Seeing Red: A Look at Bipolar Anger In this article Martin Baker explores bipolar anger. Examples are drawn from his experience as caregiver to his best friend Fran, and others happy to share their stories. What Does Bipolar Anger Feel Like? It would be hard to improve on this description: “Bipolar anger is impulsive, intense, erratic, and explosive. It is being asked a simple question and responding with irrational anger and/or irritation. It is lashing out, for no logical reason, on those that love and care for you. It’s driving down the road and whetting the blade of your pocket knife on the side mirror because someone is driving too close to you. It is the inability to listen to rational behavior and even answering the question ‘why?’” (Mariah) Others also talked about its explosive nature: “I can ignore issues for only so long then my anger towards another person spikes. I have been known to yell really really hard, say extremely mean things and sometimes throw things but I wouldn’t physically hurt someone.” (Susan) “Bipolar rage is very real and it can be very, very violent. I will chase people and pick a fight.” (Julie) The anger is mostly directed towards others but it can turn inward, manifesting as self-harm: “I said very mean things in texts to my now ex-boyfriend. Basically I am on the attack personally without direct provocation. Then I get back in the mode of attacking myself … biting myself, pulling my hair, and hitting myself.” (Susan) Mariah shared that anger comes easier to her than addressing what is actually happening in her life: “It is easy for me to tell those that I love to leave me and never come back, even offering to help them pack. It is easy for me to say ‘Fuck it!’ and let people go, rather than admit that I am the one hurting inside. It is easy to push all other emotions aside and let the rage erupt inside of me until it spills out into the household, creating chaos all around me.” (Mariah) In a similar vein Vikki describes anger as “bipolar’s go-to emotion.” This might sound like taking the easy way out but to me it reinforces how desperately hard it can be to engage more “reasonable” responses when anger takes hold. Timing and Triggers Jen traces her anger back to childhood and the suppression of emotions from an early age: “I think for me, it comes from childhood trauma. I learned too soon in life that life is not always fair. I was taught that feelings should be stuffed down and I became angry about that in later life. I’m still angry about that.” (Jen) Most contributors said that anger is more of an issue during mania, especially dysphoric mania, but it can appear at any time: “For me mania anger was more because others thought I was on drugs when I wasn’t. When I’m depressed it’s more anger at me or the world.” (Vikki) Fran becomes frustrated when people fail to understand or challenge her reality. When Fran was manic she was falsely accused of being drunk or of not taking her medication, which hurt and angered her greatly. Several people mentioned driving as a specific trigger: “My bipolar anger is very unreasonable. I get angry at things that I normally don’t even notice. My worst anger is in traffic. I have absolute road rage when an episode is in full force. I have to be very, very careful when driving.” (Julie) Other people’s anger is likely to add fuel to the fire and once the line has been crossed it can be hard to pull back: “When others are angry I take it as a challenge. I push back and fight back until I feel as though I have ‘won.’ When I am in the cycle of my own anger I do not consider possible consequences and at those moments I do not care.” (Mariah) Healthy Anger As unlikely as it might seem anger can be healthy: “We were reminded in dialectical behaviour therapy (DBT) that anger is a motivator for change. We do not like something or it irritates us, so we work to change it. Without irritation and anger we would be a pretty lazy species.” (Roiben) Anger drives Fran forward when she would otherwise become mired in self-doubt. It can also help get her message across. She once became furious when I failed to recognise how desperate things were for her. Within moments she had my full attention! We can also think of anger in the face of injustice: “When things in my life don’t seem fair, or if I see that things are unfair for my friends, or even my country, I get angry. But maybe it’s okay to be a little angry.” (Jen) What Helps? There are several approaches to managing bipolar anger. It can help to avoid triggers and stressful situations. Fran’s life has become much calmer since she withdrew from social media. As she puts it, “There were plenty of good things but also plenty that pissed me off.” Calming activities such as art, listening to music, taking a bath, and meditation can help as can medication, talking therapies, prayer, and positive affirmations. “I am trying to improve by positive self-talk in the mirror and with drawing. Self-talk is really helping!” (Susan) It is worth remembering that the underlying reason or trigger for the anger is very often real and needs addressing. It can help to explore what is going on, either alone or with a trusted friend: “It is not until much later, sometimes days later, that I am able to analyze my behavior.” (Mariah) “I get so frustrated with a few of the people in my world, not so much with what they say but how they say it, and I have to ruminate for days and talk it over with Marty until I can let it go.” (Fran) Beth describes a different approach: “I feel I know the receiving end of the anger that came come with bi-polar. I have several friends who get angry with me on occasion, enough to tell me they want to end our friendship. I no longer try to ferret out what I did. I have come to understand that it is not based on anything I did most of the time. Talking it through can be incredibly counter-productive. Waiting it out, letting them know I am around if and when they are ready, and giving them space is about all I can do. I have been told by more than one that part of my getting the brunt end of anger is because the person knows I will not give up on them.” (Beth) Jen finds insight in a quote from the movie Excalibur: “Lancelot says to King Arthur ‘Your rage has unbalanced you.’ This is an amazing metaphor because I battle myself internally, like these men are doing externally and I can get unbalanced quickly.” (Jen) Being honest about how you are feeling helps. (“A heads up. Just so you know I’m in a bad mood.”) And there is always humour. Fran: I’m going to keep getting mad at you, Marty, because that’s the only way you’re going to learn. Marty: You’re going to keep getting mad at me because I’m writing an article on bipolar anger!