Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary
- Depression manifests differently for each individual and can include symptoms beyond sadness, such as irritability, agitation, and anger. These emotions can be misunderstood or overlooked in the context of depression, yet they significantly impact daily life and relationships.
- Understanding the relationship between depression and anger is crucial. Anger can be both a symptom of depression and a contributor to its severity. It can manifest outwardly, leading to outbursts or conflict, or inwardly, causing self-criticism and negative self-talk.
- Clinical studies highlight that nearly half of individuals with depression experience “agitated depression,” characterized by irritability, anxiety, and anger, alongside low mood. This combination can make managing depression more challenging and underscores the importance of addressing both emotional states.
- Managing anger and depression involves several approaches. First, addressing the underlying depressive disorder through therapy and medication is crucial. Therapy helps individuals explore and express their emotions in healthier ways, reducing the intensity of anger and improving emotional regulation.
- Recognizing triggers for anger, whether external situations or internal thoughts, is essential for managing emotional responses effectively. Techniques like journaling and mindfulness can help individuals identify triggers and develop coping strategies to mitigate anger episodes.
- Communicating openly about feelings with trusted individuals or a therapist can reduce feelings of shame and isolation associated with anger and depression. It encourages constructive dialogue and helps individuals develop healthier ways to express and manage their emotions.
- Ultimately, acknowledging and validating emotions, including anger, is essential in the treatment of depression. Seeking professional help ensures that individuals receive tailored support to manage both their emotional well-being and the symptoms of depression effectively.
The symptoms of depression can include irritability, agitation, and anger.
Most people associate depression with sadness, but not everyone experiences it that way. Sometimes the frustration of having depression builds up and comes out as anger or irritation. On the flip side, sometimes anger can get turned inward, exacerbating the symptoms of depression. Understanding how depression and anger relate to each other can help you manage both experiences.
Signs and symptoms
Depression is a mental illness characterized by changes in mood, usually lowering the mood. Affecting over 264 million people globally, it’s one of the most common psychiatric conditions in the world.
Some common signs and symptoms include these:
- Feelings of sadness, worthlessness, and hopelessness
- Changes in appetite or weight
- Insomnia
- Low self-esteem
- Fatigue, loss of motivation, or both
While these are common symptoms, depression can come in many forms that don’t always match our expectations. One example is the physical impact depression has on your body.
What depression looks like
When you think of depression, the classic symptoms we just mentioned may come to mind. Perhaps you imagine someone who’s sad and having a hard time getting out of bed. Or maybe you envision someone numb and disconnected from emotions.
But, most of us forget that depression can also present with symptoms like anger and irritability. Someone with depression may slam doors or yell at loved ones. Some people take out their anger inside—with manifestations like negative self-talk and an internal dialogue characterized by self-loathing.
When it comes to clinical depression, people often overlook the role of anger or think of it as a separate issue altogether. If you’re experiencing depression and anger, understanding their interplay can help you manage both more effectively.
What anger looks like
Everyone has their own ways of expressing anger. While one person might direct anger outward in a physical way, another may avoid confrontation entirely, turning the anger inward. Maybe you’re someone who gets over a conflict quickly, or you might be more likely to ruminate and hold a grudge.
The way you express anger not only impacts the relationships you have with the people in your life—but can affect your relationship with anger itself.
If you’re prone to outbursts, for example, you may feel so much shame afterward that you become afraid of expressing anger in the future. Ironically, this can lead to a “bottling up” effect that actually predisposes you to lose control again.
Conversely, if you feel guilty about your anger to begin with, you might look for ways you’re at fault, turning anger into self-criticism and redirecting it towards yourself.
Crossover symptoms
In psychiatry, irritability is recognized as a symptom of depression. In this context, agitation and irritability could mean you snap at family and friends, are in a bad mood, or have a hard time controlling your temper.
The research focused on the interplay of depression and anger shows that nearly half of the people with depression experience something often referred to as “agitated depression.” People with agitated depression experience symptoms such as irritability, anxiety, and anger, in addition to experiencing a low mood.
Sometimes people with agitated depression describe these feelings as “being on edge” or feeling restless. When anxiety and depression present simultaneously, the issue can become more complicated. Finally, researchers found that depressed anger is associated with severe depressive symptoms, suggesting that depression may actually contribute to anger problems.
Depression presenting as anger
Not knowing that you’re dealing with depression can make the sudden presence of anger problems all the more confusing and frustrating. Maybe you don’t understand that anger can be the dominant emotion in depression, especially for teenagers and children. In that case, it may never occur to you that depression could be the underlying issue.
As we mentioned already, you might direct anger from depression outwardly, for instance, at situations, other people, or inwardly, towards yourself.
Anger turned outward
Outward anger can take the form of lashing out at loved ones, breaking things, or raising your voice. You may have days when you’re just feeling mad at the world and cannot point to a cause. Even losing your temper in relatively minor ways can cause intense feelings of guilt and fear of rejection.
Without understanding the link between depression and anger, it’s easy to mistake anger as a fault or personal failure. Rather than some kind of moral issue, these feelings may be a symptom of a deeper issue.
If the way you express your anger causes guilt and shame, you may also direct some of that anger at yourself. Perhaps it seems as though anger turned inward will help protect others from being harmed by your outbursts. But this well-intentioned plan can often create more consequences.
Anger turned inward
Far from being constructive, inwardly-directed anger can manifest as harsh and relentless self-criticism. People living with inward anger often acknowledge that if they talked to anyone else how they speak to themselves, they’d consider it abuse.
Sometimes anger directed towards others can fuel self-loathing. This can be incredibly challenging if you’re angry and don’t feel like your anger is justified or understand why it’s arising.
For many people, anger is rooted in low self-esteem, stemming from the long-time habit of self-blame. If, deep down, you constantly believe that you’re in the wrong, you may have trouble managing conflict and asserting your needs.
And, when all of your unmet needs finally become too much, you may find yourself resorting to passive-aggression to avoid full-blown confrontations.
All of these are well-intentioned attempts to protect yourself and others. Yet, without clear communication and healthy boundaries, these types of interpersonal dynamics rarely get resolved and, over time, they can become increasingly unhealthy for everyone involved. You can also learn more about how to handle dating someone with depression.
In addition to the way anger might negatively affect your relationships with other people, it can also trap you in a cycle of self-blame, self-criticism, and self-loathing.
Managing anger and depression
If your anger stems from an underlying depressive disorder, addressing the depression first may be the most efficient solution for reducing anger problems. Typically, depression is treated with a combination of talk therapy and medication. But, you should always work with a healthcare professional to figure out what treatment options would be best suited for your needs.
Talk to someone about your feelings
If you have a challenging time expressing your emotions, working with a therapist can be helpful. Therapists provide a safe practice space to learn to express your feelings in healthy and adaptive ways. As you get more comfortable opening up, your therapist will empower you with tools to maintain that level of communication with other people in your life.
You may even find that discussing your anger openly helps reduce feelings of shame and guilt. If there are unhealthy aspects of your anger, getting them out in the open makes it easier to find skillful ways to deal with them. In short, talking about your emotions can help you see that they’re a natural and healthy part of being human.
Recognize triggers
While it’s true that irritability can come out of nowhere, there’s usually a reason for it. Keeping a journal can help you answer the question many people experiencing depression have: “Why am I so angry?”
When you consciously look for triggers, you might find that spending time with certain people puts you in a bad mood or that particular problems at work set you off.
Journals are valuable tools not only for the objectivity they provide but for the habits they build. Writing about your emotions, what triggers them, and how they affect you can help you notice them in real-time. Taking a step back to look at your state of mind without trying to change it is commonly known as mindfulness—a mental technique for gaining emotional control.
Here’s the good news: you don’t need to journal to practice this kind of self-awareness. You can practice mindfulness anywhere at any time. Try breathing exercises, taking breaks, or anything else that helps you slow down and notice how your feelings and thoughts can work. There are no wrong answers.
Take care of yourself
You can make significant improvements with mindfulness, medications, and therapy, but don’t overlook the importance of sleep. Getting good sleep is easier said than done, especially since depression is associated with insomnia. But if you’re experiencing insomnia, practicing sleep hygiene can help.
Ensuring you have an environment conducive to sleep is a good place to start. Limiting caffeine and alcohol, developing a regular sleep schedule, and exercising can also help. If you think you would benefit from a non-habit-forming sleep medication, Lemonaid’s medical team can help.
Talk to a healthcare professional today to see if non-addictive insomnia meds would be a good fit for you.
Make time for what you enjoy
By consciously dedicating blocks of time to yourself, you’re increasing what’s known as “high-quality leisure.” High-quality leisure is recreation time that’s meaningful and therapeutic, instead of activities we use to procrastinate but don’t often enjoy.
The most common example of low-quality leisure is scrolling through the news or social media feeds because the behavior has become a habit. In fact, there is a correlation between social media and mental health issues like depression and anxiety.
Low-quality leisure often fills up much more of our day than we intend, displacing time you could spend on something genuinely enriching. Whether it’s going out with friends or working on an interesting project, try to make time for activities that bring you joy and fulfillment.
Express the feelings in a healthy way
Whether your anger is directed inward or outward, identifying its source can help you learn how best to cope with it. This may mean treating any underlying depression, learning how to set boundaries with others, or shifting the negative internal dialogue.
While addressing agitated depression at its roots is necessary for managing it in the long term, it can also be helpful to find ways of coping with anger problems as they arise.
Exercise
Working out can improve self-esteem, reduce anxiety, and release feel-good chemicals in your brain. There are endless ways of exercising, and in the context of enhancing mental health, the only thing that matters is that you enjoy it enough to keep doing it.
Mindfulness
Pay attention to your thoughts, but don’t try to change or judge them- simply observe them. Mentally note that you’re upset, and reframe negative thoughts. This can help shift the way you look at your thoughts. Rather than factual statements, you’ll start to see that thoughts are just momentary appraisals of right now, subject to change just like everything else.
Distraction
This technique isn’t a substitution for getting at the underlying cause of depressed anger, but getting your mind off things that upset you can be a very practical skill. When you notice anger escalating, remove yourself from the triggering situation and focus on something else. Music, television, talking with someone, or going for a walk are all great options.
Outlook
When you learn how to communicate about and cope with your anger, you can help yourself avoid destructive behaviors, like losing your temper, suppressing your emotions, or engaging in negative self-talk.
It’s essential to address your anger head-on, but it’s just as critical to seek help for your depression. When the two are tied together, as they often are, treating the depression can also effectively treat the anger.
No matter what type of anger you’re experiencing, remember that your emotions are valid. It’s not wrong for you to feel anger—it’s just a matter of learning how to do so responsibly and adaptively.
Takeaways
- Depression can be experienced as anger, sadness, or both.
- How you perceive your anger can change both how you express and relate to it.
- Based on research, depressed anger responds well to treatments for major depression.
- Exercise, mindfulness, and meaningful pastimes may all help with agitated depression.
- If symptoms persist, it’s essential to speak with a mental health professional.
