Passive Aggression and Depression

Medical Reviewer

The problem with writing about passive aggression in any meaningful way is that it is so common and such a feature of our everyday behavior and personalities that we should really consider it normal. However, it starts to become an issue either when it affects other people in a negative way or it could be considered either as a symptom or a way of masking depression. In this Sharepost I thought I'd begin exploring a few of the features of passive aggression and how this might be associated with depression.

I could easily fill a couple of pages with examples of passive aggression but I guess we all recognize the features as ranging from minor contradictions in behavior (being pleasant when you actually feel irritated) through to more moderate actions (stubbornness, turning up late, indecision) to more significant activities designed to undermine (gossiping, back biting, deliberately making errors) or turning situations sour through bad moods, complaining and sulking. I'd be surprised if anyone reading this hasn't, at some point, used behaviors that in some way reflect these examples.

Some of the symptoms of depression include irritability and intolerance. These are fairly overt symptoms and when other symptoms are taken into consideration everything slots into place. Passive aggression is a masked form of anger expression so sometimes this makes it hard to spot. It's also not entirely clear what its role is in relation to depression so we have something of a chicken and egg situation. Depression is certainly associated with passive aggressive behavior. Stubbornness, evasiveness, complaints of personal misfortune and being misunderstood are all features of depression yet oddly can be combined with apparent helpfulness and pleasantness.

In an ideal world we are assertive enough to say what we feel in a way that isn't intended to be hostile or intimidating. In the real world we are involved in complex power structures that negate such assertiveness no matter how well intended. if we feel unable or incapable of resisting we build up resentment which leads to resistance. True passive aggression is considered by some to be an unconscious mechanism, but by definition this is hard to pin-point and prove.

Within the Diagnostic and Statistics Manual there is in fact a category of personality known as negativistic personality, or passive aggressive personality disorder. Passive aggressive behavior is not considered to be the same as the disorder, which is more ingrained and pervasive. Even so, it remains a hugely controversial diagnostic category and, for the time being at least, finds itself tucked away in the DSM appendix as "criteria sets and axes provided for further study."

Some of the associated literature with passive aggressive personality disorder does make reference to depression. In one example various subtypes of the disorder suggested by Stone* states about a third will have anxiety or depression. Repeated references to anxiety disorders, depressive disorders with agitation, dysphoria and major depressive disorders can also be found in related literature.

Unfortunately some of the most negative of human emotions are associated with passive aggression. Words like sullen, critical, argumentative, resistive, negative, scornful, hostile, spiteful, malicious, vindictive, sour, bitter, add to the list I've already outlined. One thing is for sure, passive aggression is most certainly worthy of more research if we to understand more about its place within depression and the broader human condition.


Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.