Bipolar Disorder and Aggression

This video answers the question: What is the relationship between bipolar disorder and aggression? To understand bipolar disorder, it’s first important understand that there are two types of bipolar disorder: Bipolar I and Bipolar II. Sometimes it can be difficult to differentiate between Bipolar I Disorder and Bipolar II Disorder and that's mostly because of the way that mania presents. Mania is the primary difference between these two disorders. A diagnosis of Bipolar I Disorder requires that at some point there was a manic episode. Technically speaking, depression is not required for Bipolar I Disorder, but oftentimes we see major depressive episodes. Bipolar II Disorder has at least one hypomanic episode and at least one major depressive episode. You could think of major depressive disorder as unipolar depression and, of course, Bipolar Disorder has two poles. Sometimes we hear that Bipolar II Disorder is really a less severe variant of Bipolar I Disorder, but the evidence really doesn't support that theory. Both types of bipolar disorder are serious disorders that necessitate treatment.
In the research literature, Bipolar Disorder has been linked to aggression. If we look specifically at individuals with Bipolar Disorder who are inpatient (who are hospitalized), we see that they tend to demonstrate significantly more aggressive behavior than individuals that do not have Bipolar Disorder. We also see that in inpatient settings, physical assault is equally prevalent among Bipolar Disorder, Schizophrenia, and Substance Use Disorders. This link between aggression and Bipolar Disorder is established and it is a real problem in terms of treating the disorder and keeping clients safe. Violence is a separate construct than aggression, although there is some overlap. Violence that has been associated with Bipolar Disorder is actually largely explained by comorbid Substance Use Disorders. The substance use component of that comorbid presentation is really what accounts for the violent component. Sometimes we hear this myth that individuals with Bipolar Disorder are more prone to violence and that's not really the case. This link between Bipolar Disorder and aggression does not mean that individuals with Bipolar Disorder have a tendency to engage in more severe violent behaviors.

Ballester, J., Goldstein, B., Goldstein, T. R., Yu, H., Axelson, D., Monk, K., … Birmaher, B. (2014). Prospective longitudinal course of aggression among adults with bipolar disorder. Bipolar Disorders, 16(3), 262–269. https://doi-org.mylibrary.wilmu.edu/10.1111/bdi.12168

Видео Bipolar Disorder and Aggression канала Dr. Todd Grande