“Sometimes, I feel like I’m walking on eggshells with you, Son. I never know if you’re going to be nice or start yelling.” — my Mom

As you can imagine, this hurts to hear and even more to write. I, like many people with mood disorders, struggle with agitation, anger, and random outbursts. I usually am able to de-escalate and come down from an agitated state rather quickly but, at times, I feel as if I leave myself and get caught up in the moment and let it all flow. This is one time that it is not good to go with the flow.

After an episode, I am overwhelmed by guilt and shame and feel like I am the biggest disappointment in the world. Thankfully, I have those who love me with such a furious love that I am able to pick myself up and try again. It’s been one of “those weeks” and I’ve struggled mightily with my temper, feeling misunderstood, and unheard which has led to arguments, moments of agitation, and more cussing than a sailor at sea.

This post is dedicated to anyone who may struggle with agitation or live with someone who struggles with this symptom. I hope it helps you help yourself or someone else who suffers from agitation.

Who Experiences Agitation?

Agitation occurs on a spectrum and across many types of illnesses including Bipolar Disorder, Schizophrenia, Anxiety, and Alzheimer’s Disease, just to name a few. How you treat each agitated person is as different as the person themselves. If they have the mental capacity, it’s a wonderful idea to teach the person coping mechanisms and ways to feel calm and safe when they’re agitated. These are best worked on with a professional.

What is Agitation?

The Depression and Bipolar Support Alliance define agitation as:

 a feeling of uneasiness typically accompanied by excessive talking or purposeless motions such as pacing or wringing the hands.

In addition to the symptoms listed above, the DBSA lists mild to moderate symptoms of agitation as the following:

  • Picking or pulling at hair, skin, or clothing
  • Unconscious movement
  • Outbursts
  • Shuffling feet
  • Clenching fists

As an episode of agitation escalates, the person may begin to show:

  • Excitement
  • Hostility
  • Poor impulse control
  • Tension
  • Uncooperativeness
  • Violent/disruptive behavior

For me, during extreme periods of agitation, I have paced, had outbursts, broken things such as glasses or coffee pots have found myself rubbing my head uncontrollably to try to soothe myself and calm down.

Medication has greatly helped with my agitation but I also practice mindfulness to become increasingly aware of my body and feelings. For example, I know if I’m starting to clench my fists that I need to take a breath and walk away.

Tips to De-Escalate During an Agitated Episode

Some other suggestions for agitated individuals to de-escalate are as follows:

  • Take a walk or doing another type of exercise
  • Practice deep breathing or meditation
  • Keep a journal
  • Minimize conflict
  • Relax in a quiet, dark room free of stimulation

Dealing with Someone Else During an Agitated Episode

If you’re a person dealing with someone in an agitated state, you want to make sure your safety is your number one priority. If you feel safe to speak with them, some of the following suggestions are offered in the Understanding Agitation Video Series:

  1.  You can ask them, “What’s happening right now? How can I help?”
  2. When a person doesn’t feel understood, he or she can escalate. You might say to the person, “I want to hear what it is you’re saying but I’m having trouble hearing you because of the yelling. Can you talk to me in a more calm voice so I can hear you?”
  3.  Offer people choices. Give them more of a say and help them feel understood. You want to help them feel that they are not being judged.
  4. Use empathetic listening, give them space to feel safe, or maybe they could lie down in a quiet room or get away from the stressor.

A Final Word to the Person Who Experiences Agitation

To the person who experiences agitation, it’s very important that you forgive yourself and seek to do better and better each time. Buddhist monk and teacher Thich Nhat Hanh says this about anger and dealing with our fiery selves:

If your house is on fire, the most urgent thing to do is to go back and try to put out the fire, not to run after the person you believe to be the arsonist. If you run after the person you suspect has burned your house, your house will burn down while you are chasing him or her. That is not wise. You must go back and put out the fire. So when you are angry, if you continue to interact with or argue with the other person, if you try to punish her, you are acting exactly like someone who runs after the arsonist while everything goes up in flames.

If you are losing control of yourself in conflicts and arguments, do what is necessary and walk away until you can treat the person kindly, fairly, and with respect. I know this is not easy advice to swallow and even less easy to practice, I get it, because I’m with you on this as well, but we must not use our agitated states as excuses to hurt others.

With that said, you will mess up and you will stumble. Keep getting up, forgiving yourself, and loving yourself along the journey because mental illness is a journey and one I hope, as we all walk, can learn from each other.

Be well, friends.

D6

 

For Further Research on Agitation, feel free to visit:

The Depression and Bipolar Alliance

http://www.dbsalliance.org/site/PageServer?pagename=education_understanding_agitation

Understanding Agitation Video Series

Photo by lightstars