After languishing for years in the shadows of psychiatry’s definition of adult depression, irritability is finally getting some respect again. It’s about time, you might say. A new study has found that people suffering a major depressive episode who reported that they have become grouchy, hostile, grumpy, argumentative, foul-tempered or angry will likely have a “more complex, chronic and severe form of major depressive disorder than those who do not acknowledge irritable feelings and behaviors.

We’re not talking about a small minority of the depressed either: in a 30 year study of 536 subjects who first presented with depression, 54% acknowledge irritability in feelings and behavior.

Compared with merely sad, guilt-ridden and lethargic, the irritable depressed and more severe depressive symptoms. They stayed depressed longer. They relapsed more often and they were more likely to experience other psychiatric conditions as well, including anxiety and substance abuse disorders, impulse-control problems and antisocial behavior, the study showed.

The difference between the two groups was so stark as to suggest that major depression with overt/irritability/anger might be diagnosed and treated as a distinct form of the disorder, requiring more intensive treatment.

The study began in 1978 with 536 adult Americans in 5 U.S. cities researchers interviewed subjects about their symptoms twice a year for the first five years and at least once a year thereafter for an average of more than 16 years. More than 45% of the subjects were followed for more than 20 years.

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Related articles

• Angry? Irritable? It Could Be Depression (aarp.org)
• Depression ‘second leading cause of disability worldwide’ (medicalnewstoday.com)
• Study: Depression marked by irritability has more severe symptoms (sacbee.com)