Depression doesn’t always present as lethargy, sadness, or social withdrawal. For some people, especially those with major depressive disorder with mixed features or bipolar disorder, it manifests as intense restlessness, irritability, and bursts of uncharacteristic energy. This state is agitated depression – a complex and often misunderstood condition that can be emotionally and physically exhausting.
What Is Agitated Depression?
Agitated depression is a subtype of major depressive disorder or bipolar depression characterized by the coexistence of depressive symptoms and signs of agitation or overactivity. This overlap can create internal tension that feels overwhelming and unsustainable – like being stuck in an emotional storm that has no clear direction or outlet.
You may be familiar with agitated depression if you frequently experience depressive episodes with mixed features. In other words, you exhibit some symptoms typically associated with mania or hypomania, such as increased energy or irritability, alongside core signs of depression like hopelessness or fatigue.
Signs and Symptoms of Agitation in Depression
Agitation can look different for everyone, but the hallmark behaviors and emotions may last two weeks or longer and often include features like these.
- Pacing or restlessness: Constant movement without a specific purpose, such as walking back and forth or wringing your hands.
- Unusual or exaggerated gesturing: Talking with fast or excessive hand movements.
- Rapid or loud speech: Speaking more quickly and forcefully than normal, often jumping between topics.
- Irritability and impatience: Feeling like you’re on edge, easily angered, or unable to tolerate delays.
- Hyperactivity despite fatigue: Staying physically or mentally active even with very little sleep.
- Fidgeting or nail-biting: Repetitive, nervous behaviors that indicate underlying stress.
- Impulsive behavior: Starting multiple projects or activities at once, with a sense of urgency that feels out of proportion.
- Emotional outbursts: Sudden, unpredictable fits of anger or frustration that seem out of the blue.
These symptoms can make it difficult for you to rest, relax, or engage in daily tasks. People with agitated depression may also become frustrated by their inability to find peace or emotional balance.
What Causes Agitated Depression?
While the exact causes are not fully understood, agitated depression may stem from:
- Imbalanced neurotransmitters like serotonin and dopamine
- A family history of mood disorders or bipolar disorder
- Stressful life events or trauma that destabilize your nervous system
- Unmanaged depression that has developed into a more complex mixed episode
Agitation during depression can be particularly common in people with bipolar disorder, especially those who have rapid cycling or experience more severe mood shifts.
Why It’s Important to Seek Help
Because agitated depression includes symptoms of depression and hypomania, it can increase your risk of impulsive behavior, self-harm, or suicidal ideation. The inner tension and irritability can be so intense that you feel desperate to escape it – sometimes making dangerous or uncharacteristic decisions.
Even if you do not have thoughts of suicide, this condition can still severely disrupt your life, strain your relationships, and make daily functioning feel impossible.
Getting Diagnosed and Treated
A mental health professional can diagnose agitated depression by evaluating your symptoms, medical history, and co-occurring conditions. Treatment often involves a combination approach.
- Therapy: Cognitive behavioral therapy, dialectical behavior therapy, and mindfulness-based approaches are proven ways to regulate your mood, reduce impulsivity, and improve distress tolerance.
- Medication: A doctor might prescribe antidepressants or mood stabilizers based on the source of your agitation.
- Lifestyle strategies: Learning to track your symptoms, maintain healthy sleep routines, and manage stress can be crucial parts of long-term recovery.
Find the Calm Within the Storm
Palm Springs Behavioral Health provides compassionate, evidence-based care for clients who struggle with complex mood disorders like depression and bipolar disorder. Our team will take time to understand the full picture and tailor a treatment plan for your unique emotional and psychological needs.
If you experience unrelieved agitation, restlessness, or emotional chaos, it’s time to talk to a professional. Contact us to schedule a confidential mental health evaluation and start rediscovering your clarity and stability.
