Depression comes in other forms

WE

tend to think of depression as a condition of sadness. The depressed person has low energy, sleeps a lot, and may tear up easily. The condition leads to a joyless, unmotivated existence — even the will to live may dwindle. What we may not always recognize is that depression can take a very different form.

Unhappiness

Depression can also be characterized by a state of active agitation. In this form, the depressed person has plenty of energy, but it’s mostly negative in nature.

Depression can manifest as an inefficient thinking process where the sufferer has trouble making decisions, understanding information, learning new skills, sustaining attention, and remembering. We routinely see these deficits in the “shutdown” forms of depression.

In agitated depression, the person has trouble concentrating as well, but rather than being caused by slowness and fog, the difficulty is brought on by an overactive or racing mind, frustrating rumination, or mental hyperactivity (the mind is flitting all over the place in an agitated, distractible, scattered, or overwhelmed state).

Emotions are intensely affected by depression. In “shutdown depression,” the person feels dead inside, joyless, often numb or empty. In agitated depression, the person feels actively displeased or annoyed by almost everything. We often see this in children who seem to have a million complaints interspersed with relatively few periods of relaxed happiness. We also see it in adults who are fault-finders — people who are constantly criticizing, complaining, and otherwise searching for problems both large and small.

Energy is another area dramatically affected by depressed mood. As we’ve seen, the shutdown type of depression causes people to experience lethargy, slow movements, and exhaustion. However, the agitated type of depression can cause a form of hyperactivity that can keep one from falling or staying asleep or cause one to make excessive physical movements (e.g., fidgeting, nail-biting, skin picking, pulling on clothing). The discomfort of the physical agitation can also lead a person to “self-medicate” through drugs or alcohol, attempting to bring relief, but instead usually aggravating the condition.

The social behavior of the person in “shutdown depression” is, as we’ve seen, withdrawn and isolated. This person doesn’t want to make the effort to reach out to friends, doesn’t want to talk or text, and certainly doesn’t want to see people. The person may also withdraw from family relationships, keeping thoughts and feelings inside instead of sharing.

In agitated depression, the person is often unpleasant to those closest to him. He may be able to behave appropriately to peers while barking at spouse and children or, in the case of a child, fighting with parents and siblings. Those with agitated depression seem to “pick fights” with family members and have trouble seeing the good and letting things pass.

In “shutdown depression” a person’s spiritual behavior is also affected. The person may withdraw from Hashem just as intensely as he has withdrawn from other relationships. Similarly, in the agitated form of depression, the person may be just as angry at Hashem as he is at everyone else.

Addressing Agitated Depression

Sad-style depressions are fairly easy to identify. Grumpy, irritable, agitated depressions, on the other hand, are often mistaken for bad attitudes, anxious and/or angry states, or even bad character. The first step in healing agitated depressions is accurately identifying the condition. Parents of chronically complaining children and spouses of steadily sour partners can compassionately aim their loved ones toward primary care doctors for diagnosis and referrals for treatment.

Meanwhile, there are some at-home interventions that can be used as well. For instance, the interventions that help improve “regular” depressed mood will also help agitated depression: regular exercise, meaningful spiritual activities (learning that enhances a positive mindset as well as intentional prayer), nutriceuticals (vitamins, foods, herbs, etc., prescribed by functional medicine practitioners and naturopaths), changes in diet (see Trudy Scott’s “Anti-anxiety Food Solution” for example), Bach Flower Remedies (for agitated depression consider Impatiens, Beech, and Agrimony for starters), engrossing hobbies, and any other activity or process that fosters positivity and joy. All depressions require this kind of input alongside medical and psychological treatments for a full recovery.

(Originally featured in Family First, Issue 872)