mr. Sussman, early intervention, checking treatment adherence, changing diet, or visiting the therapist can help avoid a complete episode.
When emotions start to boil, you can bring the temperature down by giving yourself time or space. That's where the classic advice of taking three deep breaths or counting to ten 🧮 and anything that can interrupt the angry reaction comes in.
Taking a step back can be even better, for both parties involved.
Pauline, a 37-year-old consultant from Lyon, knows that she needs some time for herself when she is angry. She recalls a time when she felt “super annoyed” by everything her partner did and said.
“In my mind, I heard myself say something horrible that would have made her feel bad about herself. I immediately turned around and asked him to give me some space,” she explains.
Pauline took advantage of her “alone time” to review some of the usual suspects.
“Have I taken my medication? Yes. Did I sleep well that night? Yes. Was I depressed? No. Did I have a stressful day? Not really. When I was supposed to have my next period... bingo! ”.
She adds, “Once I was able to process all of this, I went to find [my partner], hugged and kissed her, and started to explain to her what had happened and to discuss her feelings.”
Open and honest communication, as well as better education about bipolarity for all parties, makes a huge difference. Family therapy can be useful in promoting discussion about the disorder and related issues, exploring family dynamics and communication patterns, and developing a unified response strategy.
“Families can learn about the signs of bipolar anger and work together to develop a plan on what to do to better identify and manage these symptoms when they occur,” says Borenstein.
This may include walking away from a loved one when they start to get angry or taking young children away from a scene that could be unpleasant, he adds.
Recognizing that a person's words and actions are due to a change in bipolar mood 🎭 and learning to not take it personally can be quite difficult for adult partners, let alone young family members. It can be helpful to have an age-appropriate discussion about your diagnosis for children.
“You can recognize that it's a health condition and that instead of having symptoms like a rash or fever, the symptoms of bipolar disorder are behavioral disorders like mood or exhaustion that come and go,” she says. “Give children context so they know that you can be a bit more irritable, and so they understand that it's not their fault.”
Sometimes the pendulum can go too far the other way: All signs of anger and irritation are dismissed as “part of bipolarity,” even if they are justified. That's why it's so important to learn the skills needed to have a calm, candid discussion that focuses on perceived issues and not personalities. 💭
However, this conversation has no chance of happening when symptomatic irritability or anger sets in. Years of experience taught Anna when to try to talk to her husband and when to simply leave the room.
“Sometimes you can't reason with it,” she says of her husband, Marc, a television executive from the Paris region. (The couple asked that their real names not be used).
If Marc's vehemence is disproportionate to the situation, Anna leaves him alone. She has also become familiar with situations that tend to make him angry. Although he is much better at recognizing and defusing his anger today, she says that it is always tense when they are in the car together, especially when there is traffic.
“Bad drivers and rude people can set my clock off, admits Marc, 61, and then I imagine all sorts of arguments with the “at fault” person. I can almost feel my blood pressure rising.”
Now that his bipolarity is under control thanks to medication, he is usually lucid enough to take a break when he is agitated. This has not always been the case.
“I've already gotten into trouble,” he admits, recalling a meeting with a gas station customer that ended with him being taken into custody.
If he found himself facing the same inconsiderate person at the same gas station today, he would walk away and calm down.
“You need to learn to control your impulses and to know when they come up,” he explains.
It's a process that involves a lot of trial and error, he points out, and the results aren't guaranteed every time. He and his wife are considering moving to a less stressful neighborhood to avoid some of his triggers. 🏡
Other strategies he uses when he is feeling exhausted include listening to pleasant “very loud” music and engaging in physical activity.
“I do cardio and listen to music, and I generally feel a lot better at the end of my workout,” he says. 💪
Journaling helped Marie, from Pau, identify her usual triggers.
“I write how I feel so I can go back and refer to other entries to find common themes,” she explains.
Journaling helped her identify behaviors that needed to be changed, such as waiting calmly at traffic lights, being patient with others, and dealing with comments that irritate her, whether directed at me or not.
After three decades of living with bipolarity, this 61-year-old woman knows how to recognize emotional and physical signals that tell her it's time to refocus her energy. When she feels her temperament heating up, she starts listening to her favorite music.
“My therapist told me to put on my favorite music and dance when I feel angry. I must have laughed at the suggestion at first, but it works, and the only person who can see me is my cat.” 😹
Exercising on exercise machines, going to the pool, or going for a quick jog also allows her angry feelings to find a positive outlet.
“Sometimes I have to push myself to do something physical to quell the anger,” she notes.
“Going for a hike, a walk, or simply a change of scenery also helps me let off steam in a healthy way. If you go out and break through the windows in your apartment, you'll end up in more problems than at the beginning.”
Preventive stress management helps prevent anger and rage. There are a lot of different approaches out there, and the key is finding the one that works for you.
Pauline, the consultant from Lyon, says that yoga has really helped her. She is now helping others learn yoga as a way to manage their moods through a local foundation. 🧘
Pauline would have liked to have had better coping tools earlier in the course of her illness.
“I said horrible things to my siblings and parents who hurt them and they still remember them today,” she said.
As she recovered, she said, “We did a lot of healing and growth.” And rather than blaming herself for the past, she chooses to focus on how far she has come since then.
“No one is going to make you feel worse than yourself, so forgive yourself for the things you've done and say to friends and family members. [Now] I'm just taking a few deep breaths and a split second to reflect and remind myself that I'm in charge, not bipolarity.” ✌️
According to clinical psychologist Sarah Keedy, the best way for couples and families to deal with tantrums is to plan ahead.
“We all need a toolkit full of healthy strategies for dealing with our moods, and it's best to develop it in advance,” says Sarah Keedy, director of the Cognition-Emotion Neuroscience Laboratory at the University of Chicago.
It is essential that all parties sign an action plan from the start. For example, she says, discuss what you think should be done when anger starts to take over.
“Should the family member leave or should they remind you of your coping strategies? The main thing is to agree on what is acceptable in advance. This can help the situation unfold more smoothly, as well as alleviate guilt or other hurt feelings later on for all parties.”
This conversation should focus on how best to deal with potentially explosive situations, such as behaviors and circumstances that would “trigger the need for external intervention of any kind,” Ms. Keedy says — from “calling the person's medical team” when signs of unrest and anger appear to calling the police.
Try the “Because I'm worth it” exercise. (I used the L'Oréal sentence a bit 😉)
Clinical research shows that training in managing stress through cognitive behavior can help people learn to reduce their hostility and anger. Here is an exercise from the Williams LifeSkills program based on the mnemonic “I'm worth it.”
I: Is the situation important to you?
A: Is your anger appropriate given the facts of the situation?
M: Is the situation changeable?
WORTH IT: Is the action worth it?
If you answer “no” to any of these questions, Williams says, it's a signal to change your reaction — for example, by reminding yourself, “Hey, that's not that important! ” or by practicing a meditation exercise.
If you answer yes to each of the questions, you can take steps to target the trigger for your emotion, proactively rather than destructively.
This could be solving a problem to change the situation or approaching the others involved to confidently discuss how their behavior is affecting you and what you need to do differently.
Come and talk about it in our Bipolar discussion group.
