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Angry? Irritable? It Could Be Depression


Psychiatrists have long acknowledged that anger and irritability are classic symptoms of major depression in teens and children, but for some reason, prolonged adult crabbiness has been generally ignored.

A new study, however, found that depressed adults who are irritable, angry, foul-tempered and hostile are more likely to have " a more chronic and severe long-term course" of major depression than those who don't acknowledge their cranky, antisocial behavior.

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The long-running study of 536 subjects diagnosed with major depression in five U.S. cities found that more than half (292 subjects) were extremely irritable and angry. And it wasn't just the men who were short-tempered and testy - a majority of the women were, too.

The subjects were part of a U.S. National Institute of Mental Health study on depression and were followed for about 30 years. The findings were published online on Sept. 11 in the journal JAMA Psychiatry.

Compared with depressed patients who felt sad and lethargic, this grouchy group stayed depressed longer and were more likely to suffer from other psychiatric problems, including "substance abuse and anxiety disorder, more antisocial personality disorders" and poorer impulse control, wrote study author Lewis Judd, M.D., chair of the Department of Psychiatry at the University of California, San Diego, and colleagues.

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As the Los Angeles Times reported, researchers did not count those who experienced "occasional snappiness" as being part of this group. A subject was required to acknowledge that he or she was "somewhat argumentative and quick to express annoyance,"  "often shouts or loses temper" or "throws things, breaks windows, or is occasionally assaultive."

In the most extreme cases, a subject would be "repeatedly violent against things or people."

Why would depression make one person feel overcome with sadness, while another is overcome with rage? There may be a genetic factor, researchers noted, because the irritable group also tended to have more family members with bipolar disorder.

Researchers suggested that major depression with "overt irritability/anger" might be considered a separate form of depression disorder requiring more intensive treatment.

Photo: Craig Sunter/Flickr






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