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Irritability in Bipolar Disorder

Irritability in Bipolar DisorderThe past few weeks I’ve been irritable, angry, agitated, frustrated, frazzled, whatever you want to call it. It’s awful for me. It’s awful for everyone around me. If you’ve ever heard someone describe interacting with a bipolar patient as “walking on eggshells,” this is what they’re talking about. I want you to know that I fully recognize that I’m being a pain. The vast majority of the time, I’m doing the best I can to control it. However, there are some times when I just want to be angry and it feels good to get it out. Unfortunately, this is a classic bipolar disorder symptom.

Irritability has been a symptom for bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders since its inception in 1952. The term “irritability” bothers me. It’s a little vague. For example, in 2009 The Telegraph put out a list of “The 100 Most Irritating Things: Poll.” Rude shop assistants and people who smell made the top five. I hope for most people these are merely an inconvenience. However, something this simple can make someone dealing with bipolar disorder absolutely irate.  So how do we differentiate between being cranky and having a bipolar episode?

In a manic episode, it has to be considered “extreme” and either last for a week or more or be so bad that it requires hospitalization. For bipolar II, episodes are considered hypomanic and patients can function better.

Although considered a hallmark trait of mania bipolar disorder, there is not exactly an overabundance of information about it as far as adults living with the illness. There are references regarding anger and irritation that is present in major depressive disorder as well as bipolar disorder. It turns out anger episodes are almost twice as common in BD as opposed to MDD. Additionally, anger and irritability can accompany depression in bipolar disorder. Anger episodes have also been likened to panic attacks. Though since panic attacks are comparably short-lived, they don’t really qualify it for a manic episode on their own.

So, if we can’t get a great idea of what’s going on, can we at least figure out how to deal with it in the moment? For me, that’s the hardest. When I’ve worked myself into a tizzy or am getting way too angry or inappropriate during an interaction, knowing what to do about it right then is more important than knowing where it comes from. Here are some tips:

-Remove yourself from the situation
It’s incredibly difficult to rein yourself in once you get going. Your anger is going to feed on itself and you will likely only make things worse. Removing yourself does not include storming off, as good as that may feel.

-Take a time out
It can work for badly-behaved children, so why not an adult behaving like a child? When you don’t have ongoing stimuli, it’s easier to back off and think logically again.

-Communicate
This is a good idea for pretty much any situation. For dealing with anger, communicate with those involved that you are having a, possibly unjustified, hard time and that you may need to excuse yourself. Don’t let yourself use your disorder to excuse your behavior, just to inform it.

-Say you’re sorry
I mean it. Own up to it. Once you’ve calmed down, apologize for your inappropriate behavior and try to communicate what your needs and concerns really are.

If you are someone stuck in an encounter with someone dealing with bipolar irritability/anger, I’m sorry. Here are some things that might make it easier on everyone:

-Recognize that it is not about  you. We’re fighting invisible monsters.
There are absolutely situations where anger is a justifiable reaction. For people with bipolar disorder, we can be trigger happy at times. When we’re irritable but don’t have an identifiable source, the anger is going to shoot at whatever target is closest. This is incredibly unfortunate for family members, friends, employers and whoever the person is closest to at the time.

-Stay calm
You are probably going to have to take the responsibility of being the rational one in the conversation.

-Please, please do not tell us to calm down
If we could calm down, we wouldn’t be having the problem, and telling us to calm down makes us feel demeaned. This will make things worse. I guarantee it.

-You get to leave too
You should never feel obligated to stay in a situation that makes you uncomfortable. You have your own rights as a human being. Please feel free to say that you recognize our feelings, but it would be better to talk about it later.

-We need you to be patient
We are not angry to be angry. We have an illness. Expecting immediate change will be about as successful as telling a cancer cell to die and expecting it to listen, and will be just as frustrating for everyone involved.

 

 

You can find me on Twitter @LaRaeRLaBouff

Irritability in Bipolar Disorder


LaRae LaBouff


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APA Reference
LaBouff, L. (2015). Irritability in Bipolar Disorder. Psych Central. Retrieved on January 28, 2020, from https://blogs.psychcentral.com/bipolar-laid-bare/2015/08/irritability-in-bipolar-disorder/

 

Last updated: 19 Sep 2015
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