What is Agitated Depression? Dealing with Restlessness and Depression

Typical media depictions of depression might lead you to believe that depression only presents as total apathy, sadness, and a lethargy that causes you to want to stay in bed all day. Yet up to 25 percent of people with depression actually experience agitated depression symptoms, which can be quite the opposite.

What is agitated depression, and how do its symptoms differ from other symptoms of depression? Agitated depression occurs most often in people with major depressive disorder, when they are having a major depressive episode. In many ways, these episodes may be similar to a typical major depressive episode, but if you're feeling particularly agitated, it's worth recognizing how that agitation relates to depression and how the right treatment could provide relief from your symptoms.

What Is Agitated Depression?

Agitated depression isn't an official diagnosis; it's simply a way of referring to a major depressive episode with symptoms that relate to agitation. Potential causes of agitated depression generally overlap with those of depression, which may include trauma, recurring stressors, genetic predisposition, or hormonal imbalances such as those caused by thyroid problems.

With agitated depression symptoms, you might find yourself snapping at your partner or feeling restless and frustrated regardless of the circumstances. For instance, a seemingly small stressor, like your roommate not doing the dishes, could cause you to become more upset than the situation warrants. You might feel too depressed to leave your house but also feel anxious and trapped while you are at home. These seemingly conflicting feelings may feel difficult and uncomfortable to reconcile. Other symptoms of agitated depression include irritability (especially over small things), anger, fidgeting, restlessness, pacing, and incessant talking. 

Treatment for Agitated Depression

If the above symptoms seem like they apply to your situation, you may want to consult a doctor, especially if the symptoms are affecting your life significantly. Agitated depression symptoms can be associated with depressive episodes in both unipolar depression (depression without mania, also known as major depressive disorder) and bipolar disorder (characterized by depression and mania), so you will want to consult with a doctor to investigate whether you are experiencing one condition or the other to get a proper medical diagnosis. Agitated depression may also be called depression with mixed features, or a major depressive episode in which both manic symptoms and depressive symptoms occur.

Treatment for agitated depression usually includes medication, talk therapy, or some combination thereof. While a major depressive disorder diagnosis is generally treated with antidepressants, agitated depression—especially if it accompanies a bipolar diagnosis—may be treated with mood stabilizers, antipsychotics or anti-anxiety medications. A mood stabilizer can help to reduce the drastic swings between lethargy and agitation, while an anti-anxiety medication can provide some relief from the physical symptoms of anxiety or agitation, such as tense muscles or a racing heartbeat. Cognitive behavioral therapy (CBT) may also be used to find healthier ways of coping with irritation.

If you have tried one or several medications and haven't found relief yet, there is good reason to remain hopeful and persist in your search for a working treatment. In fact, only about 30% of people find the right medication for them on the first try. In some cases, your current medication might even be causing your agitation, which could mean that a different treatment may be better for you.



There are also options you could consider beyond medication. For example, transcranial magnetic stimulation, or TMS, is a treatment that has proven effective for many people who still experience depression symptoms after trying medication and talk therapy treatments. With TMS, magnetic pulses gently stimulate regions of the brain responsible for regulating mood. Unlike other non-medication treatment options, TMS is non-invasive, and the sessions tend to be short, with each one lasting only 30 minutes or less. Another bonus of TMS is that the side effects are minimal and usually dissipate quickly after the session. Agitated depression can feel like an inner tug-of-war, but the condition is treatable. With the right treatment, you can find relief from your depression symptoms and enjoy a more peaceful life.