If a man is experiencing the anger and aggression you mention, it would be a good idea to get a psychiatric evaluation (already I see men running in the opposite direction) from a well-regarded psychiatrist. There are many forms of bipolar disorder, and low mania (hypomania) may manifest itself with black moods coupled with bursts of energy.
The problem is that many antidepressants, in particular the SSRIs like paxil will destabilize and intensify the mood shifts from depression to hypomania or mania.
Primary care physicians are only too happy to prescribe antidepressants, but they are not qualified to distinguish among similar psychiatric brain dysfunctions. Even psychiatrists are not all good at diagnosing them.
Anger and aggression may well come from family experience, and can come from both that and manic phases, but it takes a gifted diagnostician to tell. Go to the psych department of a medical school if you need to, or get a referral from them. You can also consult the "Top Docs" lists published in many cities.
I emphasize this after spending a year going backwards when I allowed my family doctor to give me prozac. Eventually my sister told me that her psychiatrist had begun to think that she had bipolar, not unipolar, depression. Then I read everything I could find and took my care into my own hands.
Then depression was the overused diagnosis, now bipolar disorder seems to be so widely diagnosed that you have to wonder how accurate those physicians may be. You have the right to see the best there is, even if it's only one visit and a referral to someone on that doctor's list.
Dear John, Merely Me and all, I speak for Ireland here. It is a medical fact that men are inclined to drink as a way to try and hide the pain of Depression, also violence and younger men lash out at themselves - via suicide. Women tend to go to the Doctor and receive Antidepressants or Counselling. They seem to have more self awareness. I think there is still a 'Depression is a womens thing - Hormones' this is changing but slowly.. very slowly. When I was studying Counselling I can remember the psycologist saying that women [when depressed] are full of Sadness, under all that Sadness there is alot of Anger. Men are exactly the opposite, They are Angry, hitting out towards co workers, wives, partners, and underneath all the Anger there's dreadful Sadness.
This makes sense to me and I know I have anger way way down there.. it comes up as agitation during bad Depression, also dreadful sadness and 'if only' unbearable grief regarding life, the world and myself and what I did with my life. The Anger also comes up against myself by hating myself, how I look etc.,
Hi, Survivor -
I've asked psychiatrists about whether the anger and acting-out could be a sign of bipolar, and - while mania can certainly take that form - they've always told me that in my case it's consistent with depression. I agree that depression came to be an overused diagnosis - partly because the DSM criteria for major depression are so minimal and partly - I believe - because drug companies have so widely publicized the idea along with their message that their meds can make you happy. But the bipolar diagnosis - I think - is overused in the same way - especially for children - and the powerful drugs to treat it are now being taken by more and more people. It definitely makes me wonder about the accuracy of the diagnostic categories. The newer thinking about a spectrum for degrees of depression and bipolar makes much more sense to me.
Thanks for raising the issue.
John
Hi, Rose -
I do think anger is a part of anyone's depression - though, as you say it can be buried deep and mostly surface through attacks on oneself - battering self-esteem, ultimately turning you against your own life. It's hard for me to understand how these things come together in the experience of depression, but I know it makes sense to me too that the sadness and anger go together, whichever happens to be on the surface.
John
I showed this article to my husband who suffers from depression. It was uncanny timing because we had just had a terrible argument. Finally when things were calmer, he said it seems that my reality doesn't matter. What is your response to that statement? Thanks so much!
Hi, Dee -
Before trying to comment, I'd need to know more about that statement - are you quoting him, i.e. that it's his reality that doesn't matter? to you? Also - does he acknowledge he's depressed and get treatment for it? In any case, I always found that a conversation about my depression with my wife usually started with her saying something about my depressed behavior and me angrily denying depression had anything to do with it. It's hard to discuss without getting into an argument. We have found it much easier to listen to each other if we can check out the assumptions we're making about each other. There's a model for doing that - starting with what you observe factually, explaining how you interpret what you see/hear and then asking if that interpretation is right. The idea is to stop yourself from jumping to a conclusion and then shooting back with a reaction of anger or hurt, etc. To do that, though, you have to be pretty relaxed.
If you'd like to share more about this, you could either do it here or in an email or message. I'd be happy to see if there's anything I could offer.
John
This sounds like a gross generality. I am a man who has been fighting Double D for the last 50 years as a result of a severe choldhood infection that came very close to killing me.
I do not blame others during a Major Episode. I invariably consider myself a loser (although a successful businessman) who is not worthy of what I have. I did turn to alcohol and have been in AA for 7 years.
All humans have a different genetic make up and saying women are this and men are that could have some credibility when talking about the averages in large groups but it would appear the author is overreaching in his generalizations. Each patient has to be treated individually and these kinds of sweeping generalizations could have a negative effect on individual patients. As we all know some doctors dial into this sort of thing and develop a one-size-fits-all mentality.
JLK .
Hello, JLK -
You're so right that a one-size-fits-all explanation never works - and treatment by any reputable mental health provider has to be responsive to the individual, not just a list of symptoms. As I mentioned in this post, I've experienced both sets of symptoms at different times. I've found this line of research interesting, though, because it did make me aware that the anger I was putting out was part of depression. Over the last ten or fifteen years, the blaming of others has abated and I've thrown all the anger at myself. I think anger is what drives the constant tearing down of self-esteem and talent and judging everything I do as wrong. The other reason this research and especially Terrence Real's book have been helpful is that they're talking not so much about the whole person but about the influence of the social roles of "men" and "women." To some extent we all feel that influence as it relates to the types and intensity of emotion that men and women are expected to display. Hopefully, those stereotypes are getting out of date, but that social level is one part of the many dimensions that contribute to illnesses like depression.
Thanks for the corrective.
John
Hi John
Appreciate the measured respose. I am always on the lookout for the latest fad in treating psychiatric disorders because they are distorted by the lay press and usually end up doing more harm than good.
I am a strong believer in starting with medications to stabilize the patient because without that you cannot reach them. Then you can use logical strategies to improve the patients life. (I work with people who have serious disorders and refuse to see shrinks) These problems are for the most part, incurable, and the sooner the patient accepts that the better. But improving their lives is eminently possible.
I am also a strong sceptic on Freudian-style-forever counseling. The brain's chemical structure can be changed by therapy but over an infinitely long period of time.
As for my disorder, it is also permanent. So I have to take an ever-changing (adjusting would be more accurate) drug cocktail to keep going as my problem gets worse with age. I was lucky to finally find a Psychiatrist who specializes in psychotropic med therapy.
In a nutshell that is why I react strongly to studies that make these kinds of generalities. But thanks for your input, more knowledge is ALWAYS better
JLK
PS I will try the book. It could help with some of the strtegies I am developing for my "patients"
I can relate to alot of what you brought out. I often blame my wife and daughter, a teenager for screwing things up with me. I often feel angry and enraged, but I haven't acted out on these emotions. So I bottle things up inside and try to figure out how to move forward. I just got a new job and it's starting to get stressful. Doing a "good job" comes first so I don't show my feelings. I read the book you mentioned by Terance something and will probably reread it. Keep up the good work!
I'm sorry that you're feeling such anger and also have to keep it bottled up. Sometimes family therapy can straighten out the complicated and misunderstood feelings in these intense relationships at home. It's so easy to feel let down, ignored, hurt - and so hard to talk openly about the feelings themselves.
My best wishes to you.
John
John,
Thanks for writing so much about your own personal experiences. Misplaced anger was a clue for you to see your own depression. A. Beck mentions that in his book, Feeling Good. Taking responsibility for our own emotions through CBT is good exercise for clearing our thought life. But the impact of more generalized depression must not come from mismanaged emotions. The pattern you mention of burying expression of emotion may be closer to the what, among other things set you on a lousy path. I suspect there are much stronger determinants than either of these behaviors, though that congealed an outright extended depressive experience for yourself. Men, though not formally educated in handling emotions in our generation, have had the benefit of role models that can operate effectively without succumbing to abnormality (as if depression is not normal). What I believe throws a man into depression is blindness to his inadequate patterns for handling his full spectrum of emotional gifts, whether it is misplaced anger, substance abuse, chemical imbalance, physiological circuitry, or distorted personality traits. When a man, or woman, understands their shortcomings
they generally can at least cope with their symptoms. It doesn't help that physicians are not trained to refer patients sooner for psychological evauluations than prescribe
antidepressants to an ignorant consumer.
Hi, Ricovring -
That's a great thought about blindness to inadequate ways of handling the full range of emotional gifts. Men so often think of emotions as problems rather than gifts. They also face a lot of social pressure not to let them be fully expressed. The burying of emotion does cause them to emerge in distorted ways. For me, there was often fear behind the anger - but anger is something men feel freer to express than fear.
Thanks for your comment.
John
I found the artical true when it comes to men and depression. Men tend to act rather than withdraw. I have to add that I find that not working as a large stressor to depression as a man. I have spoken to women that say in comparison they feel the lack of friendship or strained relationships as a stressor.
Step by step...with help...it gets better.
Keep the faith
Hello -
I can well understand the stress of not working. So much of the sense of self-worth comes from work. For me, it was often a way of compensating for the feeling that I had little value on my own and needed a professional role to feel justified. I've found the stress of working at the wrong job even worse than not working at all.
I hope you can find work soon that will reduce that stress.
John
My husband is suffering from depression and is so angry and hateful. It is truly intolerable. I don't want to walk away from him but just don't know how much more I can take.
I'm really sorry you're having to live with such anger and hurtful behavior from your husband. I think it's important to let him know what your limits are at a time when emotions are running so high. My wife did that and demanded that I get treatment - I really had to listen!
I hope this improves soon.
John
Dear John and All,
I have a led a life with minimal to no anger outbursts or inner anger. Such a calm persona had often been mentioned to me and about me in affectionate ways. However, about three years ago or so I lashed out in a verbal diatribe at my wife. She was shocked and probably even a bit scared. Upon reflection, I could not understand where it came from. About six months later, I went to see a therapist because I had found myself getting overtly angry more and more often. I didn't understand it. Because of the needs of work and life in general (he says), I didn't continue with therapy, but I am considering to go back now. John's post made me aware that my depression, that I have been aware of, encompasses my anger instead of producing it. My last outburst...about three weeks ago...was in front of my 5 year old son. His frightened face helped wake me up to the need for action.
Thank you for this topic.
My husband went into a major depression about a year after his parents both died, 15 years ago. He has been on anti-depressants since then and in therapy on and off. There were years in there when, while he was under treatment for depression, he was not actively depressed. Right now he is depressed again, and has been for most of the past year, and he has just realized it in the past few weeks. I have been through a horrid year of worrying about him, wondering what was wrong with him, blaming him. It astonishes me how long it takes me to recognize the symptoms of depression in him. His anger and explosiveness, isolation, exhaustion, and withdrawal are all things that I have seen before, that got better when his depression was properly treated.
We are in the midst of some hard times in our family. Our business failed in the bad economy and both my husband and I have had to return to our former work that we did before going into business. Both of us have had to catch up professionally after some years out of our industries, and build contacts all over again, and live through a couple of years with next to no income. We have been living on savings that are nearly gone. I have a lot of health problems myself, some serious chronic conditions that made it questionable whether I could work full time. I have a tendency towards anxiety, and have been depressed myself on and off. I have finally found some good treatments, and my anxiety is under good control for the first time.
I have finally found some steady work, but my husband hasn't yet. He has been out of therapy for about a year now, which he did because we could hardly afford the sessions, but he has become increasingly isolated. He has been doing free-lance work and looking for a full-time job, but has trouble waking up in the morning, trouble staying focused, and trouble doing the thing that will probably help him the most in his job search - reaching out and being in contact with people. It's a vicious cycle. The depression gets in the way of his ability to work and find work, which reinforces the depression, and in the meantime we keep moving closer to running out of money.
My husband was also becoming more and more explosive and verbally abusive a few months ago. Without realizing he was depressed I finally sat down and told him very clearly how much he was hurting me and the kids and that it had to stop, and he really took that to heart and has controlled his anger. Maybe the loss of that outlet helped him see his own depression, because it was after that that he started talking about being depressed again.
I realize I'm writing a book here, and I thank you for the opportunity. Your article really spoke to me - I recognized so much about our situation and my husband's disease in what you wrote. I am upset with myself that I didn't recognize his depression sooner and try to help him with that, instead of going into a long period of doubting and blaming him. I'm trying not to blame myself, since that doesn't help, and I have been dealing with an awful lot myself as well. Our family is under so much stress it's really incredible. Knowing what is going on with him certainly gives me some hope - he is talking to his doctor about changing the anti-depressant and we will see what we can manage about getting him some therapy again.
I just needed to come here and share. I hope maybe he will come use this site as well.
Men often experience depression in different than women, and may be different ways of addressing the symptoms. Men are more likely to recognize that fatigue, irritability, loss of interest in pleasurable activities once, and sleep disorders, while women are more likely to admit feelings of sadness, worthlessness and / or excessive guilt.
Men are more likely than women to use alcohol or drugs when they are depressed, or become frustrated, discouraged, irritable, angry and sometimes violent. Some men throw themselves into their work to avoid talking about their depression with family or friends, or engaging in reckless, risky behavior.
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Hey John!
There is so much here to digest but this is simply an excellent topic and one that I have wondered about...are men and women more alike or more different in how their depression may manifest? I wonder too...does your temperament come into play? Do introverts experience depression differently than extraverts...it almost seems like women turn inward and men...lash out? Is that too much of a stereotype?
For me...anger is a part of my depression but it is more contained rage...it is a self blaming anger. It seems easier to take it out on myself than to look for any external causes. It does seem that it is still more socially condoned for women to cry than men but I think this is changing somewhat. What do you think? I think women are more prone to be people pleasers and worry about whether they will be liked or loved despite their depression.
I am hoping others will drop by for this discussion. There is just so much to say!
Thank you for writing this...and sharing so much of your personal experience. Can't wait to hear other commenters.
Hi, Merely Me -
The generalizations about men and women are helpful, but of course don't tell the whole story of any individual. Personality seems important, but I don't read much about it in most books on the subject - except for Martin Seligman. He attributes depression to a basic orientation of pessimism, and his version of cognitive therapy is based on learning optimism as a cure. But he sticks to his categories and doesn't take the full personality into account. The fact that I'm an introverted, intuitive type must make some difference in the way I think and feel about depression - but since depression started in early childhood I'm not sure if it influenced the development of my personality even more than personality influenced the way I experienced depression??? People are so complicated that I find it hard to pull out one strand without tugging everything else along with it.
Thanks for your comment and encouragement.
John