Uncovering Depression That Is Disguised As Anger

July 23, 2019
Anna Jankowska, LCPC

By Anna Jankowska, MA, CEAP, SAP, LCPC

Anna Jankowska is a mental health, addiction, and substance abuse counselor with over 17 years of experience and has specialized training and skill in working with individuals, groups and communities to improve mental health outcomes. NPI number: 1598843526

In recent years, mental illness has loomed large in the public imagination. People are becoming more cognizant of mental health issues, and more open about discussing mental wellness and seeking treatment. However, under the spotlight of mainstream awareness, the complexities of a mental illness like depression can be erased.

Not-so-teenage Angst

The public perception of depression has a certain character: sad, listless, self-isolating. But depression can emerge in other forms. Many people are aware, for example, of the link between depression and anxiety. Fewer people recognize anger as a depressive symptom. Uncontrolled rage may seem inconsistent with the dull, fatigued aspect of depression. Until recently, angry outbursts were observed as a sign of depression only in children and teens. Adults who experienced similar bouts were channeled toward other diagnoses, like bipolar disorder.

But according to Dr. Maurizio Fava, irritability doesn't end after adolescence. In a 1998 study, he found that one-third of depressed subjects suffer from “anger attacks” that are not unlike panic attacks.

depressed subjects suffer from anger attacks

What Does It Feel Like?

An anger attack is a flare-up of anger often accompanied by physical symptoms. These can include hot flashes, sweating, an increased heart rate, and the feeling of tightness in the chest. The physical sensation is similar to a panic attack, which leads researches to theorize that anger attacks occur when one feels “emotionally trapped”.

Of course, anger is a natural human emotion. But depression-induced anger manifests in inappropriate reactions. Those who experience this phenomenon might lose their temper over minor inconveniences. They may lash out at others for no reason. Friends and family members will notice them picking fights and acting hostile. Coworkers may notice anger outbursts which could be a sign of workplace depression.

Just as many depression patients report the feeling of a “dark cloud” following them, depression anger might feel like a cloud of irritability that just won't lift.

depression anger sadness clouds

Why does it happen?

There is no single, clear explanation for why some people's depression presents as anger. Fava's study found that people with depression who have anger attacks are more likely to also be anxious, avoidant, and antisocial. Depression is influenced by many factors. It may have genetic and biological roots. Depression can also stem from sustained exposure to harmful environmental circumstances like poverty, violence, and neglect. Trauma instills pent-up rage and anxiety that emerge later in life as rampant anger management issues.

What Can Be Done?

The first step is recognizing the problem. Many people can't clearly evaluate their own symptoms. It can be daunting to confront a loved one about depression and anger management, but it could be the wake-up call s/he needs.

The individual should be assessed by a medical professional who examines environmental and biological factors. The doctor will then offer a diagnosis and a tailored treatment plan. For some, anger management classes will be necessary to preserve healthy relationships with others. Some will be advised to alter their diet or exercise regimen. Most people fight depression anger with some combination of therapy, medication, and anger management classes.

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