Agitated Depression: Definition, Symptoms, & Treatment

Agitated depression is characterized by intense psychic conflict, distress, irritability, mood swings, and an increase in risky behavior.¹ It is more difficult to treat than regular depression and the complexity of the presentation may result in misdiagnosis. With the right treatment, usually a combination of therapy and medication, relief from symptoms is possible.

Treatment Options for Agitated Depression

Everyone’s experience with depression varies, but agitated depression is notably distressing. It is important to explain all your symptoms to your provider because an accurate diagnosis is important for driving appropriate treatment. Typically, knowing how to treat depression involves a combination of therapy and medication.

Therapy

Depression therapy is most effective when the client feels comfortable with their therapist. A therapist will be able to assess your symptoms and work with you to determine the best course of treatment, but therapies such as CBT for depression and dialectical behavioral therapy (DBT) can be used to address symptoms typical of agitated depression.⁶

It is important to explore your therapy options and various modalities offered, and it can be helpful to use an online therapist directory to begin your search. Check to see if you can schedule consultations with the few therapists that you are most interested in to find out if working together may be a good fit.

Medication

Medication for depression differs from medication to treat agitated depression in that antidepressants appear less effective for a depressive episode with mixed features than pure depression. When treating agitated depression, using an antidepressant alone may worsen symptoms.¹ If you notice new or worsening agitation, restlessness, or thoughts of suicide after beginning antidepressants, talk to your prescriber immediately or reach out to the national suicide prevention lifeline – 800-273-8255.

There is some evidence that mood stabilizers and atypical antipsychotic medications alone or in combination with antidepressants may be beneficial for treating agitated depression.⁷ Additionally, some research points to the use of small doses of neuroleptics, anticonvulsants, and lithium for treating agitated depression.⁸

7 Tips to Deal With Agitated Depression

Managing agitated depression can be challenging. Most of the tips below are focused on ways to counter or calm the agitation that you may be experiencing. It will be important for you to try out a few different strategies and then practice the one or two that work best for you. Practicing at least once a day will help you use the skills when you need them most.

Seven tips for coping with agitated depression include:

1. Follow a Screen-Free Bedtime Routine

A consistent sleep schedule is a key factor for improving mental health. Start by getting a bedtime routine that prepares your body and mind for rest. This might include things like taking a bath or shower, reading a book, listening to calming music, and drinking decaffeinated tea while the lights. Once in bed, you should be ready for sleep and not doing things like checking your phone.

2.  Exercise Regularly

Exercise serves many functions related to mental health and overall wellness. It is a great way to manage stress and use up agitated energy. Regular exercise is helpful for improving sleep and mood. Adding 30 minutes of exercise a few days a week is a great goal if you aren’t already active.

3. Cut Out Caffeine & Energy Drinks

This may seem obvious if you’re feeling agitated, but agitated depression can have other symptoms like difficulty concentrating that might result in the use of caffeine or energy drinks. Try cutting these products out for at least a week to see if some of your symptoms subside.

4. Create a Sensory Soothing Toolkit

Identify one thing that is soothing or pleasant for each of your five senses and gather it all in one place so that when you are feeling down or agitated you can engage in self-soothing. Agitated depression can feel very intense, therefore, using a technique that engages all your senses is a good way to ground yourself.

5.  Explore Relaxation Techniques

Look into guided imagery, progressive relaxation, meditation for depression, relaxed breathing exercises, and other grounding techniques. Try them out to determine which you like the best. Practice it at least once a day when you’re not feeling agitated so that you’re ready to use it under stress.

6. Practice Anger Management

If you’re experiencing agitated depression, you may struggle with how to control anger. Basic tips for anger management are to notice when you’re getting angry and remove yourself from the situation if possible. It’s easier to intervene before you reach the peak of your anger. Identify triggers for your anger. Once you begin to notice signs, then you can implement a relaxation technique you’ve been practicing.

7. Engage In Mindfulness

We often avoid being present when we are experiencing discomfort. With agitated depression, you may be focused on pain from the past or worry about the future. Mindfulness will guide you to be present in the current moment and you can find exercises on all kinds of topics including mindful eating and mindfulness for chronic pain.

Final Thoughts on Agitated Depression

Agitated depression is common and you’re not alone in feeling this way. Finding a therapist and a doctor to help you address your symptoms is the best way to get help. Make sure to emphasize all aspects of your experience when speaking with providers so they can make the proper diagnosis and begin appropriate treatment.

Agitated Depression Infographics