Medical News Today: What is the link between depression and anger?

According to researchers, there is an association between the level of anger that people experience and the severity of depression.

In a 2013 study involving 536 participants who were experiencing major depressive episodes, 54.5% reported feelings of irritability and anger.

According to the Anxiety and Depression Association of America (ADAA), depression can manifest in different ways in different people.

The ADAA note that females with depression tend to feel sad or guilty, whereas males experiencing depression are more likely to feel irritable and angry. However, although this is generally the case, it is important to note that males can still feel sadness or guilt, and females can be irritable or angry.

An older article in the journal BJPsych Advances linked feeling angry with the development of depression.

The authors of the article suggest that this anger stems from “narcissistic vulnerability,” which is when a person is extremely sensitive to any perceived rejection or loss.

Experiencing rejection may cause feelings of anger, which can lead to a person fearing that their anger will damage their relationships.

They may then turn this anger toward themselves, which can lead to low self-esteem and depression.

However, there is little research available to support this theory or show that anger can cause depression.

People who experience anger and depression may have some of the following symptoms:

• irritability
• hopelessness
• sadness or emptiness
• guilt or worthlessness
• fatigue
• difficulty concentrating
• trouble sleeping
• unexplained changes in weight
• loss of pleasure or interest in hobbies
• suicidal thoughts

A person should seek help if their symptoms:

• start to interrupt their daily life
• affect their relationships with others
• seem to be getting worse

If a person has thoughts of hurting themselves or others, they should seek help as soon as possible.

A doctor may diagnose depression when a person experiences symptoms for more than 2 weeks.

There are different types of depression. A person should discuss all of their symptoms with a doctor to ensure that they receive the correct diagnosis.

Doctors may treat depression or anger with medication, therapy, or a combination of both.

Medication

A doctor may prescribe antidepressants. These drugs can take 2–4 weeks to start working.

Common medications may include:

• Selective serotonin reuptake inhibitors (SSRIs): These include fluoxetine, sertraline, citalopram, paroxetine, and escitalopram.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): These include venlafaxine, duloxetine, and desvenlafaxine.

According to a 2019 systematic review, sertraline can be effective in treating both depression and anger.

The majority of the studies concluded that many of the individuals who experienced high levels of irritability and anger responded well to sertraline. After roughly 2 weeks, the sertraline appeared to have improved their mood and reduced their feelings of anger.

However, the authors note that not all of the participants responded to this treatment.

Therapy

Therapy involves talking to a mental health professional who may use a variety of approaches.

Some people who struggle with depression and anger may find it beneficial to participate in anger management therapy.

Some types of therapy may include:

• Cognitive behavioral therapy (CBT): The aim of this therapy is to help a person recognize their negative thoughts and apply coping strategies.
• Interpersonal therapy: This therapy may help a person improve how they relate to other people.
• Psychodynamic therapy: People use this therapy to try to understand the negative patterns of behaviors and feelings that their past experiences have caused.

The most common form of therapy that healthcare professionals recommend for the treatment of anger is CBT. However, a 2018 review suggests that it is only moderately effective.

There is not yet enough research to confirm the effectiveness of therapy in treating anger.

Brain stimulation therapies

If a person still experiences feelings of depression and hopelessness after trying medication and therapy, a doctor may recommend other treatments.

One option is electroconvulsive therapy, which involves transmitting electrical impulses into the brain. This treatment can have side effects, including memory loss.

Doctors may sometimes recommend repetitive transcranial magnetic stimulation, which uses a magnet instead of electric currents.

Lifestyle changes and natural remedies

Some people may choose to take herbal remedies to treat depression.

However, there is little research to prove that they are effective in treating depression.

Some of the substances that doctors have studied include:

• omega-3 fatty acids
• S-adenosylmethionine
• St. John’s wort

In addition to these supplements, certain lifestyle practices may help lift a person’s mood. These include:

• engaging in regular exercise
• spending time with loved ones
• eating a healthful diet

Some people also report that alternative therapies — such as acupuncture, meditation, tai chi, and yoga — can boost their mood.

Light therapy is another alternative treatment option. It involves exposing a person to a special light box. The light can help regulate the production of melatonin, a chemical that plays a role in a person’s natural sleep-wake cycle.

There is little research to suggest that anger can cause depression. However, it is a symptom that can occur alongside depression.

If a person is struggling with depression, anger, or both, they should talk to their doctor.

Treatments are available that can help a person reduce the symptoms of depression. Some medications can also help reduce feelings of anger and irritability.