Medical News Today: All you need to know about agitated depression

Depression is a persistent state of feeling hopeless, sad, or helpless. While there are some common symptoms associated with depression, people can experience depression differently.

One such example is agitated depression. Medical experts may also describe agitated depression as anxious depression or distraught depression.

Though agitated depression is not a distinct type of depression, psychiatric professionals recognize that some people have symptoms of depression as well as agitation.


Agitated depression
Depression with agitation, is known as a “mixed episode” of depression.

Mental health professionals use a manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose mental health disorders, including depression.

By using the same criteria, doctors across America can diagnose depressive symptoms in the same way.

For a doctor to diagnose someone with depression, the person must have experienced depressed mood or a loss of interest or pleasure in life (anhedonia) for at least 2 weeks.

Also, a person will also have experienced at least five of the following symptoms:

  • Feelings of sadness, hopelessness, or irritability on a nearly daily basis.
  • Lack of interest or pleasure in activities almost every day.
  • Experiencing significant weight loss or appetite loss that results in weight loss.
  • Difficulty sleeping or sleeping excessively.
  • Experiencing psychomotor agitation, restlessness, or feelings of being “slowed down.”
  • Feeling fatigued or having a lack of energy nearly every day.
  • Feeling worthless or having excessive and unexplained guilt almost every day.
  • Difficulty thinking clearly, concentrating, or making decisions on a daily basis.
  • Experiencing thoughts of death, thinking of harming one’s self, or creating a specific plan for committing suicide.

Agitation is a symptom that can cause a person to experience feelings of uneasiness and anxiety. Some of the symptoms associated with agitation include:

  • angry outbursts
  • clenching fists
  • disruptive behavior
  • excessive talking
  • feeling as if a person cannot sit still or focus
  • pacing or shuffling feet
  • tension
  • wringing of the hands
  • violent outbursts

A person who has agitated depression experiences feelings of helplessness that can make them feel out of control.

As a result, they can then feel hopeless, which may lead to depressive thoughts. Agitation can cause a person with depression to act impulsively. This could cause a person to hurt themselves or others and engage in harmful behavior.

How is agitated depression different from bipolar?

A person with bipolar disorder may experience fluctuating symptoms of depression and mania (an elevated state of being).

Mania is different from agitation because mania causes a person to feel hyper, “high,” or overly energetic. A person may only sleep a couple of hours each night and stay awake for extended periods.

Mania does not feel good or euphoric to every person, but it can to some people.

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women holding hands across table
Depression may be caused by a significant life event, such as the loss of a family member.

Agitation is often a symptom of an underlying mood disorder and is not a condition of its own. The causes of depression itself can be varied and can occur if:

  • the brain does not regulate mood appropriately
  • a person has a family history of depression and is more vulnerable to the condition
  • a person has experienced significant life events that are especially stressful or sad, such as the loss of a family member or divorce
  • a person has several chronic medical problems

Several of these factors can contribute to depression. However, doctors do not know why a person may experience agitated depression.

A person’s temperament that affects their behavior may increase the likelihood that they will experience agitation related to depression.

How is it diagnosed?

Doctors diagnose agitated depression by asking a person to describe the symptoms they are experiencing.

They may ask questions, such as when the symptoms first began, what makes the symptoms better, or what makes the symptoms worse. Sometimes a person’s loved ones may also describe the changes they have observed in a person’s personality.

A doctor will use the criteria from the DSM-5 to diagnose a person with major depressive disorder, but agitated depression is not diagnosed using DSM-5 criteria. A doctor will also try to rule out other similar conditions, including bipolar disorder.

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How is agitated depression treated?

senior man discussing depression with a counsellor
A psychiatrist or other mental health professional may help to treat agitated depression.

Doctors treat agitated depression with a variety of approaches.

In the first instance, a doctor may prescribe medications called sedatives or benzodiazepines.

Examples may include diazepam (Xanax) or lorazepam (Ativan). These medications work quickly to help a person feel calmer and can temporarily relieve agitation.

Additional steps include:

  • Medications to relieve depression: Doctors may prescribe a variety of drugs to relieve depression, including anti-depressants. If a person does not respond to these medicines, a doctor may add another drug or prescribe a different medication type entirely. Examples can include anti-anxiety medications or mood stabilizers.
  • Counseling: Seeing a psychiatrist or other mental health professional can help a person identify thoughts and feelings that can signal the start of agitation or depressive symptoms. Therapy can help a person focus on thoughts and behaviors that can help them feel better when they struggle with agitated depression.
  • Stress-relieving techniques: Relieving stress and depression through physical activity, meditation, deep breathing, and journaling can all help a person cope with feelings agitated depression.

There is no one single solution to treating agitated depression. A doctor must consider a person’s unique symptoms.

They will likely take a variety of approaches, including prescribing medications and recommending therapy.

Sometimes it can take several months or even years for a person to find the right combination of medications, therapy, and stress-relieving techniques that help them live better with their agitated depression.


While there is no cure for agitated depression, there are many treatments that can help a person live a healthier, happier life. Although finding the right combination of treatments can take time, help is available.

If a person experiences suicidal thoughts or thoughts of self-harm, they should seek emergency medical attention. Medical professionals can help identify ways to stabilize the person medically, and reduce the risks of them injuring themselves.

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