"Who Are You Calling Depressed, Assh*le?!" The Relationship Between Depression and Anger

Monday, February 02, 2015 by Meg   •   Filed under Depression

Depression is usually categorized by a lack of pleasure in things you used to enjoy, lack of energy, changes in sleep or appetite, trouble concentrating and worthlessness (see a full list of symptoms here in What Is Depression?) But there is one symptom that isn’t brought up as often because there is some taboo around it: anger. 

That’s right, all you non-depressed folks. The depressed population don’t just lay in bed feeling sad. There’s a whole slew of other stuff that goes with it. So do me a favor and don’t do something stupid like tell them to snap out of it, okay? If they could, they would. And if you mutter something of that nature, I will support them punching you. (Steps off soapbox.) 

Anyway, anger attacks are present in both obsessive compulsive disorder, and Major Depression and all three often occur together1. They are also common in anxiety, post-traumatic stress postpartum depression and other conditions like Borderline Personality Disorder. And if you get caught with PPD, PTSD, OCD, depression and anger, watch out. 

Good times. Fucking mother nature.

But borderline personalities and anger has additional mediating factors (see more here in MAOA What!? The Genetic Link Between Borderline and Bipolar). Same with narcissism (more here), psychopathy (here) and obsessive compulsive disorder (coming soon). So for today, let’s focus on the depression. 

Depression and Anger Attacks

Anger attacks are periods of autonomic nervous system arousal where you feel pissed off to the extreme. Both anxiety and depression involve the fight/flight response. And “fight” is just as prominent as “flight” in many people. Intense anger, a desire to punch and throw things, and yelling are common. And depressed individuals who have those anger attacks also have more anxiety, irritability, aggression, suicidal thoughts, and trouble with self regulation than those without this anger element2

But why? What is anger a symptom of? How do they differ from someone who has major depression but isn’t angry?

Let’s get to the basics: depression and anxiety (and a bunch of that other stuff) are related to dysregulation of serotonin and dopamine systems in the prefrontal cortex. 

Translation: if you have anxiety or depression, the chemicals in your head are all running around doing crazy shit like your neighbors after too much vodka (you know who you are).

But this trouble with regulating neurotransmitters and controlling emotion doesn’t stop at the anxiety and depression. Because when your brain doesn’t produce enough serotonin, you might be more predisposed to have aggression, especially if your dopamine is low3

But the way numerous chemicals interact ensures that not everyone with depression has this particular symptom. Not everyone suffers from extreme anger or serotonin low enough to produce it. So let’s check out what makes it more likely. 

Prolactin, Aggression and Depression

Women have a few evolutionary reasons to be aggressive. Prolactin, a hormone secreted at higher rates following childbirth has been shown to make women more aggressive, possibly as an offshoot of protecting young (more here in Lactational Aggression and Postpartum Protectiveness). And some studies have shown a link between this higher prolactin and depression, anxiety and, you guessed it, aggression and anger4. It’s a big soup of bullshit that we deal with in order to ensure that we were able to protect our young from saber-toothed tigers, and more recently, overbearing in laws. 

“Thanks a lot kids.”

But prolactin also fluctuates over time and over monthly cycles. And those with trouble regulating hormones due to conditions such as thyroid issues may be at even greater risk for this problem because of the role the thyroid plays in the regulation of prolactin5. If you have anger issues, depression and any other symptoms of thyroid dysfunction including cold hands and feet or unexplained weight gain, it might be worth it to get checked out. 

Homocysteine, Aggression, Depression and Anxiety

Those who have anger have been show to have higher homocysteine, a specific amino acid that has been linked to depression and anxiety6. Elevated homocysteine creates a toxic environment for a number of types of neurons7. And neuron death leads to more intense depressive symptoms over time because there are fewer of them to regulate your mood. (More here in Depression and Brain Changes. Read it. Trust me.) 

So how do you get high homocysteine? 

High homocysteine usually results from an inability to process it out. To do that, you need B vitamins to help your body use the amino acid instead of letting it build up until it destroys cells. This explains why most who have high homocysteine are low in folate (vitamin B9), vitamin B6 and vitamin B12. And over time this murdering of cells leads to more intense depression, more intense anger and eventually cognitive decline in older age8, 9.

Obviously this is a lot to swallow. (That’s what she said.) But understanding additional factors involved in depression and anger responses can lead to a reduction in symptoms when the underlying issues are treated. Get your hormones checked out, load up on B vitamins or try supplements like this one and stay tuned for Friday’s post on B Vitamins and John Wayne Bobbit. It’s a doozy.

Related Posts: 


  1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530280/
  2. http://www.ncbi.nlm.nih.gov/pubmed/17544515
  3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2612120/
  4. http://europepmc.org/abstract/med/6483849
  5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719326/
  6. http://www.ncbi.nlm.nih.gov/pubmed/16325154
  7. http://www.ncbi.nlm.nih.gov/pubmed/23237596
  8. http://www.ncbi.nlm.nih.gov/pubmed/11976166
  9. http://www.ncbi.nlm.nih.gov/pubmed/16155277 

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Mastery of Your Anxiety and Panic: Workbook (Treatments That Work)
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Why Zebras Don't Get Ulcers
Primatologist/biologist Robert Sapolsky on stress and your brain. Good stuff.

Mindsight: The New Science of Personal Transformation
New techniques for mindfully altering the wiring of your own brain, leading to increased happiness.

Against Depression
Detailed explanations of the systems involved in depression along with personal stories of success from psychiatrist Peter Kramer.

Famished: An Ash Park Novel
Everyone's hungry for something. Some are more famished than others.