Understanding and Managing Bipolar Disorder and Hurtful Speech: A Guide for Loved Ones

Living with a loved one diagnosed with bipolar disorder can be challenging, especially when you’re always at the receiving end of hurtful anger outbursts. It’s important to recognize that these words often stem from the illness rather than a reflection of their true feelings. Although you are aware that it’s the condition that causes them to have extreme moods – you are still human with feelings that can be triggered, and sometimes, it’s tempting to fight back.

This guide provides valuable insights and advice for those navigating this complex condition.

Understanding Bipolar Disorder

woman holding happy face with a sad face behind

Bipolar disorder is a chronic mental health condition characterized by dramatic mood swings, causing intense shifts in mood, energy levels, and concentration. Also known as manic-depressive disorder, bipolar disorder comes with shifts that involve manic episodes featuring high energy and euphoria and depressive episodes filled with intense sadness. These mood changes can significantly impact a person’s daily life. It’s important to realize that bipolar disorder is a medical condition and not a reflection of one’s character strength or a flaw in one’s personality.

Bipolar disorder manifests in four distinct types, all characterized by unusual mood swings, such as:

  • Bipolar I Disorder: This is the most severe form of the disorder, featuring manic episodes lasting at least seven days or requiring immediate hospital care due to their severity. Depressive episodes in this category can persist for two weeks or longer.
  • Bipolar II Disorder: Bipolar II is characterized by a pattern of manic and depressive episodes, though not as intensely as observed in Bipolar I.
  • Cyclothymic Disorder: Also known as cyclothymia, this disorder involves recurring periods of manic and depressive symptoms lasting at least two years. However, these symptoms do not meet the diagnostic criteria for full-blown manic or depressive episodes.
  • Other Specified and Unspecified Bipolar Disorders: This category encompasses bipolar disorder symptoms that don’t neatly fit into the above classifications.

Some may experience episodes over an extended period, while others may only have a few throughout their lives. In instances of bipolar I disorder, there is a phenomenon known as “rapid cycling,” where shifts between mania and depression can happen quickly.

Along with mood swings, people with bipolar disorder can also experience changes in sleep patterns, emotions, eating habits, and behaviors. When in their manic state, people with bipolar disorder may have clouded judgment.

Manic phase symptoms include:

  • Euphoria
  • Rapid speech and changing subjects quickly
  • Aggressive behavior
  • Irritability
  • Racing thoughts and difficulty staying focused
  • Feelings of jumpiness or on edge
  • Less need for sleep
  • Impulsive behaviors
  • Risky behaviors with no concern for consequences
  • Psychosis

Meanwhile, symptoms of the depressive phase include:

  • Feelings of sadness, helplessness, and emptiness
  • Very low energy
  • Forgetfulness
  • Disordered eating
  • Lack of interest
  • Decreased activity level
  • Trouble concentrating
  • Inability to make decisions
  • Excessive worrying
  • Unable to feel happiness or pleasure
  • Excessive fatigue
  • Sleep disturbance
  • Thoughts of suicide

What is the Relationship of Anger to Bipolar Disorder?

a woman holding a cracked mirror showing two moods

The idea that people with bipolar disorder have anger issues is something that the media have perpetuated for years. However, this depiction is stigmatizing and not entirely accurate. While people with bipolar disorder may struggle with emotional regulation and managing feelings like anger or irritability, the notion of “bipolar anger” or “bipolar rage,” particularly defined as fits of violence, is not always true.

People with bipolar disorder find it challenging to manage their own emotions. The people around them, especially their loved ones, can also experience difficulty managing their own emotions when the bipolar person is having episodes. The cyclical nature of this condition can be frustrating to navigate.

During manic episodes, a bipolar person can be very irritable, but it can happen at other times as well. Bouts of mania and even psychotic symptoms like hallucinations are possible. These can increase feelings of anger.

Even in depressive episodes, anger can be a challenge. They may feel guilty about not accomplishing their tasks, making them feel disappointed in themselves. It can lead to bouts of anger and helplessness.

Dealing with anger in the context of bipolar disorder can be difficult. Studies indicate that individuals with bipolar disorder tend to experience irritability or anger more frequently than those without the disorder. While agitation and anger are not direct symptoms of bipolar disorder, those with the condition may feel these emotions more intensely.

When individuals with bipolar disorder grapple with their emotions, it may indicate a lack of skills to manage moods effectively. Through treatment and support, they can acquire the necessary skills and strategies to navigate mood swings successfully.

When supporting someone experiencing extreme mood swings coupled with anger, it’s important to be patient and understanding. Avoid confrontation so as not to worsen the negative emotions you both feel.

Since “bipolar anger” isn’t a condition, how long the individual with bipolar disorder stays angry varies on different factors, such as the extent of treatment received.

In severe instances, anger in a person with bipolar disorder can manifest as paranoia or psychosis. If there’s any concern for personal or public safety, it’s imperative to call 911 or seek appropriate support.

Why Hurtful Words?

a silhouette of a couple fighting

Because bipolar disorder heavily impacts a person’s thoughts, emotions, and behaviors, people with the disorder may say hurtful things at times – usually stuff they don’t really mean. During manic episodes, their self-confidence heightens, and they may not filter out their speech, leading them to say harsh words without considering their implications. Conversely, depressive episodes may bring overwhelming negative emotions, contributing to agitation and unintentional hurtful remarks as a way to cope with internal struggles.

How to Handle Communication with an Angry Loved One with Bipolar Disorder

Since you already know that bipolar disorder can significantly impact an individual’s communication skills, hearing harsh and hurtful comments can be expected. Whether you’re a caregiver, spouse, or loved one, here’s how you can handle communication with them when they are angry and on a manic or depressive episode:

1. Take the time to understand bipolar disorder and its impact on your loved one

Closeup of the psychological disorder term 'Bipolar Disorder' printed in black on white paper

Arm yourself with knowledge about bipolar disorder to better comprehend your loved one’s journey. Familiarize yourself with symptoms, triggers, treatment options, and the latest research. Invest some time researching the condition from reputable sources to gain a better understanding.

Once you have learned more, talk to your loved one and understand how bipolar disorder manifests for them. Try out techniques that are helpful for handling extreme mood swings, and ask how you can support them.

It may feel like a trial-and-error process, but remember that no one solution solves all. After the anger outburst or episode passes, have an open-minded conversation and reflect together on what worked, what didn’t, what adjustments are needed, and discuss plans for the future. Collaborate to improve your communication.

Remember that, like any mental health condition, the impact and symptoms of bipolar disorder vary from person to person. While it’s helpful to have a general understanding of the condition, make sure to listen to your loved one and consider their unique experiences.

2. Avoid judgment and stigmatizing language by being compassionate

When you’re caught in a heated argument with someone in a manic or depressive episode, it’s easy for judgment to creep in. But instead of judging them or the situation, focus on the facts. Share how their behavior made you feel and why it’s unacceptable. Express how their actions and words affect you rather than resorting to blame and generalization. Instead of saying, “You always hurt me with your words,” choose to say, “I feel hurt whenever you say things like that. This approach creates a nonjudgmental space for your friend or loved one while holding them accountable for their actions.

Understand that hurtful words from a bipolar person come from an agitated downswing, and it’s not to be taken as a personal attack– it’s only a symptom of their emotional state.

Also, avoid using terms like “crazy” or “insane,” even if they sound irrational to you. It’s crucial to use respectful language to keep the dialogue productive.  

3. Recognize their limits

While treatment can help manage bipolar disorder – and some may go extended periods without episodes – it is typically a lifelong condition that can be controlled but not cured. Living a normal life and maintaining healthy relationships is possible, but it requires understanding from those around them and a willingness to make constant adjustments.

Be empathetic to their feelings, but don’t ignore or enable unhelpful behavior. Understanding and communication are key, as people with bipolar disorder may struggle to balance their emotions like others. During a manic episode that causes anger, they might need guidance from you or a medical professional to regulate their emotions.

4. Practice empathy and patience

a woman holding hands with her teenage daughter who is stressed

When dealing with a loved one with bipolar disorder, you have to practice patience and empathy. Their unpredictable behaviors may challenge your patience and endurance, but always remind yourself that these actions are symptomatic of their illness, not personal attacks. Take a moment to step into their shoes and understand their internal battle against their mind and moods.

Do not belittle or downplay their emotions. When you say phrases like “You’re just being dramatic” or “Snap out of it,” you are undermining their valid struggles and overlooking the complexities of their disorder. Instead, be patient and offer a listening ear to help understand their challenges. That way, you can be in a better position to support or help them.

However, while empathy is essential, resist the urge to claim or say that you know exactly how they feel – because you most probably don’t. Each person’s experience with bipolar disorder is unique. Instead, validate their emotions, listen attentively, and be supportive without assuming their exact experience.

5. Learn their triggers

We all have triggers that can put us in an awful mood, and the case of bipolar disorder and anger is no different. There might be specific phrases, words, situations, or people that can trigger their frustration and irritability. If someone with bipolar is experiencing these emotions, pay attention to what causes their anger or rage. When it happens twice, take note of it so you can help avoid it in the future. You can also ask them directly without triggering specific responses.

Knowing what might provoke them to anger helps you minimize their exposure to triggers and assist you in keeping them in a stable mood – thus, less hurtful words to hear for you. If you anticipate a potential trigger, you’ll be more aware and help them work on calming strategies before their mood escalates to anger. This also allows them to improve their self-awareness to take proactive measures to manage their anger episodes. 

6. Consider the timing

Choosing the right time for serious conversations is vital. During manic or depressive episodes, your loved one may not be receptive or able to think clearly. Wait for a calmer period to talk to them about their behaviors, triggers, and similar kinds of discussions so that they will more likely consider your points thoughtfully.

It can be tempting to fight back and express your own anger when in a conflict with a bipolar person, but it’s essential to stay calm to make problem-solving easier. If you find it hard to communicate without raising your voice, pointing your finger, or clenching your fists – consider taking a step back. By removing yourself from the situation and taking some time to calm down, you can improve your ability to communicate your feelings effectively and avoid triggering your anger even more.

7. Encourage them to get professional treatment

One of the most meaningful ways to help is by urging your loved one to seek professional assistance and offering your support. This might include researching mental health professionals, helping with appointments, or providing moral support during therapy sessions. Their recovery can be long, and it may include different therapies, medications, and approaches to find what works best.

Always remember that seeking help is a display of strength and a positive step toward effectively managing bipolar disorder. But remember that as your loved one progresses through recovery, do not expect or force quick results. They may take some time to identify and modify their behaviors. Whenever possible, extend grace, encouragement, and support during conflicts, especially when your loved one actively takes steps to improve communication.

8. Support them in taking medications

If well-managed, bipolar presents fewer symptoms and less frequent mood swings compared to untreated cases. Treatment can vary from person to person, and finding the right approach can take time. But once your loved one has agreed to take medications and treatment with a doctor, make sure they stick to it.

Sometimes, people with bipolar disorder decide to stop taking meds or skip therapy when they feel better, posing potential problems later on. Remember, bipolar disorder is a lifelong condition that can be effectively managed through sticking to treatment plans.

Be mindful of how you approach them when this happens so as not to cause distress. Discuss with them how they can stay on track with their medication and encourage them to stick to it in a calm yet firm manner, prioritizing their well-being throughout the conversation.

If you observe persistent feelings of anger or mood swings, it may indicate that the current meds or treatment are not suitable. There are various medications available, each with different dosages, and the person may need to try out different options. While bipolar medication should not induce irritability, it can have other unpleasant side effects like nausea.

If you believe your loved one might want to change their treatment plan, engage in open communication with them and encourage seeking medical attention.

9. Create a supportive environment

A person with bipolar disorder can significantly benefit from a stable, stress-free environment. Maintain your familiar routines, seize opportunities to relax, ensure a healthy diet and exercise, and encourage regular sleep patterns.

Managing Your Mental Health

As a support person, your role can be fulfilling, but also draining and demanding. You can feel mentally and emotionally drained as you deal with a loved one with bipolar disorder. Even if you understand that their hurtful behaviors stem from a mental health condition, it can still be hard sometimes not to take them personally. 

Don’t forget to take care of your own well-being too, while you take care of a person with a mental health problem. Here are some practical tips for taking care of your own mental health:

1. Prioritize taking care of yourself

a woman drinking coffee and relaxing on a couch at home

While you’re busy with caregiving responsibilities, it’s easy to overlook your own needs. However, self-care is a must so you can also care for your loved one better. Spend some time each day for activities that help you relax and recharge. It could be watching a movie or your favorite series, reading a book, exercising, gaming, or pursuing a hobby. You can’t pour from an empty cup, so make sure you have some time to enjoy life.

2. Seek support from your social circle

Isolation can intensify the challenges of caregiving. It’s hard enough to take care of a person with a mental health disorder, but it gets harder when you receive hurtful remarks from time to time. To save your sanity, stay connected with friends and family. Regularly share your feelings and experiences with trusted people who can offer emotional support, a fresh perspective, or a listening ear. Better yet, join support groups where you can connect with other loved ones of people with bipolar disorder or other mental health disorders.

3. Practice mindfulness and relaxation practices

Mindfulness, meditation, and relaxation techniques like yoga and deep breathing and yoga can help manage your stress and anxiety. These practices anchor you in the present moment and foster a sense of peace and calm. Make this a regular part of your self-care, especially when you need to release negative feelings after a heated argument.

4. Get some physical exercise 

Mental and physical health go hand in hand. Find the type of exercise that you love – whether it’s running, cycling, swimming, yoga, or dancing – and find time to do them. Physical activity can help bump up your endorphins, or the feel-good hormones, allowing you to remain calm, collected, happy, and energetic. And when you’re in this state of mind, you’ll be better equipped to handle the challenges of caregiving.

5. Set boundaries

If you have a bipolar person in your life who is angry, set boundaries, but also try to address their needs. While bipolar disorder doesn’t excuse disrespectful behavior, it’s crucial to recognize that their emotional expression may differ from the norm.

Establishing boundaries is vital to any healthy relationship, but it can be challenging, especially with someone with bipolar disorder. Learn to say no when you feel overwhelmed and delegate tasks whenever possible. Boundaries are essential to prevent burnout, ensure you still have the time and energy to attend to your needs, and protect your relationship.

If you want to improve communication with a friend or family member with bipolar disorder, openly share your boundaries with them. Allow them the space to respect these boundaries, but make it clear that there may be consequences if they don’t.

6. Try to seek professional help.

If you frequently find yourself in disagreements with a friend, partner, or loved one dealing with this mental health condition, consider adopting healthy communication techniques. There are many resources like books that may help, but seeking professional help from a relationship counselor, couples therapist, or family therapist can provide additional, helpful support.

Takeaway

We all know that conflicts are common in most relationships – whether romantic, spousal, familial, or close friendships – but engaging in heated arguments with someone with bipolar disorder can potentially worsen the situation.

Anger and rage are often unrecognized symptoms of bipolar disorder, which can have severe consequences in relationships. During manic or mixed episodes, individuals with bipolar disorder may experience intense anger or rage, leading them to say hurtful things they don’t mean.

It’s crucial to understand that these hurtful statements often result from the emotional dysregulation and altered perception that is associated with bipolar disorder, and these must not be taken as a genuine reflection of their feelings toward others.

Try to engage in open communication with them to handle their outbursts and improve your situation. Try to understand their feelings and encourage them to express what they’re going through, which may make their emotions feel more manageable. If cooperation is challenging, removing yourself from the situation is best when your anger becomes harmful.

It’s essential to respond with empathy instead of defensiveness when hearing hurtful remarks from someone with bipolar disorder. Learn more about their disorder, keep an open line for communication, and focus on their overall well-being. Being patient and understanding can help foster healthier interactions and maintain a harmonious relationship.