For three days now I have been feeling incredibly anxious, agitated and irritable. I’ve had a high energy level, but my brain is not allowing me to direct it into anything positive. These feelings directly following a long bout of depression make dealing with the agitation more difficult. I’m frustrated that I was unproductive then and equally unproductive now. At times I feel like I’m more destructive. Irritability is an often overlooked symptom of bipolar disorder. When people think of mania they normally think of elation. For those of us who experience dysphoria and irritability, euphoria seems almost mythological.
One big problem people with bipolar disorder face is that they sometimes do not recognize that they are having symptoms at all. This is why the Diagnostic and Statistical Manual of Mental Disorders specifies that symptoms may be observable by others but not necessarily by the patient.
This may be especially true in hypomania. With mania, the episode is more easily recognized. Mania greatly affects a person’s day-to-day functioning and can end up with hospitalization. With hypomania, a person can still function, if not at our best. That said, it is possible that what may be considered a hypomanic episode may develop into a full-blown manic episode in those with bipolar I. In these cases the level of irritability may be extreme, even if it’s not yet a manic episode.
Because irritability may not be readily apparent to those experiencing hypomania, it’s important for people to be able to more easily recognize the signs and symptoms. It’s also important to have coping mechanisms in place in case an episode of mania, hypomania or just a bad day occur.
Some signs of irritability are:
- Agitation (both physical and psychological)
- Clouded thinking
- Poor judgement
- Heightened arousal
- Elevated heart rate
- Irregular breathing patterns
- Anger or aggression
When irritability is left unchecked, there can be dramatic consequences. Irritability can swiftly turn into anger and rage. Relationships suffer. It causes the person to experience high levels of stress that can be hard on the body including headaches, heart problems, elevated blood pressure and increased stress response. This is why it’s important to have a few coping mechanisms to deal with irritability before it causes too many problems.
Some ways of coping with irritability include:
- Recognizing you might not be able to trust your feelings
- Removing yourself from the situation and taking a time out
- Meditating or praying
- Taking a moment to think before you speak or act
- Knowing the limits of what you can deal with
- Eating well
- Keeping a daily routine
- Seeking professional help
It may also be helpful to pinpoint if there is a cause for the irritability other than bipolar disorder. Some other causes of irritability are:
- Physical illnesses like chronic pain or diabetes
- Other psychological illnesses like generalized anxiety
- Situation-based anxiety
- Medication side effects
- Medication noncompliance
- Drug or alcohol use/abuse including nicotine and caffeine
- Premenstrual syndrome
No matter the cause of irritability, it’s important to address it as quickly as possible because of the potentially devastating consequences. If the problem is panic or anxiety disorders, medication may need to be prescribed to help alleviate irritability as a symptom. If medication is not the answer, a therapist may be able to help work through any underlying issues that may be causing or exacerbating your bipolar disorder.
Image credit: Ashlee Martin