Millions of Americans suffer from depression and anxiety disorders. When diagnosed accurately, treatment may help many individuals.

But what happens when the symptoms are not typical of the disorder? The chances of a correct diagnosis and effective treatment may then be reduced.

Anger is not a classic sign of depression. The Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard reference manual used by mental health professionals, does not list anger as a symptom of the condition. And the scales that are used by clinicians to determine if medication is working effectively do not include anger-specific items.

Yet clinicians frequently see anger and irritability in patients who are seeking help. In fact, irritability is seen almost as frequently as sadness and anxiety. But there is limited research on anger and its link to these disorders

Since 2001, studies of anger and aggression across psychiatric diagnoses have consistently found elevated rates of anger, irritability, and hostility among depressed patients, while studies of bipolar disorder also found elevated levels of anger.

A deeper look

My colleagues and I recently surveyed many of our patients. During a first visit, we asked them about the level of anger they felt during the previous week. The results were eye-opening.

  • Two-thirds of individuals reported notable irritability and anger.
  • Half reported a moderate or severe level of subjective anger.
  • One in five endorsed moderate-to-severe levels of current overt aggression.

A number of mental health conditions may be associated with an increased level of anger or aggression. Those include major depressive disorder, bipolar disorder, post-traumatic stress disorder (PTSD), general anxiety disorder and others. More research is needed on this subject, so we can understand this connection better.

If you are experiencing anger or aggression, discuss it with your doctor or mental health professional. It could be a sign of another condition that can be treated.

Learn more about our outpatient psychiatric services and our team of experts.

Mark Zimmerman, MD

Dr. Mark Zimmerman is a psychiatrist and director of the Adult Partial Hospital Program and outpatient psychiatry at Rhode Island Hospital.

Outpatient Psychiatry