Why am I depressed? Anger and Aggression as Another Cause of Depression:

The goal of this brief commentary is to provide you with a slightly different understanding of depression, a perspective that you may not necessarily find in your usual internet search. I would like to build upon my earlier article and look at anger and aggression as another cause of depression. It is important to put my bias up front, I am a trained psychoanalyst, so the perspective I take is solely from a psychodynamic orientation which is built upon my educational background and years of clinical experience.

What Causes Depression? Anger & Aggression?

What causes depression is a very complicated question with many answers. Depression can sometimes be triggered by a traumatic event such as the death of a loved one, a break-up or divorce or any abrupt and unanticipated changed circumstance. The real problem, however, lies in the individual’s inability to accept the loss. Unlike many people who suffer a devastating loss, the fact that something is over, or has permanently changed, can be both frustrating and infuriating. The feeling (which may or may not be conscious) is that someone took something away from me, and therefore they, or someone, has to pay. Someone has to suffer, much like I am suffering.

One way to ensure someone is suffering is to let them know, remind them constantly and continuously, that you are in pain. More importantly, it needs to be made clear that there is nothing they can say, no advice they can give, or support they can offer that can ameliorate the suffering. The goal, which is not intended, is to upset or frustrate the other person in an attempt to make them feel responsible for your suffering.

Anger and its Link to an Empty Feeling

Another way to punish someone is to be critical, devalue, and diminish them. This can play out internally (in one’s mind) or one may behave overtly aggressive. When you criticize and devalue a loved one, or in many situations anything of value, such as a compliment, a promotion, or a piece of advice, the important people around you begin to lose their status and value. In fact, everything, the compliments, advice, promotion, etc. all begin to lose their value. These devaluations and attacks have very serious consequences on one’s self-esteem. For instance, if you devalue your job, or partner, your own self-representation as someone connected to a devalued job/other can leave you feeling like a failure and in turn this increases the depression. ??

When one attacks and devalues in this aggressive way, and denigrates anything of value, this leads to the destruction of any possibility for love and connection. If this vicious cycle of attack, denigration, judgement, and criticism is not broken you can be left with an inner world devoid of meaningful, valued, and loving emotions. It is not uncommon, in fact, that I hear many depressed patients complain of an incredibly painful and visceral feeling that something is missing, there is a void of some sort, they tell me, as they point to the empty space they feel in their chest or upper stomach.???

The aggression, anger and subjugation are sometimes directed against oneself. Aggression in the form of continuous self-criticism deteriorates the representation of the self and has a negative impact on one’s capacity to function in a productive way. If hatred of oneself consumes much of your energy and mental space in an internal war this drains all motivation and interest in life and therefore prohibits any movement towards a more fulfilling existence.?

One Treatment Approach: The Act of Containment

In my work with depressed patients the main goal is to help them begin to examine and think about what they are feeling.?The fact that one is depressed indicates that while they know something is wrong, they are not yet able to deal with the feelings that are causing the depression. In other words, rather than deal with the feelings and solve the problem, for instance, some depressed patients will get angry and critical. It is far more complicated and requires more technical tact when the anger comes out indirectly in the form of pouting, whining, and complaining about how most things in life are of little value. With this in mind, the first step entails “containment,” which means I have to help this kind of patient express his anger more directly. Containment does NOT mean sitting around passively listening to all of the complaints. It is an active process, and when it goes accordingly the anger can be expressed more directly. This has valuable consequences and sets the therapeutic stage for the next level of intervention. This act of containment, an active way of working with these patients, and the next treatment steps are so important that it will require its own separate article, which will be coming soon.

Wrapping it Up

If you or someone you know suffers with this kind of angry depression it is important to keep in mind that the depression, anger, and criticisms may be just the manifest level of the problem. More genuine and true feelings that are too overwhelming and therefore difficult to see and process are pushed away with anger and judgements.?Treatment, that will have a lasting impact, allow one to get to these more complicated and painful feelings. If you have any questions about this commentary or if you or someone you know suffers with this kind of angry depression feel free to reach out.??