Some bipolar mood episodes can make us behave in ways that are “mean and nasty.” They aren’t fun—for anybody—but the good news is we can learn to recognize and prevent them before our relationships suffer.
Many people believe that bipolar disorder comes with only sad depression or euphoric mania. In reality, this is just 50% of bipolar disorder. The other side of bipolar includes symptoms of irritation, anger, restlessness, and a mean and nasty mood. This mood swing can be from either agitated depression, or an episode with mixed features, which I call dysphoric mania.
Typical Symptoms of “Mean and Nasty” Bipolar Episodes
Anger at specific people whom you believe have done you wrong.
Anger at businesses or governments who are not doing what you believe they should do.
Physical anger—your arms and legs want to punch and kick whatever is around you.
Talking more forcefully and sometimes more loudly than normal.
A marked increase in cussing and language you would not normally use in a normal conversation.
Blaming everyone, except yourself, for how you feel. (There’s a real lack of insight in this mood swing.)
Unable to see the positive; and when others point it out, these people seem stupid and unaware—and you let them know it!
Extremely opinionated and aggressive with your opinions.
Fully entrenched in confirmation bias. You will look for articles and information that match your unhappiness and prove your opinions.
Is It Agitated Depression or Dysphoric (“Mixed”) Mania?
Judging from my own experiences with these episodes, as well as with my clients, it’s not difficult to tell the difference between agitated depression and “mixed” episodes, which I call dysphoric mania.
Dysphoric mania comes with very obvious manic changes in energy: The person will sleep less and not be tired. You will see changes in spending, sexuality, volume and speed of talking; an inability to let others have opinions; aggression, and/or risk-taking behaviors.
If it’s agitated depression, the person will still sleep or will be very tired if sleep is disrupted. Agitated depression isn’t as physically energized as dysphoric mania. It doesn’t have an increase in spending or sexuality, and the person will not be as physically aggressive as a person who is in a mixed state.
Another way to tell the difference is to look at the intensity of the symptoms. The symptoms themselves will be the same in each type of mood swing, but the intensity of the behavior will be much stronger in dysphoric mania than in agitated depression.
How to Help Yourself When You Have a “Mean and Nasty” Episode
Write down what you think, say, and do during one of these episodes (or have a close friend and/or family member help you, if you are dealing with lack of insight). Documenting what you think, say, and do can help you determine if it’s agitated depression or dysphoric mania. You can also use this list in the future to prevent the mood swing from going too far. I call this being a bipolar detective.
Here is an example of my think, says, does list from my last agitated depression:
What I said to others and wrote in my journal:
The government where I live is so f—ing stupid. They are incompetent and I HATE them. They should all be fired! They lied to the press and caused enormous distress for all of us!
I can’t believe how dumb everyone is! People are sheep and they are stupid! They are blind and I can’t figure out how they can be so dumb!
This life is too hard. It’s ridiculous that my life is so hard. I can’t find peace anywhere.
I called friends and complained heavily about my life and the world.
I couldn’t find a comfortable place to sit! Nothing felt right. Chairs were uncomfortable, and nothing was calming.
Sleep was difficult. I wanted to sleep and I slept, but I woke up throughout the night and got up too early. I felt tired and stressed. (This is often called “wired and tired.”)
I felt anger boiling in me, and I needed to release it somehow! I was mad at everyone!
Sounds were too loud and people were really upsetting me with their loud talking and chewing and being stupid!
I had trouble seeing the other side of a situation because I was right! People are blind and can’t see what I can see! They are making excusing for stupid people! I wanted to tell my friends they are just sheep and are being lied to!
I do NOT think like this at all when I’m stable. I’m not a mean or unkind person. This is a downswing. (My behaviors are exactly the same during dysphoric mania, but my energy levels are through the roof. I am much, much more aggressive during mania, including my driving behaviors.)
How I Ended the Agitated Depression
Writing my thoughts and behaviors down in my journal really helped me recognize that I was sick and I needed to help myself so that I wouldn’t ruin any relationships:
I stopped talking about politics and world events.
I tried to be nice to myself and remind myself that I have bipolar and this is simply a symptom. What matters is that I caught it—and that is a positive.
When the world feels out of control, it’s natural that bipolar disorder would be affected. Sometimes this can lead to what we consider typical depression symptoms, such as sadness or lack of energy, but it can also lead to an irritated, nasty downswing called agitated depression, or a manic episode called “mixed” or dysphoric mania.
People with bipolar disorder get mean and nasty during agitated downswings or dysphoric manias because this is a symptom of bipolar disorder.
It’s not okay, and it doesn’t mean that we get to go around yelling and abusing people. But it’s important to know we’re not doing this on purpose.
I had this recent downswing because of having surgery. The stress and the anesthesia affected my mood. This is normal. I had a plan in place and caught the episode within 24 hours.
If you’re a loved one who wants help to communicate with someone in a “mean and nasty” mood swing, please read more about my Bipolar Conversation technique. It works!
We can teach ourselves to recognize, stop, and hopefully prevent “mean and nasty” mood swings!
Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get It Done When You’re Depressed, and The Health Cards Treatment System for Bipolar Disorder. She is a columnist and blogger for bp Magazine, and she won the Mental Health America journalism award for the best mental health column in the US. Julie was also the recipient of the Eli Lilly Reintegration Achievement Award for her work in bipolar disorder advocacy. Julie is a bipolar disorder expert for ShareCare, a site created by Dr. Oz and Oprah. Julie is CEU certified and regularly trains health care professionals, including psychiatric residents, social workers, therapists, and general practitioners, on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People magazine. She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called "Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis, and Depression." You can find more about her work at JulieFast.com and BipolarHappens.com.
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