What Is Agitated Depression?

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Table of Contents

Overview

Symptoms

Diagnosis

Causes

Treatment

Coping

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Agitated depression (AD) is a relatively severe type ofclinical depressionthat combines the persistent sadness, pessimism, low energy, and low or “empty” mood of typical depression with agitated symptoms such as irritability,anxiety, restlessness, excessive talking, fidgeting, and/or angry outbursts.

Thismental health conditionmay also be referred to as unipolar, mixed state, mixed features, mixedmania, depression with psychomotor agitation, or mixed episode depression.

At a GlanceAgitated depression can lead to features of depression mixed with symptoms of agitation, restlessness, and anger. Symptoms of the condition can overlap with other types of depression, so diagnosis can sometimes be challenging. Like other forms of depression, a combination of factors, including genetics, brain chemistry, stress, and environmental factors, can contribute to the onset of agitated depression. If you are experiencing symptoms of this condition, effective treatments such as therapy, medication, and lifestyle changes can help.

At a Glance

Agitated depression can lead to features of depression mixed with symptoms of agitation, restlessness, and anger. Symptoms of the condition can overlap with other types of depression, so diagnosis can sometimes be challenging. Like other forms of depression, a combination of factors, including genetics, brain chemistry, stress, and environmental factors, can contribute to the onset of agitated depression. If you are experiencing symptoms of this condition, effective treatments such as therapy, medication, and lifestyle changes can help.

How to Cope With Depression and Anxiety at the Same Time

Understanding Agitated Depression

There are manytypes of depressionwhich, as a group of mental health disorders, affect over 264 million people of all ages worldwide.AD is one way depression manifests.

The diagnosis remains somewhat controversial and inconsistent (for example, some clinicians prefer to use the diagnosis of depression with mixed features or consider it part ofbipolar disorder) as the characteristics of the condition overlap with a variety of other types of depression.

However, researchers and clinicians are increasingly understanding that depression, mania, and mental health, in general, exist on a spectrum, which is why various names may be used to describe a person’s depression and that each person does not necessarily exhibit all of the possible symptoms.

Generally, a person with agitated depression experiences the intense malaise, lack of energy, hopelessness, and apathy of typical depression as well as an urge to act out, which is often expressed in volatile behavior, insomnia, negative mood, racing thoughts, and a short temper.

While these symptoms may also occur in depression, for those with agitated depression these issues are more pronounced and persistent.

Find out more about causes, risk factors, diagnosis, and treatment of agitated depression below.

Depression Disorder With Mixed Features

Symptoms of Agitated Depression

If you or a loved one are having suicidal thoughts, contact the National Suicide Prevention Lifeline at988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are having suicidal thoughts, contact the National Suicide Prevention Lifeline at988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Agitated Symptoms

Additionally, those with agitated depression will also experience some of the following signs and symptoms that define their condition as “agitated:”

As noted above, each person may have a unique combination of depressive and agitative symptoms that together present as agitated depression.

Diagnosing Agitated Depression

As noted above, the diagnosis of this disorder is not entirely straightforward as it overlaps with several types of depression. Sometimes, a person is diagnosed with depression first and then agitated depression later, once the nuances of their condition come to light in therapy.

For diagnosis, symptoms of the condition are present for at least two weeks and at least two symptoms of physical agitation and/or mental agitation are experienced along with typical symptoms of depression.

A key component of agitated depression is that, unlike some other mental health conditions where states of agitation, elation, and/or activity come in waves (such as withbipolar disorder), the feelings and behavior of agitation are constant along with the symptoms of depression. The symptoms of agitation are also more extreme and persistent than with other types of depression.

Another facet of agitated depression that mental health providers will evaluate and watch out for is a propensity for substance use disorders, self-harm, and suicidal ideation. It’s important to know that people with this condition are more likely to engage in these harmful thoughts and behaviors.

What Causes Agitated Depression?

Like many mental health conditions, the causes or triggers of agitated depression are complex and thought to arise from a combination of factors, including heredity, brain chemistry, childhood trauma, emotional distress,environmental factors, comorbid mental health conditions, and other issues.

Some common risk factors and contributing factors for developing agitated depression include the following:Dysfunctional family lifeFeelings of lossFeelings of inferiority, regret, and/or worthlessnessHormonal imbalancesHypothyroidismOther mental health conditions, such asbipolar disorder,attention deficit and hyperactivity disorder(ADHD), and anxiety disordersPoor coping skillsProlonged stressTraumatic events

Some common risk factors and contributing factors for developing agitated depression include the following:

Often, there may be a combination of factors that contribute to the development of this disorder. Sometimes, the causes may not be completely clear.

Additionally, some medications for depression may prompt agitated behaviors in the people who take them, causing the person to develop agitated depression as a result.

Why Are Some People Prone to Depression?

Treatments for Agitated Depression

Treatment options for agitated depression are similar to those for other types of depression and usually include talk therapy and medications.

Psychotherapy

Cognitive-behavioral therapy, which seeks to help a person recognize and change negative or destructive thought patterns, is often used to treat this condition.

Medications

Antidepressants, mood stabilizers, and/or anti-anxiety medications are also often used in combination with therapy. Note that it can take time (typically from one to two months or longer) for medications to take effect—and to find the right one for you at the correct dosage.

ECT

In more severe cases when other treatments are not working,electroconvulsive therapy(ECT) may also be used.

Agitated depression can be challenging to treat, making it very important to stick to your prescribed treatment plan, even when your symptoms seem to be improving and/or you when you are out of a depressive episode.

Can Depression Go Away on Its Own?

Coping With Agitated Depression

Know that with treatment, agitated depression can be managed effectively. As noted above, consistent treatment is the best way to find relief from this condition.

Getting care early in your depressive episodes also makes treatment success more likely and effective.

In addition to therapy, where you can work on transforming and taking charge of your thoughts and actions, there are many strategies and skills you can work on to help you cope with this condition, including the following:

What This Means For YouFinding out that you have agitated depression can be upsetting but know that your diagnosis can be the beginning of getting help.With proper treatment and consistent attention to taking care of your mental health, you can regain—and maintain—control over your life and mental health.

What This Means For You

Finding out that you have agitated depression can be upsetting but know that your diagnosis can be the beginning of getting help.With proper treatment and consistent attention to taking care of your mental health, you can regain—and maintain—control over your life and mental health.

Finding out that you have agitated depression can be upsetting but know that your diagnosis can be the beginning of getting help.

With proper treatment and consistent attention to taking care of your mental health, you can regain—and maintain—control over your life and mental health.

Tips for Overcoming Depression

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Depression.Shim IH, Bahk WM, Woo YS, Yoon BH.Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review.Clin Psychopharmacol Neurosci. 2018;16(4):376-382. doi:10.9758/cpn.2018.16.4.376Akiskal HS, Benazzi F, Perugi G, Rihmer Z.Agitated “unipolar” depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy.J Affect Disord. 2005;85(3):245-58. doi:10.1016/j.jad.2004.12.004National Institute of Mental Health.Depression.Serra F, Gordon-Smith K, Perry A, Fraser C, Di Florio A, Craddock N, Jones I, Jones L.Agitated depression in bipolar disorder.Bipolar Disord. 2019;21(6):547-555. doi:10.1111/bdi.12778Tolentino JC, Schmidt SL. DSM-5Criteria and Depression Severity: Implications for Clinical Practice.Front Psychiatry. 2018;9:450. doi:10.3389/fpsyt.2018.00450Leventhal AM, Gelernter J, Oslin D, Anton RF, Farrer LA, Kranzler HR.Agitated depression in substance dependence.Drug Alcohol Depend. 2011;116(1-3):163-169. doi:10.1016/j.drugalcdep.2010.12.012National Institute of Mental Health.What Is Depression?Xie Y, Wu Z, Sun L, et al.The effects and mechanisms of exercise on the treatment of depression.Front Psychiatry. 2021;12:705559. doi:10.3389/fpsyt.2021.705559

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Depression.Shim IH, Bahk WM, Woo YS, Yoon BH.Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review.Clin Psychopharmacol Neurosci. 2018;16(4):376-382. doi:10.9758/cpn.2018.16.4.376Akiskal HS, Benazzi F, Perugi G, Rihmer Z.Agitated “unipolar” depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy.J Affect Disord. 2005;85(3):245-58. doi:10.1016/j.jad.2004.12.004National Institute of Mental Health.Depression.Serra F, Gordon-Smith K, Perry A, Fraser C, Di Florio A, Craddock N, Jones I, Jones L.Agitated depression in bipolar disorder.Bipolar Disord. 2019;21(6):547-555. doi:10.1111/bdi.12778Tolentino JC, Schmidt SL. DSM-5Criteria and Depression Severity: Implications for Clinical Practice.Front Psychiatry. 2018;9:450. doi:10.3389/fpsyt.2018.00450Leventhal AM, Gelernter J, Oslin D, Anton RF, Farrer LA, Kranzler HR.Agitated depression in substance dependence.Drug Alcohol Depend. 2011;116(1-3):163-169. doi:10.1016/j.drugalcdep.2010.12.012National Institute of Mental Health.What Is Depression?Xie Y, Wu Z, Sun L, et al.The effects and mechanisms of exercise on the treatment of depression.Front Psychiatry. 2021;12:705559. doi:10.3389/fpsyt.2021.705559

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

World Health Organization.Depression.Shim IH, Bahk WM, Woo YS, Yoon BH.Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review.Clin Psychopharmacol Neurosci. 2018;16(4):376-382. doi:10.9758/cpn.2018.16.4.376Akiskal HS, Benazzi F, Perugi G, Rihmer Z.Agitated “unipolar” depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy.J Affect Disord. 2005;85(3):245-58. doi:10.1016/j.jad.2004.12.004National Institute of Mental Health.Depression.Serra F, Gordon-Smith K, Perry A, Fraser C, Di Florio A, Craddock N, Jones I, Jones L.Agitated depression in bipolar disorder.Bipolar Disord. 2019;21(6):547-555. doi:10.1111/bdi.12778Tolentino JC, Schmidt SL. DSM-5Criteria and Depression Severity: Implications for Clinical Practice.Front Psychiatry. 2018;9:450. doi:10.3389/fpsyt.2018.00450Leventhal AM, Gelernter J, Oslin D, Anton RF, Farrer LA, Kranzler HR.Agitated depression in substance dependence.Drug Alcohol Depend. 2011;116(1-3):163-169. doi:10.1016/j.drugalcdep.2010.12.012National Institute of Mental Health.What Is Depression?Xie Y, Wu Z, Sun L, et al.The effects and mechanisms of exercise on the treatment of depression.Front Psychiatry. 2021;12:705559. doi:10.3389/fpsyt.2021.705559

World Health Organization.Depression.

Shim IH, Bahk WM, Woo YS, Yoon BH.Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review.Clin Psychopharmacol Neurosci. 2018;16(4):376-382. doi:10.9758/cpn.2018.16.4.376

Akiskal HS, Benazzi F, Perugi G, Rihmer Z.Agitated “unipolar” depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy.J Affect Disord. 2005;85(3):245-58. doi:10.1016/j.jad.2004.12.004

National Institute of Mental Health.Depression.

Serra F, Gordon-Smith K, Perry A, Fraser C, Di Florio A, Craddock N, Jones I, Jones L.Agitated depression in bipolar disorder.Bipolar Disord. 2019;21(6):547-555. doi:10.1111/bdi.12778

Tolentino JC, Schmidt SL. DSM-5Criteria and Depression Severity: Implications for Clinical Practice.Front Psychiatry. 2018;9:450. doi:10.3389/fpsyt.2018.00450

Leventhal AM, Gelernter J, Oslin D, Anton RF, Farrer LA, Kranzler HR.Agitated depression in substance dependence.Drug Alcohol Depend. 2011;116(1-3):163-169. doi:10.1016/j.drugalcdep.2010.12.012

National Institute of Mental Health.What Is Depression?

Xie Y, Wu Z, Sun L, et al.The effects and mechanisms of exercise on the treatment of depression.Front Psychiatry. 2021;12:705559. doi:10.3389/fpsyt.2021.705559

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