July 13, 2024

Agitated Depression

A person is considered to be suffering from agitated depression if they are restless, irritable and exhibit the normal signs of depression.  Unlike other depressive disorders, the state of agitation is exceptionally severe and can be debilitating.  Overall, it is more likely to occur in elderly or middle aged patients with fewer cases occurring in younger individuals.

Long ago, agitated depression was called melancholia agitate – or roughly translated, an agitated  melancholy.  The name came from the marked difference that patients exhibited.  In many of the major depressive disorders, patients experience a sense of lethargy, sadness and an inability to be motivated.  With agitated depression, patients often report the same sense of melancholy, but may also exhibit signs of anger, irritableness or an unusual feeling of agitation.

Although it does not significantly differ from other major depressive disorders, agitated  depression may actually be misdiagnosed.  It often overlaps with other psychological disorders which make it difficult to accurately diagnose.

Because of this overlap, some psychologists are currently advocating that it be relabeled a subtype of bipolar disorder.  With its drastic mood swings, some psychologists argue, it exhibits more signs of a mixed bipolar episode.  Nonetheless, experts have continued researching the subject.

In 2004, a team of Italian researchers looked into case studies of 336 agitated  patients who had been diagnosed with depression, but not agitated  depression.  They found that the misdiagnosis of depression led to the wrong therapy and treatment process.  Over time, the misdiagnosis hampered patients’ progress and even heightened symptoms.  Psychologists must be careful to correctly diagnosis agitated  depression so that the correct treatment process can be undertaken.

Agitated Depression Symptoms

A sense of agitation is not enough for Agitated  Depressive Disorder to be diagnosed.  Patients must exhibit several of the following symptoms over a period of days to be considered for diagnosis:


  • Motor agitation
  • Pulling or rubbing of hair or clothes
  • Pacing
  • Racing thoughts
  • Psychic agitation
  • Outbursts that may include shouts or complaints
  • Inability to sit still
  • Handwringing
  • Intense inner tension
  • Excessive talking

Patients who suffer from agitated  depression often exhibit feelings of anger, irritation, insomnia, fidgeting or restlessness.  Unlike typical depression, patients will not feel the same sense of fatigue or sadness.

Diagnosis and Treatment for Agitated Depression

Doctors will first try to rule out any other causes such as an infection, vitamin deficiency or hormone imbalance.  They may perform an MRI, X-rays, urine samples or a spinal tap to make sure that the diagnosis is correct.

Many health conditions mimic the same signs as agitated deficiency disorder so doctors are very careful to test for any other causes.  According to the Diagnostic and Statistical Manual of Mental Disorders, if all of the symptoms have been present for at least a week and there are no other causes, a diagnosis of agitated depression may be made.

Once a diagnosis has been made, a  doctor will recommend a treatment plan.  Depending on the patient’s symptoms, the health professional may choose to prescribe antipsychotics, sedatives or anti-depressants.

Patients may also be treated with some form of psychological counseling or therapy.  Often, doctors choose to use psychotherapy alone or with medication to help cure the patient of their agitated  depression.  Combining some form of medication and therapy is generally the most common form of treatment.

Causes of an Agitated Depression Diagnosis

Agitated  depression can be caused by numerous psychiatric or neurological sources.

Bipolar Disorder

The root of agitated  depression may stem from other disorders like schizophrenia, bipolar affective disorder, personality disorder or premenstrual dysphoric disorder.

Drug or Alcohol Use

Some of the patients who suffer from agitated  depression also have problems with drug or alcohol use.  Since drugs or alcohol may be used as an attempt to self-medicate for bipolar disorder or depression, it can in turn lead to a more severe depressive state or a depression episode which can manifest itself as agitated depression.

Central Nervous System Diseases

Central nervous system diseases can increase the likelihood of someone being diagnosed with agitated  depression.  They may have a brain abscess, dementia or a brain tumor.

Additional Causes

Miscellaneous causes include chronic pain, acute diseases or diseases of the heart and lungs.

An ironic cause could be the medications that originally were prescribed to treat typical depression.  Since each person has a slightly different mental and physical chemistry, the treatment for one person may not work for another.  If the wrong depression medication is prescribed for a patient, it may actually serve to increase their feelings of agitation or irritableness and lead to a new diagnosis of agitated  depression.

Environmental Factors

The onset of Agitated  Depression may be triggered by several environmental and lifestyle factors.  A difficult relationship, divorce, chronic illness or loss of a loved one may serve as a catalyst for the disorder.  Likewise, any unwelcome change or ongoing problem at work may start or heighten the symptoms.

anger and depressionPrognosis for Agitated Depression

Patients who have been diagnosed with the disorder should steer clear of any drug such as methamphetamine or cocaine.  Natural solutions like a healthy diet and exercise can help improve the symptoms.  As long as treatment recommendations are followed, the patient can recover and prevent future relapses.

Complications of Agitated Depression Disorder

If this disorder is left untreated or physician’s advice is not followed, it may result in the patient having problems in their work and family life.  Over time, this can lead to the patient engaging in increasingly risky behavior or even result in suicide.

As a condition brought on by a diverse makeup of genetic, environmental and psychological factors, agitated  depression can cause a severe disruption in normal life.  Left untreated, this disorder can become dangerous for the patient and those around them.

Going to a doctor or psychologist is the first step toward recovering completely.  A medical professional can perform tests to discover if agitated  depression is the issue and device a course of treatment.

Since this disorder often overlaps with other psychological or physical disorders, patients should always seek out a professional and not self-diagnose.

Over time, the prognosis for patients is favorable.  As long as the affected patient follows his or her doctor’s advice, an individual affected by agitated depression should be able to recover completely and return to their normal lives.


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