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 Marcia Purse

Risk Factors for Violence in Bipolar Disorder

By , About.com GuideFebruary 27, 2011

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Writing in Psychiatric Times, Drs. Allison Lee and Igor Galynker took a look at some of the risk factors for violence in people who have bipolar disorder, with special emphasis on childhood trauma. They noted that childhood trauma itself is linked to increased potential for violence in itself - as well as increased vulnerability to mood and personality disorders.

Since bipolar disorder alone does carry some increased risk for violent behavior, a history of trauma in childhood in a person with bipolar disorder thus raises that risk considerably, especially when 2 or more types of trauma are involved, the doctors said. Trauma history in BP is also associated with "earlier onset of bipolar disorder, faster cycling, and increased rates of suicide." They also quoted the shockingly sad figure that almost 50% of adults with bipolar disorder have a history of childhood trauma, with a high rate of emotional abuse.

Other factors the doctors identified as increasing the potential for violence include:

  • The bipolar person also has borderline personality disorder.
  • The person has a history of impulsive acts - especially acts of aggression (not necessarily violent).
  • Substance abuse. Self-medicating with drugs and/or alcohol is an all-too-common problem in those who have BP, and is known to promote aggressive to violent behavior.
An article in Duke Health News mentions an additional factor: living in an area where violence is prevalent.

Finally, there is another sobering statistic reported in Psychiatric News: more than a quarter of persons with severe mental illnesses are crime victims each year - a rate 11 times greater than the general population.

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Comments
February 28, 2011 at 5:41 pm
(1) Peter says:

I believe that bipolar individuals have the same issue that typical people have Substance abuse. Self-medicating with drugs and/or alcohol is an all-too-common problem in those who have BP, as well as those that have other illnesses or the every day person are known to promote aggressive to violent behavior.
If the study is looking for violence in those with bipolar they will find it. If you look at bipolar individuals to the risk factor for violence you may get a different answer. You see what you want to see & you hear what you want to hear.
Good section on people with mental illness more often crime victims was a good wake up. Many people do not realize how bipolar sufferers are taken advantage of or are victims of violence. Keep up the writing, opinions are what keeps the world turning.
A bipolar personality

March 1, 2011 at 5:20 am
(2) Chris M says:

There has been evidence of violent episodes with persons who have Bi polar who have experienced childhood traumas, as one who has Bi Polar 1 but is quite stable now and well managed. I now support persons with mental health challenges, reach the same goal along their journey,I have witnessed these episodes of violence personally, and I also had some episodes myself when I was unstable in my mental health, so this does not come as new news , but is relevant so people’s awareness of the challenges people who have mental illness go through and the effect of abuse/trauma in childhood/the part it plays in adult life.

March 1, 2011 at 9:14 am
(3) Anniem says:

One of my first pdocs told me that if I hadn’t been abused as a child, chances are that I may have been known as a colorful character and that’s about it. The statistic you gave about how many of us were abused sadly did not surprise me. As far as me being the one who was violent, I know there were times I threw things. I don’t remember though, as I was extremely unstable at the time. My husband has told me, that’s the only reason I know about it. Wonderful piece, would like to see more on the subject.

March 1, 2011 at 11:03 am
(4) Joe Kraynak says:

As Peter suggests, it’s not bipolar disorder that increases the risk of violence. It’s the substance abuse and perhaps, as discussed in this article, other factors including childhood trauma. (See the article “Mental illness alone not linked to violence.”)

What’s really going on is that the risk of substance abuse is higher for those with bipolar: 20 percent vs 2 percent for the general population according to one estimate. I expect this is more prevalent among those who don’t have access or can’t afford health care or prescription medications, so they try to self-medicate.

This may seem like a minor distinction — whether the bipolar increases the risk of violence or bipolar increases the risk of substance abuse which increases the risk of violence — but I think it is an important one to make. The bipolar label carries enough stigma. We don’t need to add to it by suggesting that “bipolar disorder alone does carry some increased risk for violent behavior,” when at least one study shows otherwise.

March 1, 2011 at 12:00 pm
(5) Juan says:

Hi all, what I have experienced is that I tend to become more irritable and lash out when I’m manic. I was like that a while back and someone who know me well brought it to my attention. I discussed it with my pdoc who adjusted my meds. I am fine now. My conclusion is that yes, people with bp does have a tendency to become more violent.

March 1, 2011 at 6:14 pm
(6) Winston says:

From ww
I have been seeing pdocs for about twenty years I had severe childhood traumas since I was three. From my father and people who looked over me such as teachers and camp counselors. Starting around 5 years of age, I was threatened by my father who said he will beat me to death. He would best me until I couldn’t move.
In my adolecence I had head traumas that knocked mr unconscious. after college in 1998. I couldn’t work more than a year because of my anger. I have severe road rage and came close to death when an armored car driver threatened mom and I with a gun because I gave him the finger. I’m also worried that ihave sociopathic tendenncies.
I believe the head traumas I sustained made me bipolar 1
I’m 40 and once in a while dad would threaten me again. When my pdoc wanted to meet the family, my father refused to come. Because he threatened to beat the pdoc to death. He also pulled the belt on him. I refuse to marry and have children because I know I will pass it on. For some reason o hate the neighbors. I would get paranoid when they confronted me
I recently lost my temper in class and the teacher quit. Must be making a big stink here
I never done illegal drugs and I would drink alcohol one bottle per year. Also caffine would set me off. Sugar carbs and chocolate are my drugs plus Seroquel, klonopin and meds for tourettes. My only outlet is playing the piano or drums at restaurants.

March 4, 2011 at 7:21 pm
(7) robbi says:

I was abused at a young age and I am violent and aggressive. I don’t mean I hit people or anything like that but I yell and scream. I throw things. I have a lot of anger because of my abuse and I guess because of my bipolar too. I believe that people with bipolar can very well be violent. I also believe that when there is abuse or trauma it makes it more so, because you have other issues to deal with.

March 17, 2011 at 11:39 am
(8) Allison M. R. Lee, M.D. says:

It’s very interesting to read all the different comments here – I’m glad the article is stimulating discussion of this important issue. In my experience, one thing that can be difficult for individuals with bipolar disorder is that uncharacteristic aggressive behavior while manic can put an enormous strain on relationships. At the Family Center for Bipolar Disorder we work with families to manage the challenges that come with living with Bipolar Disorder, including the “fallout” that can come after a manic episode. You can visit us online at http://www.bpfamily.org/.

March 28, 2011 at 9:03 pm
(9) momofpolar says:

My son suffers from bi-polar disorder terribly, which I link to the fact that he is type one diabetic. Perhaps diabetes is the contributing childhood trauma, however, I get very frustrated when I read or hear people say that if someone has any kind of problem that it must be because he or she had a horrible childhood. There are many, many, many people who suffer with bipolar and other terrible mental illnesses or personality afflictions that were raised in loving, stable, caring environments. There was never any smoking drinking or drugs in our home. My children were never abused, were always fed and always had a warm, safe roof over their heads. They were active in church and had rules to live by. Although I may never be at peace with my son’s illness nor the violence and anger he unleashes on us sometimes without warning, I have made my peace with the fact that I did everything I could to give him every advantage. Having a family member that is not only bipolar, but violent and angry, often suicidal and unpredictable is very frightening and stressful, so please for once stop blaming everyone else or assuming that they were traumatized or had/have a horrible life. That is not always true! Sometimes it is simply just the cards they were dealt and there is no rhyme or reason to it.

August 8, 2011 at 9:02 am
(10) Gill Clarke says:

Hi, I would like to say I agree with you totaly on what you say about a childs background, I have twin sons and one has bipolar, he won’t take his med’s and is turning into a horrible person who I know longer like, but I still love and care for him too,he had a spell of 8 weeks in a unit to diagnose this bipolar about 3 years ago, although my son has been like this for most of his life, when he came out of this mental unit they found him a flat and at first everything was good for around a year ( he still had episodes ) but nothing of which was to come, he has become very abusive and violent and although he no longer live with us he turns up drunk in the early hours of the night causing trouble with his twin who still live’s at home with us. I am at my wits end and don’t know what to do, we have have rang the police quite a few times just to take him home.

April 12, 2011 at 9:03 pm
(11) Winston says:

Hi,
Things been kinda rough here. I ‘ve been rather impulsive recently especially with buying things. If i go to the mall with my mom or dad, I would have to buy clothes or shoes or iPod accessories.
The trigger occurred a year ago when my father started buying things for me, like a 50 in tv, a new laptop, 10 years ago he bought me a big truck. I told him that I don’t need these things. That was the same way as a child, he was distant an unpredictable, but the y he showed his love was buying buying my brother and me things. When i turned 17 i told him I need a job but he said you don’t need to.
Anyway m brother and i have impulse issues. Especially when shopping. I’m a musician and play in restaurants, living at home. Within the last 6 months I spent 6000.00 from music stores because I’m a drummer and i create music on the piano.
I recently was prescribed lithium from my pdoc but this still hasn’t worked i take 300 mg 2x a day.
Now my mm and i are gong to Alaska And I’m afraid to fly or sit on a bus. My father also has the same issues, he can’t sit on. Plane , one time in Taipei, my dad had to go to the ER before we coud get off the plane. He was diagnosed with PTSD, i personally think he has bipolar disorder. I also have blackouts or lapses in memory. Today i was playing music for 30 minutes but my folks said i was playing for 5 hours!My mom and her relatives have better ways of dealing with stress, they were never hit.
Last month i was getting my a+ certification and It professional certification through occupational rehab, I was up three days at a time studying. I stopped meds cold turkey around this time, but had a breakdown and got the flu.
The only thing that helps my bipolar disorder is playing the piano especially Bach, the drums and will ackemans songs on the guitar.
Sorry for the misspellinggs. My ipAd is dying.
Winston
It’s unfortunate that orporal punishment is one of the main ways of discipline.
Sorry for the visual racing mind on this message.

July 12, 2011 at 5:34 pm
(12) Susan says:

It brought me to tears to read about the statistics of violence and BP disorder. I was brought up in an emotionally and physically abusive home,also sexually abused by my father and a priest. I just came home from 6 weeks of hospitalization fighting rapid cycling for years and I would always tell the staff when they would inquire if I were suicidal, “no, never I am always homicidal”.I received ECT for years and have had my medications changed again and ECT started again after taking a break for 5 years because monthly treatments were traumatizing at the institution I was receiving them at. This new facility is wonderful and I am hopeful. I have always wanted to help people I am am RN and this is my last ditch to stay in this field without having to take courses or classes again.

July 22, 2011 at 4:41 pm
(13) Rhonda says:

My husband is just now seeking treatment for his BPD after being diagnosed serveral years ago. For many years now I have been trying to manage his condition myself with basically baby sitting every moment of his life making sure something doesn’t happen. He has cheated on me been physically abusive and his quit several good jobs out of the blue just because he was in a bad mood, run us into dept and spends all his money on vicodin while I pay all the bills. I am now at the point that I don’t trust him at all, afraid of him, and just plain depressed. What I want to know is the medication really going to change him back? He thinks he just needs meds and not consoling in addtion (doesn’t believe in it)but he will go to make me happy. I just want him to be the guy he used to be…. we have been together since we were 14 and 15 years old and now we are 35 and 36 with 2 kids.I’m really just afraid that this is how my life is going to be forever. I could really use some advice. Thanks, Rhonda

April 16, 2012 at 2:34 am
(14) dave says:

I have bipolar 1 and in over the years I was the victim of dozens of crimes by family, friends, and complete strangers again and again. The police, doctors, and any other authority never believed me and never would defend me because they say because I’m mental I can’t be believed. Sometimes they would arrest or detain me and then abuse me telling me I was powerless. I feel so awkward now and won’t let anyone into my life anymore. Life is hopeless now but I’m a survivor and have to continue on somehow. People with mental illness have to be very careful with who and why they do what they door they get kicked around like dogs,sorry to say

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