Anger in Depression

Feeling anger is something we have all been through, it's a completely natural human emotion. The triggers for anger vary from person to person, as do the responses to angry episodes. For some, it may include expressing it verbally, whereas others may do things physically by reacting violently or breaking things. At the opposite end of the spectrum, some people express anger very passively, such as ignoring people. Less commonly, people may hide their anger as they feel unable to let it out or express it adequately. As you can see, it's a highly subjective concept. Sometimes, anger can get out of control. It can cause problems with: relationships, work, and possibly the law. In the longer term, unresolved anger is linked to health conditions such as: high blood pressure, depression, anxiety and heart disease. In particular, this post is interested in the relationship between anger and depression.

"I need a little room to breathe, because I'm one step closer to the edge, and I'm about to, break." - Linkin' Park (One Step Closer)

A while ago, I did a post on identifying anxiety and depression. In that post, I went through each of the conditions, the symptoms and how to try and curb them. Today, I'd like to focus on one particular symptom: anger. In this post, I'll use the terms 'anger' and 'irritability' interchangeably, since there is significant overlap between the two. I'll address: the causes/triggers of anger, the various expressions/manifestations of anger, the ways to manage anger constructively, the relationship between anger & depression, and finally, I'll turn to my own experiences with anger & depression.

I should explain at the start, anger and aggression are NOT the same thing. Anger is an emotion that we feel. Aggression is how some of us behave when we feel angry. Not everyone who feels angry is aggressive, and not everyone who acts aggressively is angry. Sometimes people behave aggressively because they feel afraid or threatened.

Causes

As I explained, anger is a very subjective concept. As a result, people can interpret situations differently - a situation that makes you feel very angry may not make someone else feel angry at all. Other factors come into play here, such as: our upbringing (witnessing the anger of parents, being punished for expressing anger or growing up thinking that expressing anger in an aggressive way is okay), past experiences (such as trauma, abuse and bullying - these events can influence how we act in certain situations) and our current circumstances (if you're stressed now, or there is a lot going on in your life, you are more likely to lose your temper). There are, of course, some very common causes of anger. Usually, they include situations in which we feel:

• Threatened or attacked;

• Frustrated or powerless;

• Like we're being invalidated or treated unfairly; and/or

• Like people are not respecting our feelings or possessions    

Expressions/Manifestations

A feeling of anger can create a rush of adrenaline through the body, so before you recognise the emotion you're feeling you might notice some of the following:

• Faster heartbeat;   

• Quick breathing;

• Tension in your body;

• Tapping your feet; and/or

• Clenching your jaw or fists.

Anger can have physical effects on the body, which include:

• A churning feeling in your stomach;

• Tightness in your chest;

• An increased and rapid heartbeat;

• Weak legs;

• Tense muscles;

• You feel hot;

• You have an urge to go to the toilet;

• Sweating, especially your palms;

• A pounding sensation in your head;

• Shaking or trembling; and/or

• Dizziness.

Further, there are also effects on your mind:

• Feeling tense, nervous or unable to relax;

• Feeling guilty;

• Feeling resentful towards other people or situations;

• You are easily irritated;

• The 'red mist' comes down on you; and/or

• Feeling humiliated.

Management

There are three common and useful approaches to managing anger.

The first thing which you may wish to consider are anger management courses. There are a number of programmes available. A great resource is the NHS website, particularly here. These courses are also available privately and a good starting point would be the British Association for Counselling and Psychotherapy, which hosts a number of events and has a plethora of resources to help find the right therapy for you.

Typically, anger management programmes involve one to one counselling and working in a small group. The programmes may consist of a 1-day or weekend course. In some cases, it may be over a couple of months. It is important to find a structure and programme which works for you. The structure of the programmes can differ, depending on who's providing it. It is common, however, for programmes to include: cognitive behavioural therapy (CBT - I have spoken about this in previous blog posts, here) as well as counselling.

Alternatively, there are some techniques that you can use to manage your anger when you find yourself in difficult situations. There are three techniques I would recommend. The first thing you can do, is look out for warning signs as I have outlined above. If you're experiencing any of them, or even a combination, it may be worth removing yourself from the situation until they subside. Secondly, you can buy yourself time to think. This can be anything from counting to ten before you respond, going for a short walk, or speaking to someone that you trust who is completely detached from the situation; that objectivity can be very helpful in bringing some much needed perspective in such circumstances. Finally, you could try some calming techniques: breathing slowly and relaxing your body to release tension are good starting points. For others, physically exerting the anger may help. For example, hitting a pillow may give short-term relief. There are also productive ways to physically vent your anger such as through sports or the use of the gym. In these circumstances, you are channeling your anger but using them in a constructive manner and to your own benefit.

The final one considers the long term and planning for the future. If you think about how to manage your anger when you're calm, you can avoid feeling overwhelmed in the heat of the moment. This can include a number of things. Firstly, learning your triggers. It may be worth asking whether there are certain circumstances or topics that provoke anger in you? It may well be helpful to keep a diary to see what patterns form. Secondly, you could examine your thought patterns. During moments of anger, you may think in terms of 'always', 'never' and 'should'. However, in reality things are rarely so black and white. Making an effort to replace these words with softer terms like 'sometimes' or 'could' when thinking about your situation might help you to break up negative thought patterns. Thirdly, you could try to develop your communication skills. Here, you can think about what is making you angry and what you want to change about it. Ask yourself whether talking about it can address the issue. LISTEN to the other person's point of view to see where they are coming from. When communicating, be specific about what is making you angry and be prepared for the situation to go wrong as a worst case scenario. By doing so, you can interpret the situation, and, if it is going awry, you can withdraw from the situation and have the conversation later. Finally, you could consider changing your lifestyle. Prime examples can be: the reduction of drugs and alcohol, an increase in exercise/sport, improving your sleep and developing your emotional resilience.

Anger & Depression

There is a significant overlap between both anger and depression. Historically, Sigmund Freud (the founder of modern psychoanalysis) referred to depression as "anger turned inward." I'll accept that this is somewhat a simplification, but it does make the point clearly. Many of those suffering from depression and anxiety are at odds with themselves because their mind is throwing significant waves of negativity at them.

As you've probably started to pick up from my posts, there are common threads within mental health discussions and they can intersect in numerous ways. For example, at the very start of this post I referred to 'irritability', which is also a symptom of depression. The physical effects of feeling anger also reflect the sensations we feel during an anxiety/panic attack. On top of that, we can also see from the above: feelings of hopelessness, sadness and a lack of motivation or concentration can lead to frustration and anger. They are all symptomatic of depression and even, anxiety. These feelings can be exacerbated in certain situations. For some people, they may suffer the double-whammy of having topics which are capable of bringing up sensations of both anger and anxiety. Sometimes, an anxiety attack can be the cause of anger due to the feeling of being out of control of one's own emotional state. It is therefore very common to be suffering from depression (and anxiety) and be prone to bouts/outbursts of anger.

My Experiences

Oddly (at least by my own standards) my experience with anger is somewhat mixed. In some situations, I'm very passive and will just shut down and not talk to anyone. At other times, I'll express it verbally through expletive-filled rants. Alternatively, I'll (rather unhealthily) bottle my anger up sometimes. I can also go from 0-100 in the matter of a blink of an eye in some situations. I guess for me, the reaction is very much depending on the context of the issue at hand and where my level of comfort is. I do tend to find that my anger is bound up with depression and anxiety. I'm much more likely to become angry (although usually in the passive sense) and stop talking when I feel I've lost control of a situation or am feeling particularly hopeless, sad, lost or struggling for concentration. One prime example is a vicious cycle of: losing control, getting angry about losing control and catastrophising and again losing control because I've succumbed to catastrophising as opposed to curbing the thought process. In other cases, again by way of an example, I can feel angry after a particularly bad day (in the mental sense) where I have kept chipping away at myself by dealing in absolutes/finality and bring up nothing but negativity. I've started to address this slowly but surely by replacing those completely negative findings with slightly softer alternatives. I also try and find at least one positive in everything (regardless of how small it is) to try and defeat that line of reasoning. I'll admit it's a work in process, but I'm making small strides which I am grateful for.

Practically, I try to get my anger out in the same way I do with my stress: sport. In a previous post, I went into detail about how football has, for me, been a way of getting everything out of my system in a constructive way. I've started to add to this: I've taken up long distance running and am also hoping to get back into a gym routine once my master's degree is complete. My motivation for this is quite simple: use any anger, frustration or stress in a constructive way for self-improvement.

In another post, I talk about music. I tend to listen exclusively to Linkin' Park and Mike Shinoda when I'm angry. I'll sit there and just breathe whilst listening to the music and eventually find that my body calms down: my breathing slows and the tension in my body starts to release. When I combine this with the alternative of meditation (either the sound of rain of the sound of waves on the beach), I've always been able to calm down. For me, it's clear that these particular artists and sounds work in a way which reduces my negative emotions.

Before I sign off, here are some fantastic links which I hope are of use to you:

• https://www.mind.org.uk/information-support/types-of-mental-health-problems/anger/managing-outbursts/#.XTtkwy3Mz-Y

• https://www.nhs.uk/conditions/stress-anxiety-depression/about-anger/

• https://www.healthline.com/health/depression/anger-and-irritation

• https://www.psychologytoday.com/gb/blog/compassion-matters/201710/the-role-anger-in-depression

• https://www.npr.org/sections/health-shots/2019/02/04/689747637/if-youre-often-angry-or-irritable-you-may-be-depressed

• https://www.helpguide.org/articles/depression/depression-symptoms-and-warning-signs.htm

Remember: you are a beautiful human being. You are loved. You matter. You have so much good that you can offer this world.

Until next time,

J x