Breaking Down Bipolar Anger

Patient Expert

I've commented extensively on anger. My website provides a broad overview article, and an oldie but goodie on the same site, Bipolar or Bichronic, deals with the frustrations of operating in different states of time than the rest of the world. Last year I did a YouTube video on managing anger, where I get in a fight with a koala (it was all his fault), plus a YouTube version of my bichronic piece, renamed The Bipolar Time Warp. This week Therese Borchard of Beyond Blue published my experience on what it was like being guided through a loving kindness meditation while wanting to apply a baseball bat to some idiot's head.

But it was a deceptively simple question by Macigrae that appeared in the Ask feature on this site that really got me thinking. "Does being bipolar cause anger problems?" Macigrae asked. That was it. Nothing else. Call it a case of less is more.

"Short answer," I replied, "yes." Then I added, "but then we need to break it down."

I had never broken down anger before, but - trust me - my first-hand experience makes me an expert. Anger? I've got more words for anger than Eskimos have for snow. Let's begin:

Surprisingly, anger is not listed as a symptom of bipolar, but the fine print to the DSM does acknowledge "irritable" mood for hypomania. The next edition to the DSM needs to upgrade "irritable" to "anger," and apply it to depression, mania, mixed states, as well as hypomania, then wrap it in a bow and call it "bipolar anger." (Trust me, I'll be absolutely livid if they don't.)

So what are we looking for in "bipolar anger"?

Hyped-up anger: This is what I would call my time warp anger, where one's brain is operating at a speed far faster than the rest of the world. You don't have time to wait. If there are five people standing in your way to get to the photocopy machine, you need to knock them down. Now. Simple. What's their problem?

It's as if your entire life has been placed on hold. Tech support isn't getting back to you. The frustration builds. The slow simmer becomes a boil. Then all hell breaks loose.

Agitated anger: You're up and down at the same time, what the experts call a "mixed state," where depression meets mania. If you're mostly depressed, this would be an agitated depression. If you're mostly hypomanic, this would be an irritable or dysphoric hypomania. If your mixed state involves full-blown mania, you are raging out of control.

Think road rage. Your brain is hellishly churning over and you feel like you're crawling out of your skin. You literally want to wring your hands around the neck of the rest of the world, and heaven help the first person who happens to cross your path.

Impulsive anger: You're revved up. You can't hold back your emotions. You're reacting impulsively. If you're feeling good, you may buy everyone a round of drinks. If someone gets under your skin, you may pour one of those drinks over the person's head. In this state of mind, your frontal lobes have effectively been taken off line. There is no modulating gray matter standing between your primitive limbic system and your next action.

And there's your boss' wife, looking very sexy. (Oh, crap.)

And there's your boss. What's a beautiful woman like her married to an idiot like him? (Start looking for another job.)

Grumpy anger: You literally wake up on the wrong side of bed, or feel that way. Your brain hasn't booted up right, which makes getting through the day a challenge. Your neurons aren't engaged. If they're talking, they're communicating with great effort over huge chasms.

It's as if someone poured molasses through the top of your head. At the same time, some disconnected wire somewhere inside your cranium is emitting random sparks. Sparks swimming in molasses. Your emotions are not exactly combustible, but your frustration is showing.

This is definitely not the time for your loved one to come bouncing in the room in some new outfit, asking, "How do I look?" You badly want to respond with something buoyant like, "very very sex-x-xy," only to find yourself snarling, "your butt is hanging out."

Anxiety-driven anger: You know the feeling. Your hot date hasn't shown up. The food is going to be gone by the time you reach the front of the buffet line. You are wondering if you are going to be paid. Most days, you can handle the situation, but not today. You're amped up. Your thoughts are racing, and you can't control them. Now you feel your world spinning out of control.

Pity your poor date when he or she does show up. Or those innocents in front of you in the buffet line. Or the person who has your check in the mail. You are about to make someone's life very miserable.

No doubt, you can add many more types of bipolar anger to this list. Also, you probably perceive quite a bit of overlap, as when anxiety meets agitated meets hyped-up. But I trust you get the gist of what I am driving at, namely:

Awareness is our greatest ally in these and other situations. Full recognition of what is going on in your mind at any given time is the equivalent of having a reliable oil light on your control panel. When it goes on, you know you need to take preventive action fast, before your entire engine seizes up.

If you're like me, you are probably very adept in certain situations and very inept in others. Please share your wisdom with us, as well as where you can use some sage advice. We are all learning. We all need to know.

Be smart. Live well ...