Your heart is beating fast. Your thoughts are racing. You’re losing control of your emotions and actions. These are just some of the things you may experience when you’re feeling rage. And rage is an emotion that’s often unfairly associated with people who have been diagnosed with bipolar disorder. 

Bipolar disorder is a mood disorder characterized by shifts in emotion and energy. It causes alternating shifts between manic highs and depressive lows. A common symptom of a mood shift is uncontrollable anger, sometimes known as bipolar rage.

We’ll talk about the signs of bipolar rage to be aware of, some potential triggers, coping strategies you can use to manage a rage episode and a treatment option that can help you address your bipolar disorder.

Signs of bipolar rage to look out for

Bipolar disorder causes periods of extreme mood shifts, known as episodes. Manic episodes, or mania, refer to times of elevated positive emotions and energy levels. Depressive episodes are characterized by intense negative emotions and lack of energy. While the length of both mania and depressive episodes can vary in duration, bipolar 1 mania episodes can last up to seven days and depressive episodes can last more than two weeks. 

It’s possible to experience rage during both mania or depressive episodes, but it can look different for each. For example, depressive rage may be self-directed while manic rage can be more explosive.

Bipolar rage can be characterized as intense, impulsive and often uncontrollable outbursts of anger. Indicators of impending rage are different for mania and depression, but here are a few signs of bipolar rage to be aware of:

During depressive episodes:

• Chest tightness — When you’re experiencing deep negative feelings during depressive episodes, such as uncontrolled anger, your blood pressure and heartbeat can rise. This affects the blood flow to your heart and causes a tight feeling in your chest.
• Overreacting — When you’re feeling down, you can become highly sensitive and critical toward yourself. This can lead to you overreacting about a comment or situation.
• Constantly feeling annoyed — Everyone feels annoyed or impatient sometimes. But uncontrolled rage can make you feel like annoyance is right under the surface for days or weeks at a time.
• Remarks from others — It’s not always easy to recognize the rage in ourselves in the moment. That’s why other people mention your “anger issues.” 

During manic episodes:

• Twitching — Rage can cause stress responses throughout the body due to increased adrenaline. A possible response is muscle twitching.
• Strained relationships — If you’re taking your rage out toward, or around, other people, it can cause issues in your interpersonal relationships.
• Verbal or physical attacks — It’s possible for uncontrollable rage to come to a head. This may result in you lashing out verbally or physically toward someone. 
• Issues at work — Uncontrolled rage can interfere with your respectful tone toward your superiors. It can also affect your interactions with your co-workers.

Bipolar rage triggers

Bipolar disorder episodes can be triggered by a variety of complex factors. The rage that’s triggered during depressive or manic bipolar episodes can make it difficult to see or think straight. 

Here are a few situations or circumstances that can trigger rage during a bipolar episode:

• Lack of sleep — Sleep plays a crucial role in the cognitive functions required to emotionally regulate your emotions. Not getting enough sleep or having an inadequate night’s sleep can impact emotion regulation and increase sensitivity to stress. 
• Alcohol or using drugs — The use of certain substances, including alcohol or stimulants, can exacerbate mood instability in individuals with bipolar disorder and contribute to rage.
• Disrupted routine or plan changes — Structured routines can soothe negative emotions that may impact sensitive circadian rhythms. Uncertainty or alterations in the routine can trigger rage.
• Criticism or rejection — Heightened sensitivity can lead to overreacting, a sign of uncontrolled anger. It can be triggered by criticism or feeling rejected by someone.
• Overstimulation — If your senses feel overwhelmed from lights, sounds or crowded areas during a bipolar episode, it can lead to uncontrolled rage.
• Stressful life events — Significant life events or issues can make you feel a whirlwind of emotions that can be difficult to manage. This may lead to uncontrolled rage. Examples include losing a job, having financial setbacks or ending a relationship.
• Relationship problems — Interpersonal relationships are often a source of support during bipolar episodes. So when you’re experiencing issues in the relationships you have come to depend on, it can result in rage.
• Physical health issues — A physical health concern can also affect your mental and emotional health. If you’re experiencing physical health issues during a bipolar episode, the stress and pain can lead to uncontrolled rage.
• Seasonal changes — You’ll experience interruptions in your circadian rhythm as the seasons change. They can impact your emotional regulation, potentially leading to uncontrolled anger.
• Trauma — Experiencing a traumatic event is a trigger for many negative cognitive and emotional patterns. These patterns may be contributors to uncontrolled rage.
• Unmet needs — Everyone wants to feel like they have what they need on a daily basis. This is especially true when you have a mental health disorder that requires additional support. If a person with bipolar disorder doesn’t feel like their needs are being met, it can lead to anger. An example of an unmet need is a lack of assistance from others.
• Loss of control — Having the need to feel in control isn’t unique to people with bipolar disorder. But not having that control can trigger negative emotions during a bipolar episode, such as uncontrolled rage.
• Chronic stress — A majority of the previously mentioned triggers can lead to stress. However, having stress on a daily basis can result in rage during a manic or depressive episode due to feeling overwhelmed. Family obligations and workloads can lead to chronic stress.

Benefits of psychotherapy for bipolar rage

Dealing with bipolar rage requires a comprehensive approach that addresses the underlying mood disorder while incorporating strategies that support emotional regulation.

Bipolar disorder can’t be cured, but it can be treated and managed. Psychotherapy can be a valuable and integral component of your bipolar treatment plan. Benefits of working with a psychotherapist for bipolar disorder include:

• Education and understanding — Therapy can help individuals with bipolar disorder gain a deeper understanding of their symptoms, triggers, and the impact their mood disorder has on their daily lives.
• Coping strategies — A psychotherapist can help you develop coping strategies to manage your bipolar rage in the future. Possible strategies include stress relief techniques and emotional regulation skills.
• Medication adherence — It’s not easy to take medication as prescribed during an episode, especially if you’re experiencing rage. A psychotherapist will ensure that you’re adhering to your medication on a regular basis.
• Trigger identification — Bipolar rage can have many potential triggers. However, it can be difficult to recognize which ones affect you personally. A therapist can help you identify the triggers for your rage in order to better prepare for them in the future.
• Addressing co-occurring mental health issues — People with bipolar disorder are often diagnosed with other mental health disorders as well. It often co-occurs alongside an anxiety disorder. A therapist can make sure that you’re working on your mental health as a whole. They’ll address how the signs of one disorder can be connected to the other.
• Support during stressful transitions — A therapist can help you through changes in your life that can trigger your bipolar rage. They’ll help you work through the emotions you’re experiencing. You can also come to terms with your new reality after a transition.
• Treatment and relapse prevention planning — Talking to a therapist about your bipolar rage is just one step in your mental health journey. They can help you design a treatment plan specific to your needs that will provide long-term solutions and reduce the risk of future relapses.

Process-based therapy for bipolar rage

At Lightfully Behavioral Health, we see clients as whole people, not symptoms or diagnoses, and we understand that you’re more than your rage. We use process-based therapy, or PBT, as our clinical model, which can be integrated into every treatment plan. 

The goal of PBT is to provide you with holistic, personalized treatment that targets the core process issues that are at the root of many mental health disorders, including bipolar disorder. These core process issues include:

• Difficulty with emotions
• Difficulty with thoughts
• Difficulty with relationships
• Difficulty with behaviors

These core processes are addressed through evidence-based integrated interventions, such as arousal reduction and relational interventions. Your PBT plan is customized to your specific needs and symptoms. This customization is done by an experienced clinician who will make sure your plan includes the most effective combination of interventions for your disorder.

Lightfully Behavioral Health can alleviate your bipolar rage with PBT

Not only does bipolar rage stem from a mental health disorder that can impact your quality of life, but it can lead to strained relationships, issues at work and more. Lightfully can help you learn how to better manage your bipolar disorder symptoms, including rage, in a kind and supportive setting. We’re focused on providing you with evidence-based, clearly defined, data-driven and whole-person-centered care.

Change is possible. When you’re ready to get some support as you work to better your mental health, reach out to our Admissions Concierge Team. We’ll take the next steps on that path together, toward the fullest, brightest version of you.