My last hospitalization for depression happened after a suicide attempt. My primary nurse kept asked me what I was angry about. She was insistent that I must have been angry about something to have tried to kill myself. She seemed annoyed when I assured her that no, I wasn’t angry, and anger had nothing to do with anything.
She wasn’t the only nurse with weird ideas; another thought I was depressed because I was single. I dismissed the anger as a random quirky belief, but I later discovered that depression as anger turned inward is actually a thing.
By actually a thing, I mean that it’s a belief that’s been around for a while. According to an article in Psychology Today1, Freud characterized melancholia (aka depression) as anger turned inward in self-reproach and self-attack.
A journal article by Busch, written from a psychodynamic perspective, has this to say:
Anger in people with depression often stems from narcissistic vulnerability, a sensitivity to perceived or actual loss or rejection. These angry reactions cause intrapsychic conflicts through the onset of guilt and the fear that angry feelings will disrupt relationships. These conflicts lead to anger being directed inwards, further lowering self-esteem, creating a vicious cycle.
While narcissistic vulnerability is probably part of the psychoanalytic/psychodynamic bread and butter, I’m not sure it’s really all that palatable for the casual reader.
My personal take on Freud is that his ideas were a weird mix of both good and out there. While it seems reasonable that anger turned inward could be an experience that some people with depression have, I don’t buy it across the board. Then again, I’m not a fan of ideas that reduce any mental illness to something that occurs just one way.
In an article on The Mighty, Lily Greunewald described her own experience of anger turned inwards in depression. She likened it to having her illness tell her that she’s worthless, her actions are pointless, and she deserves to be punished. When she was able to recognize that the anger was coming from her depression’s voice, she could step back from it. She wrote:
It’s OK to be angry sometimes, to feel passionately opposed to someone or something but staying angry at yourself will just reinforce everything depression wants you to believe. It will probably take a lot more hard work for me to exercise anger in an outward, healthy way but for now I am going to try to forgive myself and quiet that voice when it shouts at me again.
It’s not up to me to judge her experience, but Greuenwald’s description struck me as more suggestive of shame than anger per se. A quick Google search shows that anger and shame often comingle, and one may be projected as the other. Still, on an intuitive level, a depression–shame connection seems to make more sense in my mind than a depression–anger connection.
And then there’s me
For me, shame isn’t much of an issue. Guilt can be problematic sometimes, but I have a well-established level of comfort with myself that doesn’t leave much room for shame. I’m a pretty logical person, and while emotions aren’t logical, I tend to think that if I’m going to be angry, I’d rather direct it outwardly. Also, I don’t particularly like people, so that helps.
I have flare-ups of intense irritability sometimes when I’m depressed, and there will be a stream of annoyance that comes spewing out of me. Combine this with being in hospital and having my autonomy taken away, and I’m too busy yelling and swearing and having shit fits directed at other people to have any anger left to be directing inward. While irritability can certainly be a symptom of depression, it’s also a fit with my usual tendency to attribute difficult situations to external causes unless there’s a clear reason to do otherwise. Whether that’s good or bad is debatable, but it does tend to keep shame and inward anger at bay.
I can see the depression–anger connection being an issue if were was a lot of anger directed at a particular person, but for whatever reason it was impossible and/or unacceptable to express the anger, and also impossible to change the situation. And really, if it’s helpful for anybody to frame their illness that way, whatever works is a good thing.
So, if depression and inwardly turned anger are doing a tango, what can help? An article in Psychology Today2 on the role of anger in depression suggested that self-compassion and adaptive outward expression of anger are helpful. Sounds reasonable enough.
I’m just not seeing a connection between anger and depression in myself. Is that connection something that resonates for you?
- Busch, F. N. (2009). Anger and depression. Advances in Psychiatric Treatment, 15(4), 271-278.
- Psychology Today (1): The perplexing notion of depression as “anger turned inward”
- Psychology Today (2): The role of anger in depression
- The Mighty: When I realized that depression was my anger turned inwards