There is a popular image of someone with depression. You might picture someone with a sad look on their face. You might think of someone who is fatigued and has little energy. Depressed people feel sad or hopeless. They may have little interest in meaningful or pleasurable activities.
Even the companies who sell depression medication feed this popular image. Their TV ads show people who are not smiling and look down. One of them has people walking around, holding a picture of a frowning face in front of their own face.
None of these people look angry, and yet, anger can be a part of depression. In fact, one of the diagnostic criteria in the Diagnostic and Statistics Manual (DSM) is ‘psychomotor agitation.”
It is important to understand the relationship between anger and depression. And yet, because they can look so different, you might not even consider that they are related.
Anger is a powerful emotion. You can feel the emotions racing through your body. You can feel the angry thoughts racing through your mind. If you are depressed, you may feel a lack of energy or desire. Anger is an expressive emotion. When you are angry, you are motivated to act, even if the action you take is not a good one. If you are depressed, there is little motivation for changing your behavior.
It is important to determine if anger is a part of your depression. You can focus on one or the other, but if you don’t see how they may be feeding each other, it is hard to develop a different relationship with your anger or depression.
The idea that there is a relationship between anger and depression has been around for a long time. Sigmund Freud was the first person to suggest that depression is anger turned inward. That is an overly simplistic description of the relationship between the two, but research suggests that anger can enhance the symptoms of several emotional disorders. Anger can interfere with efforts to treat these disorders.
One of the ways to look at the relationship between anger and depression is to explore the power of negative thoughts that people have about themselves.
If you struggle with depression, you don’t just have passing negative thoughts about a particular behavior. Most likely, you have developed an extensive narrative about your failures and your inability to live a meaningful life. You are living out a depression-saturated story, and anything in your life that suggests otherwise gets left out of the story.
This narrative also contains a variety of characters that are inner critics. These critics can describe anything you do—or anything you don’t do—as wrong or bad. You don’t just feel guilty for a bad decision, for something you did. You feel a deep shame about who you are as a person. This is where the anger shows up. You get mad at yourself for being this way. You become even more critical of yourself. There are more messages about how you are powerless and pathetic. You are beating up on yourself (beating up is an expression of anger), and the depression-saturated story always wins.
One of the most courageous things you can do is to identify and even listen to these inner critics without trying to push them away or letting them control you. No, it is not an easy thing to do, but it allows you to develop a different relationship with these parts of you. You don’t get rid of the depression-saturated narrative. You see the narrative for what it is…a narrative…a story.
One of the ways I work with people who struggle with depression is to externalize these inner critics who are turning their anger on them. An example. Often, I will invite a client to picture the depression sitting across the room from them. I might even have them imagine what it looks like and sounds like. Then, we have a conversation with the depression. How is the depression getting you to act? What is the depression telling you about yourself? When you buy into what the depression is saying, how does it make you feel? What does it get your to do?
And perhaps the most important questions: What do you think of what the depression is saying? Do you like it? Does it take you towards or away from the person you want to be?
All of these questions don’t confront and fight with the inner critics. They let them have their say, so you can get enough psychological flexibility to choose differently. If you would like to learn more about this, please visit my depression treatment specialty page.