Aggression & Bipolar

While manic, bipolar patients can get aggressive.

Aggression is a common symptom of bipolar disorder, also known as manic depression. However, it is also a common symptom of other types of mental illnesses like attention deficit hyperactivity disorder (ADHD), so it is important for the patient to get a proper diagnosis so he can get effective treatment. Not everyone with bipolar disorder will become aggressive to themselves or others.

Amount

Patients hospitalized with bipolar disorder are often in a manic or depressive cycle. It is usually those in the manic state that are more aggressive to others, such as the hospital staff. In patients older than 15, those suffering from bipolar disorder, especially Bipolar Type I, are the most aggressive, according to psychologist Klara Latalova.

Types

Bipolar patients can become aggressive verbally or physically. They may suddenly swear, ridicule or threaten others. They may also throw objects at others or directly attack other people with their hands. For example, British comedian and writer Stephen Fry once, during a manic phase as a teenager, struck a nurse just because she told him to tie his shoelaces, according to his documentary "Stephen Fry: The Secret Life of a Manic Depressive." During the depressive phase, bipolar patients may turn aggression towards themselves and try to commit suicide.

Causes

Each bipolar patient becomes aggressive for different reasons. During mania, the patient has racing thoughts, outlandish dreams and abundant energy. This can disturb normal thought process and inhibitions. Patients in the manic phase will also lose their inhibitions to taking drugs, spending money and indulge in dangerous sex. During mania, a patient may be convinced that she feels fine and does not need to see a doctor and may get angry if anyone suggests that she should.

Speculation

It is unknown what causes bipolar disorder, although it does run in families. Schizophrenia also can run in families and some schizophrenic patients can become angry or aggressive. The genes currently thought to be the cause of bipolar are areas on Chromosome 6 and 450. But even possessing the variant for bipolar or schizophrenia does not guarantee a person will develop it, but does mean that he will be more prone to developing it than others.

Treatment

Bipolar disorder is incurable, although some patients go into remission. Some patients will cycle through mania and depression only a few times in their lives, while others may continually go through cycles. Bipolar disorder as a whole is treated with medications such as lithium and with cognitive behavior therapy. Patients can learn to distinguish between reality and how their symptoms could be distorting their thinking. Patients going on antidepressants need to be monitored closely so that they do not go into antidepressant-induced mania, which could include becoming aggressive. The mania is a bad reaction to an antidepressant and will go away once the patient is taken off the medication.

References

• "The Family Intervention Guide to Mental Illness"; Bodie Morey and Kim T. Mueser, Ph.D.; 2007
• NAMI: Mental Illnesses: Bipolar Disorder
• "Bipolar Disorder and Aggression." Klára Látalová, PhD, et al. International Journal of Medical Practice; June 25, 2009
• "Stephen Fry: The Secret Life of the Manic Depressive." BBC; Originally aired Sept. 19, 2006
• National Institutes of Health News: Schizophrenia and Bipolar Disorder Share Genetic Roots:

Resources

• NAMI: National Alliance on Mental Illness
• NAMI: Attention Deficit Hyperactivity Disorder
• Bipolar Support Group