On TV and in the media, people with bipolar disorder are often depicted as dangerous. Here’s what science says about violence and bipolar disorder.

Stigma around mental health conditions still persists, especially when it comes to the concept of violence.

In fact, a U.S. survey shows that up to 75% of the general population thinks that people with mental illness are violent.

The truth is that although there’s a link between bipolar disorder and an increased risk for aggression, the vast majority of people with bipolar disorder are not dangerous. In fact, people with mental health conditions are more likely to be the victims of other people’s violent actions.

The vast majority of people with severe mental health conditions, such as bipolar disorder, are not violent. However, there’s a moderate link between violence and bipolar disorder.

Still, the association is complex and isn’t necessarily a direct link.

Research from 2015 and 2018 suggests that when people with bipolar disorder do engage in violence, there are often other factors at play besides the illness itself, such as substance use, a recent suicide attempt, or a learning disability.

Overall, aggressive behavior is more likely to occur during manic, mixed mood, or psychotic states.

One study in people with bipolar disorder suggests that people with current psychosis had significantly higher total aggression scores, hostility, and anger than those without current psychosis.

Another 12-month inpatient study found that of 151 people with bipolar I disorder, a total of 11.92% (18 participants) experienced any form of aggression — this included verbal aggression or aggression against self, objects, or others.

Most of the aggression was verbal (9.27% or 14 participants). Only 1.32% (2 in 151 people) acted in a physically aggressive way toward others.

Most of the aggression took place during the active stages of bipolar disorder. Only 2.64% of the participants displayed signs of aggression during euthymia (a “normal” or tranquil mood — neither manic or depressed). This number is close to that of the general population.

Personality disorders and alcohol use were the primary risk factors for irritability in people with bipolar disorder. Drug use was linked to both irritability and aggressive behaviors directed toward others or objects.

Participants who regularly had mental health treatment visits showed significantly less aggressive behaviors than those who had treatment visits less frequently.

Overall, the study findings show that a large majority of people with symptoms of agitation or irritability don’t take any violent action. The few aggressive episodes were primarily carried out during the active phases of bipolar disorder and were mostly linked to alcohol or drug use.

The researchers believe their findings can be helpful in reducing the stigma of having a mental health diagnosis.

Childhood trauma is a contributing factor for symptoms of aggression in people with bipolar disorder. However, the association is complex and involves several factors.

Overall, childhood trauma is reported at a much higher rate among people with bipolar disorder, compared with the general population.

In particular, aggression in bipolar disorder is significantly linked to:

Research also suggests that childhood trauma is linked to more severe symptoms in bipolar disorder, including:

  • earlier age of onset
  • an increased risk for at least one suicide attempt
  • rapid cycling
  • more mood episodes
  • a higher occurrence of substance use

Talk therapy (aka psychotherapy) is a good way to learn how to manage difficult emotions, including anger and irritability.

One of the most popular forms of psychotherapy is cognitive behavioral therapy (CBT). This type of therapy targets negative or distorted thought processes. It also helps you recognize how your emotions and thoughts influence your actions.

Research in 2017 suggests that CBT can lower the risk of relapse in bipolar disorder and improve depressive symptoms, mania severity, and social functioning.

You may also want to consider dialectic behavioral therapy (DBT). This type of therapy gives people the skills to manage difficult emotions and better handle relationship conflicts.

A pilot study in 2013 found that DBT improved emotional control, increased mindful awareness, and reduced depressive symptoms in adults with bipolar disorder.

Likely influenced by TV shows, movies, and the media, many people believe that people with bipolar disorder are dangerous. Yet, statistics and research indicate that the vast majority of people with this condition aren’t violent.

Some people with the condition may show more signs of aggression, but various factors often play a role in this, like alcohol or substance use.

Plus, oftentimes these people direct anger and aggression toward themselves or objects rather than other people.

If you or a loved one has difficulties with anger or aggression in bipolar disorder, you can reach out for professional help. Many types of therapy and anger management classes can help you manage difficult emotions.

Also consider joining an online or local support group for people with bipolar disorder or their families. The following sites may be a good starting point: