WELLNESS
02/05/2019 05:45 EST | Updated 03/05/2019 19:18 EST

The Depression Symptom We Rarely Talk About

Depression is often associated with sadness, but there's another emotional response that gets little attention.

Anyone who has ever gotten cut off in traffic or stubbed their toe on a coffee table knows how quickly anger can go from zero to 100. Most of the time, getting mad is just a part of being human. But in some cases, constant rage could be a sign of a deeper issue: depression.

A 2014 study found that that anger — both overt and suppressed — is actually a common sign of the mental health condition. Psychologists suggest that people who have difficulties coping with their anger are at risk of developing depression. Experts have even described the mental illness as “self-directed anger” or “anger turned inwards.”

“It doesn’t always look like depression, but it is,” said Marianna Strongin, a licensed clinical psychologist in New York.

Research has shown anger is associated with “greater symptom severity and worse treatment response” when it’s part of a mental health condition like depression. That’s why Strongin encourages anyone who is feeling angrier than usual to reach out for help instead of brushing it off.

“A patient will say they’ve noticed, or their friends have noticed, that they’re lashing out more,” she said. “Although they come in to address their anger, when we start digging, the anger is usually a symptom of depression.”

Rather than feeling sad or empty, like we commonly believe people with depression do, some people more quickly turn to anger. Strongin said that’s because it’s often easier to feel angry than it is to experience more morose emotions.

“Sadness is much harder to experience,” she said. “Sadness is a phase, and anger is a verb ― it moves through you. So sometimes [people with depression] distract themselves to not feel sad, so instead, anger gets triggered.”

James Boast via Getty Images

According to the National Institute of Mental Healthmany of the estimated 16.2 million American adults who live with depression are women ages 18 to 25. But Florida-based psychologist Sherry Benton says it’s typically men who exhibit anger as a symptom.

“Their natural inclination tends to lean toward isolation,” she said. “With this comes the need to withdraw from relationships with others, even ones that are healthy. Anger is a seamless secondary symptom to this, since lashing out is generally an effective method of pushing people away.”

Because men so often push loved ones away and mask their depression entirely, it’s more likely to be deadly. Approximately 17 percent of men will have major depression at least once in their lives, and men are 4 times more likely than women to die by suicide, according to a Harvard Medical School report. 

But that doesn’t mean women don’t experience anger as a symptom of depression too. Elizabeth, an artist living in Oregon who asked that her real name not be used to protect her privacy, was diagnosed with depression when she was 19 and experienced anger as a symptom. She noticed it was getting out of hand when she snapped at a co-worker during a meeting and broke a window at an ex-boyfriend’s house.

My mom has commented before that I seem angry, and that I should ‘do something about it,’” said Elizabeth, who is now 29. “I think I had a perception of depression as being a weakness, which I don’t believe at all anymore, but made me hesitant to call a spade a spade when I was younger.”

Elizabeth was able to manage her condition and her anger symptoms through a combination of antidepressants and healthy lifestyle changes.

“I started going to yoga classes while I was really struggling with depression about a year ago, and definitely feel like it has increased my awareness of my body and my breathing, which can sometimes help me get out of a funk,” she said.

With just anger, it’s never just anger. It’s always symbolic of something not working.Marianna Strongin, licensed clinical psychologist

In addition to medication, breathing practices and exercise, Strongin said journaling can be a beneficial tool in managing anger and getting to the root cause of a patient’s depression. She tells her patients to write down their negative thoughts, then question them and look for evidence that what they’re saying is true.

“If the thought is ‘I’m not good enough,’ I’d ask, ‘How are you not?’” she said. “When you have insecure thoughts, follow them up with answers.”

But no matter what tools you find useful, the first step is getting help. Talking with a mental health professional can help you manage depression and its accompanying symptoms.

“With just anger, it’s never just anger,” Strongin said. “It’s always symbolic of something not working.”

“Living With” is a guide to navigating conditions that affect your mind and body. Each month, HuffPost Life will tackle very real issues people live with by offering different stories, advice and ways to connect with others who understand what it’s like. In February, we’re covering depression. Got an experience you’d like to share? Email wellness@huffpost.com.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

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