If you search the Diagnostic and Statistical Manual of Mental Disorders, you will see that anger is not a symptom of bipolar disorder. If you search the International Classification of Diseases manual (maintained by the World Health Organization) you will see that anger is not a symptom of bipolar disorder. It doesn’t appear to be recognized, or even proposed, that a symptom of bipolar disorder is anger.
The trouble with this seems to be that many people do experience anger, irritation and aggression as symptoms of their bipolar disorder. I am one of those people.
Anger Is Not a Symptom of Bipolar Disorder?
As I said, anger is not, in any way, a recognized symptom of bipolar disorder, but in my experience, and in the experience of many others, anger seems to be associated with bipolar disorder. In my case, I find myself full of anger, hatred and irritation so much of the time it’s astounding. And they are not my “normal” states. I’m actually quite a positive person naturally. These states are atop my normal. I can feel it.
But that doesn’t mean that the feelings of anger, irritation and hatred of everything are any less real. (I don’t experience aggressiveness.)
I’m Not Angry With Anyone or at Anything
Let’s be clear, when I say I’m angry, irritated and hateful, these feelings are not related to anyone, anything or any experience, they are just feelings popping out from nowhere. This is particularly distressing to me because if you’re angry at a situation or at a person, you can deal with that feeling and move past it but when you’re angry at nothing, there is nothing to resolve and so the feeling smothers you like a fire blanket indefinitely.
I Don’t Take My Bipolar Anger Out on People
One of the most common things I hear from loved ones of people with bipolar disorder is that people with bipolar are very angry and lash out at others and have rages. I do not do this. I may feel angry, but I have great control over my actions and do not take this feeling out on others. And I believe, just because it may be because of my bipolar, that doesn’t give me any right to be angry at others for a disease that distinctly isn’t their fault. It’s up to me to find a way to deal with this anger on my own in a way that doesn’t hurt others.
Is Bipolar Anger a Medication Side Effect?
Now, it is possible that the reason that anger is not recognized as a symptom of bipolar disorder is because it, indeed, is not a symptom of bipolar disorder and is, instead, a side effect from bipolar medication. I have no way of proving this to be true or false, so I’m just throwing it out there. I will say that my bipolar anger has developed over many years, and wasn’t there initially, so it’s quite possible that it is related to the medication that I take. (And I have noticed that some medications can make me unabashedly angry and irritated; I’ve gotten off of those medications for that reason.)
It Doesn’t Matter Why You Have Bipolar Anger; It Matters What You Do with It
I do believe, also, that many people are angry at bipolar disorder in general. People are angry at being sick. People are angry they have to take medication. People are, quite reasonably, angry at having to deal with all the pain and suffering that comes from this disease.
But no matter why you’re angry, and no matter if it really is a symptom of bipolar disorder, what matters is that you don’t take that anger out on other people. Rages aren’t okay even if that anger is being driven by an illness. Taking your anger out on others is not helpful for your relationships, is not healthy and hurts people. You need to recognize the anger within yourself and learn to deal with it in a less harmful way.
Sometimes this means a medication adjustment (yes, this can help) so talk to your doctor about your anger and don’t hide it from him or her. Sometimes this can mean gaining new coping skills to deal with your strong emotions like learning about cognitive behavioral therapy. And sometimes this means delving into other reasons that may be making your angry, perhaps with the help of therapist.
No matter what you choose to do, one thing I know for sure is that you don’t want to let anger control your life or your interactions with others because that will hurt them and, ultimately, you.
I absolutely agree. Sometimes i get so irritated..so angry… for no reason. I dont take it out on others…but the battle of having to “watch” myself is horrible. Every action making sure I control breathing..count…watever to calm down. I dont take it out on anyone…because its no ones fault. So sometimes i splash my face with ice water…. Sometimes just going into an isolated area like the closet for just a minute. It sometimes creeps up on me too.
Thank you for taking the time to address this.
I too have noticed everything i read excludes anger.
I was diagnosed about 4 months ago, so im new to this, still learning. It helps to see others are dealing with it,band there are people trying to help.
I believe that anger is absolutely a symptom of bipolar. I have never had mania, and was told by my doctor when I was diagnosed that I have anger instead of mania. It doesn’t happen often, but when it does, watch out. I hate it, because it is not me at all. It comes out of nowhere and freaks me out.
Yes, absolutely. Anger and irritability is deinitely a part of my bipolar disorder. I can suddenly explode and just smash something, anything. Everything and everyone is getting on my nerves and I just want to punch someone in the face, for no good reason. I don’t act on the violent thoughts but, I have smashed a lot of my dearest posessions.
And then, the next day I just wonder “Wtf was all THAT about?!” And so, the guilt and shame sets in…
Thanks, Mark, for this great link. I’ll read the article a little at a time, because it’s long. I can relate to: ” triggering intense guilt and self-criticism” and “including rejection and loss.” But I can’t relate to this, because this is not my case: “an increase in its tolerability and to diminished guilt and depression.” It has NEVER been tolerable for me! Now, since I have medication and therapy, I occasionally get irritable when people (or internet/phone rerouting) are rude. I think I am learning not to react so much, thanks to my great therapist. But when I do get irritable, people think I’m “blowing up” or “going off” on them. But that sort of teeninesy anger episode is like fizz top of the soda — they have NEVER seen MT. VESUVIUS!! My “real” anger is a serious EXPLOSION, triggered by something, followed by depression and crying — the whole episode has been known to last up to 6 hours.
Thanks again for the link — I look forward to what others have to say about the article.
“since I have medication and therapy, I occasionally get irritable when people (or internet/phone rerouting) are rude.”
-I don’t know what to make of this remark. I don’t know if it was written to help or to hurt, but at this point I don’t really care. I’m so beaten down and defeated that I’m nearly numb to all of the daily input I receive, live and digital.
“My “real” anger is a serious EXPLOSION, triggered by something, followed by depression and crying — the whole episode has been known to last up to 6 hours.”
-Yes, this remark is true for me, or at least it WAS true. Luckily, for those that induced that “episode”, that was my somewhat controlled reaction. But in reality, that was also just “fizz from a shook up soda”. NOBODY has seen my REAL anger, ever. I pray that day never comes but if they keep pushing and prodding rest assured, no one will want to be there to see it “pop off”. Here’s a metaphor that fits nicely. Imagine a wild lion caught and caged then provoked, abused, and teased by it’s captor constantly simply for the captors amusement while being locked up. We all know that lions aren’t stupid. Yes, they are instinctual (emotional) creatures ruled by their environment, bu they are also problem solvers. Slowly but surely the lion will get wise to the captors “game” and then begin to “play along” by acting docile and indifferent to it’s captors torment. This behavior will instill false confidence in the captor that the lion is no longer interested in attacking. One day the captor will decide it is safe to let the lion out of the cage because of it’s decreased or non existent aggression. I’m sure we can all imagine what happens to the captor the millisecond he springs that lock, that safety, that buffer between life and death.
Now let’s think about something we didn’t consider in the above metaphor. Let’s take that SAME lion and the SAME captor and put them in a different circumstance. For example: The “would be” captor is in the wild looking to capture a lion, he spots the lion chillin’ under a shade tree, minding it’s own business. The captor devises his plan, but while he conspires against the lion, something tells him to move on, a gut instinct, call it goodwill, an understanding, a certain respect for the life of that lion. The “would have been” captor moves on without ever gaining the attention of the lion and they both carry on with the rest of their lives, however they choose to live it.-Now, isn’t that a MUCH better outcome for lion AND the man? I certainly think so. It is infinitely better than the latter scenario, wherein the man gets eaten by the lion for tormenting it, then the lion being shot dead by the “moral authority” (police) for simply carrying out it’s obligatory and justified vengeance against it’s tormentor.
There might be some people who read this and think to themselves; “But what if the captor’s intentions WERE good? What if he was “training” the lion to be more social and friendly to people, to “get along?” To me, that is the ABSOLUTE WORST way of thinking about this situation. Because who are we to change the behavior of another living creature? What gives us that authority? What makes us think that we are so much better than someone, or something else that we take it upon ourselves to change them/it to adopt our own interpretation of “appropriate social behavior”? Human beings in general need to learn to just let it be. Nature, be it human or otherwise, IS the way it is. It follows it’s own course, it has no conscience, moral obligation, or ill will. It just IS, and the sooner we ALL accept that, the better off the world will be.
Some think that I don’t see a problem within myself, but instead I see a problem with the world. They are wrong. The problem DOES lie within me because I think that the world can change without changing myself inside. Just my two cents.
Thank you for your post. I know its 4 years old but I totally agree with the idea.
It is the way society is and functions.
Growing up..ppl used to care. Even the hateful people weren’t horrible.
Society today has become ruthless for the most part. Everyone is self concerned.
In my case..i turned a new leaf..i try to be kind, nice as much as possible…kind of like ” pay it forward”.
Unfortunately now, caring is seen as weakness. Thoughtfulness is perceived as opportunity.
I do know you cant change the world. I dream of a society like i grew up in. Of course when you are young you dont appreciate it entirely, but thinking on it now…it would be great….but the realist in me knows it is the way it is. So for know I just do my best to deal with all of the rudeness, abusive behaviour, etc.
I hope things have gotten better for you. If you see this and you have a second, reply to this with anything you’ve found that helps.
Im still learning…its really hard and seems to get harder everyday…especially with the irritation of society today.
Wishful thinking for myself that I am not angry, but everyone around me comments that I do get very angry and lash out at others and have rages.
I should also mention that I’ve never once had a spontaneous manic episode. They were all prescription drug induced.
Another thing. While I take my cocktail of prescription drugs everyday, it is important to emphasise, that modifying brain chemistry with drugs does not necessarily solve a person’s problems in living. By problems in living, I mean domestic issues, setbacks in life etc.
Imagine Godzilla came trampling your city and you were afraid you would die. Putting pills in your mouth will not remove the monster. Actually, this is an example my psychiatrist gave me. Sure, pills ease the MENTAL FEELING of distress. That’s different from solving problems in living. Pills cannot unrape a rape victim, they can’t make lost time come back etc. This plays into the anger department. The things that a person has gone through.
Natasha, I have a bipolar diagnosis. A diagnosis I received as a result of antidepressant induced mania (originally prescribed because I was traumatised, depressed, and had obsessions). Yes, antidepressants do cause mania in a subset of the population put on them. No, these are not manic episodes that just happen to pop up while you’re on the drug, but they are due to the the drug. SSRIs get me “high” over a period of time. I’ve tried this with escitalopram, sertraline, fluvoxamine and venlafaxine. http://www.ncbi.nlm.nih.gov/pubmed/15289250
I also come from a horrible household. I have/had an abusive father as well. My anger is very much associated with the things I’ve been through rather than something purely biological. Conflating the two in my case would be horrible and I would certainly want to punch someone in the face (with my “bipolar anger”), even if it’s a psychiatrist, who says that my anger all boils down to a psychiatric label. Thankfully, my psychiatrist is not an idiot who does that. You should mention trauma and abuse in your article as well.
A bipolar diagnosis is a descriptive label which says that a person has experienced depression and mania. It doesn’t say why, other than the usual explanation of interacting biological, psychological and social factors.
It would be more useful if you stopped talking about “bipolar anger”, “bipolar this”, “bipolar that”, and laid things out in a more detailed manner. I have met many people with bipolar labels. All different from one another with different causal factors going into them exhibiting depression and/or mania. “Bipolar anger” makes it sound like there is a specific entity called bipolar disorder (as though it’s like the varicella virus) which is associated with anger. It removes the focus from the problems in living people face and the psychological and social factors (which in addition to biology (duh, since we have a body and a brain) which precipitate certain behaviours. Even if you do want to talk about “bipolar anger”, do mention that bipolar disorder is a label which says that a person has experienced depression and mania, with causal factors varying from individual to individual. It does a great disservice to people in different situations. So while you may go around trumpeting “I have a brain disease”, it does a great disservice to those of us in different situations.
Let me tell you one tactic that my biological father uses. He hurts me (not physically) till I feel depressed, and when I feel depressed because of what I’m being put through, he says it’s due to bipolar disorder. See, how clever that is?! It’s like adding insult to injury and rubbing salt to wounds.
I have a humble suggestion. Stop talking purely in terms of labels, and open those labels up for what they are. THAT means something. A good psychiatrist does that. A wholesome analysis. Frankly, labels really have the potential to obfuscate. As someone who has a wide readership, you have a responsibility to convey things properly because though your intentions may be good, you may be inadvertently causing some harm.
I understand that you’ve talked about yourself in this article. But as I said, wide readership. What you write, is all some might know about.
You may have good intentions at heart. But I’ve read some of your articles, and they
“Let me tell you one tactic that my biological father uses. He hurts me (not physically) till I feel depressed, and when I feel depressed because of what I’m being put through, he says it’s due to bipolar disorder. See, how clever that is?! It’s like adding insult to injury and rubbing salt to wounds.”
Nail on head. So spot on it’s scary. It’s as if this statement was written about MY exact circumstances, but replace “biological father” with “biological mother”. And believe me, it is VERY difficult to refer to her as my mother because in reality she is a MONSTER, not a mother.
Your words are so very true in your reply xy12, we need more people like you in this world. We are so much more than just the “bipolar” label.
I come from a very dysfunctional family and i’m the scapegoat. They labeled me bipolar (also caused by antidepressants). Almost all my family members try to incite negative emotions in me and then blame it on my bipolar. My sister slapped me across the face and when I punched her back in self defense, my brother in law, who’s a cop, threatened to commit me. My paranoia and anger are not symptoms of any chemical imbalance but natural reactions to life circumstances. I’ve learned to stay away from toxic people like my family. I don’t care if others think i’m bipolar and use that label to try and get under my skin. I know who I am and don’t need a label to justify my actions.
I wonder if the anger is a cover up for the frustration, hurt and isolation experienced when moods shift. We are taught with CBT to manage symptoms but when life gets busy and I get comfortable in ” stable” a shift in mood can take me by surprise. A shift changes how I feel, how I think and how I behave. Each time I have a major shift it takes me longer to recover. I am nearly 47 and a lot of my energy goes into masking my symptoms at work so I can keep working or into practicing CBT in my head to get through the day. I feel resentment and isolation at those times. I call this “sad and lonely”. Anger has to go somewhere and in nearly all cases it turns inward giving my inner demons super strength. It is a difficult illness to manage day to day and I believe that validation of this can go a long way to relieving some of that anger.
Kerry, your post about anger/irritability certainly speaks to me, too! Mark, I look forward to reading the article at the link that your posted. Thanks to both of you! And thanks Natasha, too, for your great blog.
I have struggled with anger most of my life. Someone recently explained to me there are three paths to choose from when dealing with anger. 1) internalize it and hurt yourself, 2)externalize the anger and lash out at others or 3) process the anger. For me the great challenge is overcoming the impulsivity to react now, but I’m working on it. If I’m patient and give myself time, I can see it is possible to process the anger and I actually feel some sense of accomplishment for the effort. Doubt it will ever become a habit but at least I see progress.
I know anger. He is my inspiration for art and music. He lives within
and rarely exposes himself except to taunt me to become something
I would rather not be, or something I may aspire to create. Occasionally he
is me, and I am him, and we are all together – koo koo ka choo :)
Anger and bouts of adrenaline fueled rage are definitely a part of my BP2 disorder. They appear only during my depressed mood swings. It is a predictable pattern that begins with the blanket anger, lasting for 4 to 5 days, then onward to rage. The rage can easily be triggered by someone or something that is causing me acute stress. In an instant I have gone into out of control rage. Fortunately, I have not hurt anyone, but I have destroyed personal items such as computer equipment, telephones, the clothing I am wearing at the time and recently turned the rage inward and self harmed. After the rage has subsided, I am totally drained of energy and have to rest for at least a day to recuperate. I am shocked by being so out of control and my memory of the outburst is fuzzy. It’s as if I was drunk and have to rely upon a witness to give me the details of what I did.
I believe anger and rage are an extension of the acute anxiety that I experience when in BP depression. It seems to be an adrenaline based “fight or flight” malfunction that is totally inappropriate relative to the level of stress and similar to the close cousin of acute panic attacks.
Gosh! Robert, this sounds just like I used to be (except I didn’t injure/self harm) , for most of my life until I moved to a city when I was 54 or 56 and finally got competent professional help/treatment and meds. My diagnosis is BP2, also.
I believe bipolar disorder, along with the anxiety it produces, can be the cause of anger. For me, there is no underlying reason why I had so much anger in my teens and 20s. My family was baffled by it. I don’t have abuse or neglect in my past, I was loved and I knew it. Anyway, the minute I was treated correctly, the anger went away. I believe people with a lot of anxiety (which includes a lot of people with bipolar disorder) may also have anger attacks. (Google “anger attacks” if you want to read about them, they are panic attacks with anger involved). I had a TON of anger…brewing, explosive, and otherwise… as a young adult, but, depending on the med I was taking, it would disappear. I’ve been explosion-free since I started taking Seroquel in my early 30s. Not saying it’s a fix for everyone, but it worked for me. I only have overblown anger on occasion now. It could very well be that age has mellowed me, too. I’m not sure why, but I do know it’s a relief not to carry that burden of anger all the time.
In my own case I am pretty sure that my anger issues are at least part bipolar. One of the most dramatic effects of starting on a valproate based medication was that I got a lot less angry – before that I had been pretty much pissed of for weeks or maybe even months. I did actually have a reason for my anger but it was too constant and extreme to just be about that certain reason. It did actually make me do some good changes like finding another doctor and a psychiatric team that I felt took my problems more seriously. It was not my first period of anger and irritability though, I had a period of prolonged hypomania a few years earlier and I sure was VERY irritable for a while, it actually made me experience nearly every possible emotion during somewhat less than a year, I was not depressed during that time but I went from cheerful to irritable to heartbroken to hypomanic infatuation. I can be unstable anyway because I have ADHD and I’ve also been diagnosed with personality problems but that hypomania (or maybe it was mania) was a pretty distinct period even though it was messy. Anger may not be a diagnostic criterion for bipolar but irritability is mentioned in the DSM criteria. Unfortunately some of my anger has come back but it is at least not half as bad as when I was not on medication.
A very timely post (again.) I have just come down from a wonderful period of hypo-mania (I got so much done and even got an award at work!) Now as I come crashing down into my more normal state of profound depression, the anger is back. People are idiots, the people I work with are incompetent, I hate my company and the, “I wish I was dead,” mantra is endlessly looping. I cruelly lash out at people and even as I see myself doing it, I feel powerless to stop it. This anger component to my bipolar is in no way related to medication, as it is something which with I have dealt since long before I was diagnosed and medicated. I am aware of it, I hate it and yet I feel powerless to stop it.
Thank you so much for this, and exactly at the right time. My 11 year old is in the process of being evaluated for mood disorder at 11. He has always handled my problems easily and with a humor that makes them much easier for all of us to bare. But since he has started having problems he often is angry and can’t explain why. I had him read the two paragraphs about being angry at the bipolar, not anyone or anything, and how he may not be able to control the anger but that he was responsible for his actions, and it gave him what he needed to start talking through some of his reasonably conflicted emotions. Thank you for a we wonderful, as always, post, from both of us
i totally relate Natasha. i have exactly same thing than you and this is like describing me 100%. i do get that irritation or anger of certain medication or if i increase my dose over certain limit. but i noticed that lots of my anger comes out of my anxiety.before i get bad panic attacks or bad anxiety, often 2 days before, i am really irritated, it kind of builds up before my anxiety or panic hits. so i think in my case it is a symptom of a co- morbid anxiety more than actual bipolar. i also can be irritated during depression, but that is usually just something small, my bipolar II is ( lucky me ) well under control, only anxiety might sometimes surprise me , my moods are on pretty good level and i am fully functioning.
Natasha wrote, in part: One of the most common things I hear from loved ones of people with bipolar disorder is that people with bipolar are very angry and lash out at others and have rages.
She is fortunate that she herself is not like that. I am — or was, until I was 54 years old and got a dx of Bipolar II, rapid cycling, and started medication. I don’t have rages anymore. But with a med change last November after two months of severe depression when the prior medications stopped working, I have had some episodes of such severe irritability and reactivity that it has me concerned. But, before my medications started when I was 54, I had terrible, terrible rages. I was, though, involved in a dysfunctional relationship with my dad, who had rages and periods of morose silence which often followed anyone challenging or disagreeing wit him. As a lawyer and later a judge, he had the great privilege at work to be always right. That was his job — to be right and prove it. He thought he had the same freedom to be right, at home. But anyway, two marriages on my part followed, that were also dysfunctional and abusive. The husband and I had screaming arguments, where one or both of us broke or threw things. I would rage sometimes for 6 hours, then sob for another few hours because I regretted and was ashamed of my behavior. I find it pretty incredible that the DSM does not list anger as a symptom of bipolar. It seems obvious that it is…my friends who are bipolar have this problem, too.
Is anger one of the symptoms of bipolar? I certainly believe so. Not only do I believe it is one of the problems that come with bipolar, I believe that there is a logical psychological aftermath of rage that is caused by the consequences of having bipolar disorder. It is an angry disease which feeds on itself, almost like a snake trying to swallow its own tail.
There are far too many memories of bipolar family members in my past for me to believe differently.
My father’s mother evidently had occasional good moods that would delight her family. It must have been like the sun coming out from behind a cloud for a day after months of rain. I never saw her smile. Her brows were knit together in a permanent frown and the corners of her mouth were perpetually downward. Her family was held hostage to her headaches, fears and crying spells.
Mother told me my father was a sweet, caring man before the age of around forty, when his personality inexplicably changed. Back in the late 40s people just thought it was nerves. By the time I was six I was baffled at how this father whom I had adored so much could turn into someone so frightening. By the time I was in fourth grade he was an actual danger to our family during manic phases. His anger grew as his mania would progress over the weeks from a lighthearted, humorous and affectionate phase to a frenzied, impatient and raging phase. His eyebrows would actually grow bushier.
I remember sitting in the back seat of the car and quietly crying after he blurted out that he hated everybody. ” Even me?” “I hate everybody!”
I remember at the same age feeling extremely upset at the movie, “Old Yeller.” Why did the dog change? Why did they have to kill the dog? Why would the dog bite its own beloved master? Why did it start hating the boy? I look back on this and can see the parallels that were going on in my mind.
Like my father when he was young, one of my brothers was an especially kind and intelligent young man. Also, like my father, he was around forty when it became apparent he was bipolar.
In m brother’s first few episodes he did not seem to have the anger that my father did.
But in the episodes that followed, his anger grew progressively worse over time. Having suffered the loss of a child, two bitter divorces and longterm estrangement from his only surviving child, his bitterness was understandable. But his rages lashed out in all directions with little to no provocation, just as my father’s had. Unlike my father, he would get into altercations with strangers and has been injured at times.
Understanding why he had such rage, it seemed necessary to walk on eggshells and tolerate any unacceptable behaviors without making waves by complaining. But it was impossible to avoid his angry outbursts.
I was briefly married to a bipolar man who was continually seething with hostility. I never knew what would set him off and would not tolerate his behavior. At this stage of life I would like to finally take my own turn at being understood and tolerated.
I believe that anger and hostility are definitely symptomatic of the disease, but I also believe that being a victim of the disease causes a reactive rage. Who would not be angry about having his decisions doubted and questioned at all times, even by himself, because of his mental state? Who wouldn’t be upset about the estranged relationships and financial losses? The humiliation of realizing that many consider your behavior as foolish? The fact that your career has been abbreviated by this disease? Rage is surely both a symptom and a result of bipolar disorder.
According to the UK’s Royal College of Psychiatrists, the National Health Service (NHS) and MIND (mental health charity), cite Irritability as a symptom of Bipolar Disorder, which obviously is the first step towards Anger, while Bipolar UK cites ‘Irritability leading to Anger’. So, perhaps the perspective of the illness is slightly different over here than in Canada.
My personal experience fits the latter – irritable leading to anger, in both depressive and hypomanic states. I find it arises by two different routes: First is frustration – e.g. due to an argument; something not working out as planned of expected. Second is a defensive mechanism, i.e. when I *need* to be left alone to work through a mood and someone won’t let me have the space that I *absolutely need*, when they don’t or won’t listen but persist on pushing into my space (Does that make sense to you?)
Harryf200, you explain so well…”Second is a defensive mechanism, i.e. when I *need* to be left alone to work through a mood and someone won’t let me have the space that I *absolutely need*, when they don’t or won’t listen but persist on pushing into my space (Does that make sense to you?)” Oh, does it ever make sense to me! One of the main reasons I was put on Social Security Disability in my 50s was just that. As a woman, and also because of the hiring rules that one could only get a job in a field that you’d already worked in, I was not able to find a job that fit me. The only areas I in which I had experience since high school and early 20s were secretarial/office work, and teaching. The easiest jobs for me to get were secretarial, because I am a speed typist and can edit, spell well, etc etc. But subservience is not one of my strong points. I don’t work well for other people. (I later figured out that I work happily and competently as a contractor and self employed.) But, with bipolar disorder in my case came lack of stamina, so I only could work part time. So working for myself did not work out when I got a divorce. After my divorce, I moved to a larger city to try to get an office job. Low level office workers as I sometimes was, work in “cubicles” that are open, and anyone can come by and talk to you — or give you orders — all day. There was no privacy. It would sometimes irritate me, and it certainly stressed me out. I needed a quiet, dark room to myself to renew my good humor — but that was never something — even a “reasonable accommodation” that I was given. As I became more proficient in office work, I became an office manager — but that didn’t work out either. Office managers — clerical workers in general but particularly office managers, now that most of them are underpaid women, whereas men used to be well paid office managers till women started working in that title of job — get the blame for anything that goes wrong. Why? I’ll tell you why — because clerical workers are like the foundation of a house. The edifice is beautifully built and decorated, but the foundation upon which the building rests is grey concrete and that nobody notices until it gets a crack or crumbles. When the foundation — or clerical underpinnings of an organization — fail, that’s what or who gets the blame. In office work, a good manager makes sure that the clerical staff have adequate training and instructions of how to do the job. But too often managers are not good teachers. In fact, the American Management Association at the time I was working promoted a course for managers called something like “The Art of Intimidation.” Yes! Believe it! I used to get their brochures in the mail! The brochures touted the many companies that had sent their management teams to this course. You would recognize the names of all of them, because you see their stores almost every day!
I’ve wondered about that too. Certainly irritability and anger commonly present in people with mood disorders (irritability is usually the first thing I notice if I’m decompensating). Most clinicians do associate irritability and anger with depression particularly, and several screening tools check for it explicitly.
While it doesn’t have an answer about why its not included as an explicit symptom, I found this review article on anger and depression which shares a number of interesting current and historical perspectives: http://apt.rcpsych.org/content/15/4/271