Behavioral dysregulation may be commonly found in patients with major affective disorders. Patients with increased impulsivity may be considered at higher suicide risk, poor psychosocial adjustment, aggression and legal problems as well as impairments in daily life activities when compared with those with lower impulsivity. Impulsivity and aggression represent fundamental issues that should be systematically assessed and correctly managed when dealing with patients with mood disorders. Although multiple theories have been proposed, the neurobiological determinants underlying the emergence of impulsivity/aggressiveness in mood disorders patients is still poorly understood. Conversely, psychological assumptions may significantly help clinicians to correctly manage patients with mood disorders. Specific behavioral strategies may be used to manage the emergence of impulsivity/aggression in mood disorders patients either in the short- and long-term period. In particular, patients should be seriously engaged in a therapeutic alliance and several psychoterapeutic approaches have been successfully used in order to reduce the potential of impulsivity/aggression.