Agitated depression (A guide)

Depression is a form of depression that includes anxiety and depression as well.

People who are vulnerable to agitated depression have trouble managing their feelings.

They may experience guilt, anxiety, hopelessness, troublesome, agitation, nervousness and melancholic feelings at the same time. 

However, there are few causes of agitated depression. It is not even known as a disorder or disease.

Agitated depression can be treated by seeing a doctor, mental health professional or a psychologist and by talking openly about one’s problem.

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What is depression?

Depression is a common and serious medical illness that negatively affects how you, feel the way you think and how you act.

Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed.

It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

It may include hopelessness, loss or increase in appetite and sleep, constant low mood, and low self-esteem.

The symptoms should remain for at least two weeks to be clinically diagnosed. 

What causes Depression?

There are several reasons of depression. Most evident among them is genetic heredity.

There are 24% chances of transferring depression into next generation. People who suffer from depression often have a biological reason for depression. 

However, there are many different reasons to depression as well.

Some stressful event, loss of job, broken relationship or unbearable stressful circumstances can lead towards depression especially when exposed to longer period of time. 

Other contributing factors to depression are personality types, workload, environmental toxins and ineffective coping strategies. 

How depression can be assessed?

There are several ways of measuring depression. Most popular and preferably used tool is Beck Depression inventory.

It was created by Aaron T. Beck. It is a 21-question multiple-choice self-report inventory, one of the most widely used psychometric tests for measuring the severity of depression.

Its development marked a shift among mental health professionals.

There are other ways of measuring depression too. People who are suffering from depression often report less interest in daily activities.

There already established interests are diminished. However, there are chances to be cured from depression.

How depression can be managed?

Depression can be cured in several ways. More effective and powerful method is through medication especially when depression is severe.

However, moderate to low levels of depression can be cured from therapeutic techniques.

Among all therapies established till date, Cognitive Behavior therapy is widely used therapy for treating depression. 

However, strong coping, support from loved ones and regular therapy sessions can decrease the severity of depression. 

What is anxiety?

Anxiety is a normal and often healthy emotion. However, when a person regularly feels disproportionate levels of anxiety, it might become a medical disorder.

Anxiety disorders form a category of mental health diagnoses that lead to excessive nervousness, fear, apprehension, and worry.

The feelings of anxiety can cause physiological changes as well that may include excessive heart rate, stomach pain, blotting, nausea, and discomfort.

Like depression, anxiety also has genetic predisposition.

People who have anxiety transfer this into next generations with the probability of 19%.

Other factors rather than genetics can also lead to anxiety such as poor self-control, bullying, excessive guilt or fear, and constant worry.

How to assess Anxiety?

Like depression, anxiety can also be measured objectively.

Many researchers developed the standardized measures to check the anxiety levels of the patients. 

Agitated depression (A guide)

What is agitated depression?

Agitated depression is not a medical term, but some people use it to describe this combination of anxiety and depression.

Mixed depression, or major depressive disorder with mixed features, is another way to describe depression that also involves agitation and physical restlessness.

Symptoms of agitated depression

Agitation

Symptoms of agitation include:

  • Angry outbursts
  • Disruptive or impulsive behavior
  • Excessive talking or movement
  • Difficulty sitting still
  • Problems with focusing or having a conversation
  • Pacing or shuffling the feet
  • Tension, anxiety, and irritability
  • Wringing the hands or clenching the fists

Symptoms can appear suddenly or over time. They can also range from a nagging sense of unease to aggression.

If agitation leads to impulsive or aggressive behavior, it could result in harm to the person or to others.

Frequent agitation can affect a person’s:

  • Relationships
  • Work or school performance
  • Overall health and safety

Clinical Forms of Agitated Depression

  1. Psychotic agitated depression
    Proposed name: Melancholia
  2. Non-psychotic agitated depression
    Meets the RDC criteria
  3. Excites anxious depression
    Provisional name: Psychic agitation and racing or crowded thoughts.

Reasons of agitated depression

The extensive use of antidepressant drugs in the treatment of all forms of depression makes the question of the real nature of agitated depression a crucial issue because many patients have adverse outcomes, including increased agitation, increased insomnia, increased risk of suicide, and sometimes the onset of psychotic symptoms. 

The main symptoms are depressive mood with marked anxiety, restlessness, and often delusions.

In other cases, psychic agitation and racing or crowded thoughts prevail alongside anxiety and depressed mood. 

Aside from depression and other mental health conditions, agitation may include:

  • Being in a new environment
  • Substance use or withdrawal
  • Having alcohol in the system

Some medical conditions also increase the risk of agitation, such as:

  • Infections, including sepsis
  • dementia
  • Endocrine problems
  • Exposure to toxins
  • Electrolyte imbalance

People with some of these conditions, such as dementia and substance use, may also have depression and anxiety.

How agitated depression is diagnosed?

A psychiatrist can diagnose agitated depression. They’ll do this through talk therapy and observing your mannerisms and mood.

Your doctor may also order a blood test to rule out other potential causes of irritability, like vitamin deficiencies or hormone imbalances.

Your doctor will also rule out other types of depression and bipolar disorder.

Bipolar disorder is often characterized by mood swings and sometimes irritability.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), a diagnosis of agitated depression is based on the following:

  • You have experienced at least one major depressive episode.
  • You have at least two of the following symptoms:
  • Psychomotor agitation, or physical symptoms of agitation and restlessness
  • Racing or crowded thoughts
  • Psychic agitation, or intense inner tension

You doctor may diagnosis you with depression first, and agitated depression later.

Management

Treatment plan of agitated depression varies from person to person.

However, there are some techniques that can be used with the patients of agitated depression. 

Medications

Medications can help stabilize your mood. Your therapist may prescribe one or more of the following:

  • Antidepressants
  • Antianxiety medications
  • Mood stabilizers

In many cases, finding the right medication, dosage, or combination of medications will take some time.

Medications must be used carefully in cases of agitated depression.

They may have the opposite effect on those with agitated depression than on those with typical depression.

Therapy

Psychotherapy is an essential part of treating any type of mood disorder. Your therapist can help you identify your triggers.

They’ll also help you develop coping mechanisms and habits to help you manage your symptoms.

Cognitive behavioral therapy (CBT) is often used for agitated depression.

In CBT, your therapist will have you talk through your problems and feelings.

And you’ll work together on changing thoughts and behaviors.

If needed, your therapist may use de-escalation techniques, such as:

  • speaking in a slow, soft voice
  • giving you space
  • offering you a quiet place to calm down

In many cases, a combination of therapy and medications is the most effective treatment for agitated depression.

Behavioral Activation

Behavioral activation is a technique that helps patients of depression to increase their activities by modifying their routine.

Usually the patients of agitated depression do not involve in activities that once were pleasurable for them.

The purpose of this activity is to change their monotonous pattern of life and to bring them back to life. 

Counseling

A qualified and experienced counselor can help a person identify thoughts and feelings that can signal the start of agitation or depressive symptoms.

Therapy can help a person focus on thoughts and behaviors that can help them feel better when they experience agitated depression.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

Self-help tips

The following tips can help some people when they start to experience agitation:

  • Get some space. For example, go outside for a walk.
  • Talk to a trusted person about any increasing feelings of agitation, as they may be able to help deescalate the situation.
  • Notice thirst, hunger, or any other feelings of discomfort.

Stress relieving techniques

Tips for relieving stress, anxiety, and depression include:

  • Getting enough physical activity
  • Following a healthful diet
  • Practicing good sleep habits
  • Meditating
  • Deep breathing
  • Spending time doing enjoyable activities with friends
  • Gardening or spending time in the open air
  • Journaling

There is no one single way to relieve agitated depression, as each person’s situation will be different. A doctor will likely recommend a variety of approaches, including medication and counseling.

Sometimes, it can take time to find the right combination of medications, therapy, and stress relieving techniques that will help.

A person should persevere with their treatment plan as much as possible, and they should speak to a doctor if they feel that, after giving it a good try, is it not working.

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

FAQs

What is depression?

Depression is more than being sad or feeling grief after a loss.

Depression is a medical condition which affects your thoughts, feelings, physical health and behaviors.

It affects normal day-to-day activities.

Who is at risk of developing depression?

These factors can increase the risk of developing or triggering depression:

– Having relatives with depression

– Being a woman

– Having traumatic experiences as a child

– Having family members who have committed suicide

– Experiencing stressful life events

– Having few friends or other personal relationships

– Recently having given birth (postpartum depression)

– Having a serious illness

– Abusing alcohol or drugs

What do I need to tell my doctor?

– Write down any symptoms you’ve had

– Write down key personal information

– Make a list of all medications you are taking

– Write down questions to ask your doctor

– Take a family member or friend along

How can we treat agitated depression?

Researchers are still looking for consistent treatment options for individuals with agitated depression as the symptoms of agitated depression overlap with other mood disorders. 

However, psychological therapies such as cognitive behavioral therapy can help you cope with the challenges of agitated depression.

Please feel free to comment on the content or ask any questions in the comments section below.

What we recommend for depression

Professional counselling

If you are suffering from depression then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

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