Anger is one of the hardest emotions to express in therapy. When I say to a client, “It sounds like you are pretty angry with so-and-so”, they often deny it. Then the next session they come in and tell me about how they expressed anger to this person face-to-face. I would sometimes rather be angry than feel jealousy, grief, embarrassment, or regret. How about you?

In therapy, I treat individual anger by helping to “clean up” the emotions surrounding it. We first deal with the “meta emotion” – essentially the feeling about the feeling. How do you feel about being angry?

When feeling anger, people also often feel:

• stressed out or confused
• mad at themselves, guilty
• embarrassed

As with most negative emotions, a little of it is not a problem, especially if you are using anger productively.

How can you do that?

1. Anger is first felt physically. If you have issues controlling your anger, pay attention to your body and notice how it “buzzes” to attention and becomes angry before your mind does.
2. Once you notice the physical symptoms, you learn to train your body to calm down so that rational thought can proceed. The research shows marked cognitive decline when you pulse rises above 100 due to agitation. So remind yourself that you can’t think properly until you calm yourself down.
3. Train yourself to be calm by focusing on your breath, or using a mantra to talk yourself down. A reassuring sentence like “I will be understood” or “I am in control of myself” can help, but make it personal to you.
4. Seek support from those close to you for help monitoring anger. Ask them to tell you when they perceive you to be angry, and help you communicate your feelings so that you can be understood without escalating tension.
5. Work to understand some of your trigger feelings about anger, and learn how to manage those. Some people might always make you angry. Can you develop a different belief about them to avoid inflaming your anger? Can you avoid activities that escalate your anger (perhaps golf or traffic?) until you understand yourself better?

If someone has told you that they think you have a problem with anger, do yourself a favor and get help. Anger leads to physical health problems and is very treatable.

We think of someone as being “bipolar” in quite casually these days; usually we’re describing someone who is moody. Be careful with that label: true bipolar symptoms are like no moodiness you’ve ever seen. Bipolar Disorder is actually two separate disorders:

Bipolar I (classic): one or more manic or mixed episodes of mood; sometimes includes depressive episodes.
Bipolar 2 (rapid cycling): at least one hypo-manic episode and one major depressive episode. Depressive episodes are usually more frequent and intense.

Bipolar I, which is classic bipolar and a more serious diagnosis is more characterized by its manic episodes and does not even always include depressive episodes. A true manic episode has three of the following:

1. Inflated self-esteem or grandiosity
2. Decreased need for sleep (feels rested after only 3 hours of sleep)
3. More talkative than usual or pressure to keep talking
4. Flight of ideas or experience that thoughts are racing
5. Distractibility (attention too easily drawn to unimportant or irrelevant external stimuli)
6. Increase in goal-directed activity (at work, at school, or sexually)
7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

While rapid-cycling bipolar (Bipolar 2)’s hypo-manic episodes can look simply like a high-functioning person, the depression in this disorder is what usually brings a client in for treatment.

How It’s Treated: Classic bipolar in treatment has some experimentation at first followed by hopefully a steep rise in improvement. Bipolar disorder is one of those diagnoses that therapists very grateful for the medication options available. Clients almost always require medication. There’s usually a mood stabilizer, as well as two other medications to help frame the high and low. When properly medicated, a person with Bipolar disorder feels relief and usually sees their medication as an important part of treatment.

Therapy is essential to help control behavior that results from bipolar disorder. A trusted therapist is crucial to maintaining a stable level of functioning. A client must also have his medication monitored regularly.