Depression and Anger

This Depression and Anger article takes a look at the relationship between anger and depression. Learn how depression and anger can co-exist, what the risk factors are for anger and depression, and treatment options for both depression and anger.


People may feel that there is some link between depression and anger, even though they seem to contrast sharply. To many, depression suggests a muting of emotion and a withdrawal from action, while anger suggests overwhelming emotion and perhaps too much action. This article looks at some of the connections between depression and anger.

Depression, Anger, and Grief

The five stages of grief, identified by Dr. Elisabeth Kubler-Ross, reveal one aspect of the relationship between anger and grief. The five stages are, in order,

  • Denial and isolation
  • Anger
  • Bargaining
  • Depression
  • Acceptance

Here, we see that anger and depression are both part of the progression, separated by only one step. It is generally recognized that experiencing both is part of the way that people work through bereavement, although occasionally individuals can get stuck in one of the five stages.

Anger Leading to Depression

Just as anger leads to depression on the way to acceptance in grief, anger can lead to depression in other circumstances. But whether or not this is a good thing is not always clear. Anger, sometimes called righteous anger can come about when we perceive some wrong or injustice.

Such anger can lead to depression when a person has given up on achieving justice, and giving up may or may not be wise. On the one hand, if the injustice or wrong is truly insurmountable and giving up is a well-considered decision, the person may be on the road to acceptance. But it’s also possible that giving up with second thoughts may lead a person to feelings of guilt and shame, as well as depression, for not continuing to protest what was wrong or try to right it.

Depression and Anger Co-existing

Because depression often manifests with numbness, it may not be easy to envision clinical depression linked with anger. But it does happen. Major depressive disorder with melancholic features - characterized by anxiety or blankness - may be what most people picture when depression is mentioned, but it is actually only one kind of major depressive disorder. Major depressive disorder with anger is another, and as many as a third of those who have a major depression have attacks of anger.

Research is ongoing. A study published in Psychotherapy and Psychosomatics determined that major depressive disorder (MDD) with anger may fit into a diagnosis spectrum between major depressive disorder without anger on the one hand and bipolar II disorder on the other hand. Another study has showed an association between MDD with anger on the one hand and smoking and high cholesterol on the other.

Anger and Depression as Risk Factors

Chronic anger and major depression are turning up in studies of risk factors for heart disease. Experiencing symptoms of major depression increases the likelihood of sudden cardiac death in women more than twice as much as normal. Also, adults who are chronically angry and do not have a history of heart disease, may be 19 percent more likely than others to develop heart disease, and angry or hostile people who already have heart disease are nearly twenty-five percent more likely to receive a poor prognosis.

People may not be accustomed to thinking of feelings and attitudes as being bad for health in the way that smoking or high blood pressure is. But the 2009 study published in the Journal of the American College of Cardiology suggests that they should - in this instance - be considered in the same light.

Treatment of Depression and Anger

Antidepressants are a standard and frontline treatment for depression, as a general rule. But antidepressants are not always successful in fully addressing the symptoms. Anticonvulsants, also known as anti-seizure medications, have been tested in the first decade of the twenty-first century, and several of them have shown some success in treating the anger element when depression and anger are combined.

Sources

biopsychiatry.com
pn.psychiatryonline.org
memorialhospital.org
ncbi.nlm.nih.gov
informahealthcare.com
linkinghub.elsevier.com
webmd.com

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