What is agitated depression?

We often associate major depressive disorder (MDD) or depression with sadness, hopelessness, loss of motivation, and low energy. People who are depressed might stop doing things they enjoy and start spending more time alone. All of these experiences are known symptoms of depression. But they aren’t the only ones. 

Some people experience what’s often called agitated depression. It’s not an official diagnosis or condition. But it can be a helpful term to describe a specific pattern of symptoms. People with agitated depression often have many of the more common depression symptoms. But, in addition, they also experience significant agitation, which can include feeling restless, irritable, or increased impulsivity. 

Sometimes, agitated depression can signal the presence of bipolar disorder. Mania, a core symptom of this condition, often includes periods of agitation. Experiences of mania and depression can vary widely. So, it can be hard to tell what’s causing agitation. But, whether your symptoms are due to major depressive disorder (MDD), bipolar disorder, or something else, help is available.

With the right support, you can manage agitation in your mind and body.

Recognizing symptoms of agitated depression

Most people know what it’s like to feel agitated. Agitation can make you feel on edge, jittery, or like you might “snap” at the smallest inconvenience. Experiencing occasional agitation doesn’t mean you have a mental health condition. But if it’s constant and impacting your quality of life or relationships, it could be cause for concern. 

We have a lot to learn about agitated depression. Experts are working to create tools to identify it, but it isn’t always easy to spot. Currently, it’s not something you can be formally diagnosed with. So, how do you know if you have agitated depression? A mental health professional can listen to your concerns and provide an assessment. 

But in the meantime, here are some examples of how it might show up:

• Difficulty concentrating
• Restlessness
• Constant movement or fidgeting
• Sleep problems
• Irritability or limited patience
• Feeling “wired” while also experiencing fatigue
• Increased anxiety
• Rapid talking
• Frustration

Some of these symptoms may also overlap with bipolar disorder, so it’s important to talk to a mental health provider to get clarity on what you’re experiencing.

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What’s known about causes of agitated depression

Researchers are still working to understand the causes of agitated depression. But they’ve identified a few possibilities:

• Brain differences: Research suggests  that agitated depression might be linked to differences in brain activity. Specifically, there was dysregulated communication between the parts of the brain involved in movement, rest, and self-reflection.
• Substance use: People who use cocaine, sedatives, or hallucinogens may be at greater risk for agitated depression. But opioid dependence appears to have the strongest link to agitated depression.
• Medication: Some of the medications frequently used to treat MDD may make agitated depression worse. If you’re taking medication and experiencing increased agitation or having thoughts of harming yourself, contact your provider right away.*

*A note on safety: Agitated depression carries an increased risk of suicidality. If you’re having thoughts of harming yourself, don’t hesitate to ask for help. You can contact the National Suicide and Crisis Lifeline by dialing 988 from any phone. Their counselors will provide confidential support and resources to help keep you safe.

Treatment options for agitated depression

Agitated depression is considered a severe form of depression. So it may require a specific treatment approach. Here’s what that might include:

• Medication: Certain mental health medications have been shown to reduce agitation. But it can take some time for these medications to work and to find the right dose. It’s important to work closely with your provider to figure out what works best for you. 
• Talk therapy: A variety of talk therapies can help you manage agitation. For example, cognitive behavioral therapy (CBT) can effectively treat both MDD and bipolar disorder. CBT can help you identify and interrupt unhelpful thought patterns. It can also help you learn new ways to cope with stress. 
• Self-care: If agitation is affecting your well-being, self-care can help. For example, if you’re feeling tense, try some gentle movement. Go for a walk or do some light stretching. Or, if your mind is racing, try focusing on your breath. A quick breathwork exercise can help you relax.

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People with agitated depression may appear tense, irritable, angry, or restless. It can impact sleep, concentration, and other aspects of daily functioning. Fortunately, these symptoms can be managed with the right support. Therapy, self-care, and medication (if needed) can help you feel calmer, balance your mood, and improve your quality of life.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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