Here, we present a review on aggression in bipolar disorder, based on questionnaire-assessed violence, violent crimes, and suicide. Additionally, the anti-aggressive effects of lithium used in medical drug formulations, and in drinking water were discussed. Clinical genetics and pathophysiology of aggression were explained and therapeutic coping were also proposed. Usually, symptoms of bipolar disorder are investigated in the purview of mood, activity, and thought. Apparently, there has been minimal investigation on aggression associated with bipolar disorder. Aggression in bipolar disorder is often directed towards others (violent crime in its serious from) and against oneself (suicide in its worst form). These are serious problems that cannot be overlooked. Although aggression in bipolar disorder and in schizophrenia is commonly attributed to the accompanying substance abuse, aggression in bipolar disorder, but not schizophrenia, has been revealed to be at least partially derived from the expression of a specific gene exclusively associated with bipolar disorder. This is important because the findings suggest that aggression may be attributed to bipolar disorder itself, and lithium may be an effective treatment for aggression as well as bipolar disorder. In any case, it is important to treat bipolar disorder with considerable attention to aggression.
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