Depression and expressing anger
August 1, 2018 9:22 PM   Subscribe

I started a new medication recently that I believe is lowering my anger threshold. I'm looking for experience and thoughts on a specific perspective given to me by a relative.

You are not a doctor, you are not a therapist, etc.

I've been on the new antidepressants for a little less than 2 months. Over the past week or so, I've noticed I'm quicker to stress out about things that irritate me (people talking loudly in the office) or get frustrated with interactions that are less than satisfying (hard, as dealing with cranky/unresponsive people is most of my job). I'm pretty sure these heightened responses are related to the meds as "getting pissy" is not generally how I respond to daily/minor inconveniences. It's not worth the emotional energy. However controlling my temper all day is making me tired. Tl;dr this is NOT USUAL for me.

I mentioned the above to a relative. This relative talked about how dhe perceived depression as anger turned on the self and wondered if externalizing it may helpful. She mentioned that a friend had gone through something similar -- the friend had processed and let her anger out in unexpected ways.

Friends, does this seem reasonable or applicable? Do you have any experience with depression-related anger? Is getting mad about inconsiderate coworkers a way to focus anger on something other than myself, and if so, is that ultimately better? Is this a bad patient/medicine combination? Please talk to me about your experiences with depression and anger.

(For the record: I already have a followup dr appointment and I'm not getting aggro enough to hurt others/myself. Capping a temper all day is just tiring as heck.)
posted by snerson to Health & Fitness (18 answers total) 2 users marked this as a favorite
Irritability is the first symptom I get on my way to a mixed episode. Are you sure you have unipolar depression? If you are actually on the bipolar spectrum, this medication may not be for you. Consult your doctor.

Exercise can help with irritability in the meantime.
posted by crazycanuck at 9:50 PM on August 1, 2018 [1 favorite]

This happened to me when my doctor switched me to a higher dose of Wellbutrin. I became so angry at things like dropping a kitchen utensil that I would throw it at the wall and scream! Totally unlike me. It got worse and worse until a few months in I realized I was having a ... psychotic break of sorts? I couldn’t function. I started having hallucinations at night. Panic attacks all day. I wanted to die, it was so painful.

I went straight to the doctor, she switched my meds and the anger went away as well as the untreated depression.

You should reach out to your doctor ASAP. Don’t suffer like I did for any longer. Your dose might be too strong or the med isn’t working for you. There are other meds out there that work differently.
posted by joan_holloway at 9:55 PM on August 1, 2018 [14 favorites]

Wellbutrin (bupropion) made me angry, in a way that is out-of-character for me: a need to physically vent. Something that would have been merely annoying made me want to punch walls. I went to sleep and woke up angry at the world in general.

Some drugs have a rebound effect, as they start to wear off for the day - amphetamines in particular do this. If there's a timing component, that might be worth looking at as well.
posted by ApathyGirl at 9:58 PM on August 1, 2018 [5 favorites]

Wellbutrin (if that's what you're taking) can exacerbate anxiety in some people. What you're describing sounds a lot like anxiety to me.
posted by praemunire at 10:43 PM on August 1, 2018 [4 favorites]

Zoloft made me angry. Sooo not fun.
posted by luckynerd at 11:02 PM on August 1, 2018

I absolutely do think that for me being angry with myself is both a symptom and a cause of depression. It's a vicious cycle that is part of the larger phenomenon known as the Mousewheel of Doom. It goes basically like this: I feel crappy and awful. Why am I feeling so crappy and awful, my life is great compared to so many other people's lives, I have no right to feel crappy and awful, I am a bad person and DESERVE to feel crappy and awful. [Then I start feeling even more crappy and awful and then comes the anger bit.] Why am I STILL feeling crappy and awful?! I hate myself for feeling crappy and awful when I have no real reason to feel this bad! I am such a waste of space! Look at that stupid [insert physical characteristic or personality quirk here, anything will do], it's [disgusting/infuriating/otherwise angry-making].... I'm running out of energy to describe it now, but I think you get the overall idea. Because of course, getting angry at myself doesn't make me feel any better, it makes me feel worse which then exacerbates the anger and squeak-squeak-squeak goes the mousewheel of doom.

However! Getting angry at your coworkers for making noise is not a helpful alternative to the mousewheel. If you also have internally-directed anger, turning it into a firehose that you use to blast everyone around you isn't so great either, and as you say, restraining that amount of internal pressure is exhausting. I get that part too. For me I don't think it's a constant side-effect of my meds, just a thing that happens sometimes.

If it is a constant thing, you should absolutely talk to the doc about it. I don't think it's very sustainable.
posted by Athanassiel at 11:40 PM on August 1, 2018 [3 favorites]

Me on Wellbutrin, twice. I cried with rage while I was driving because of THE GODDAMN SUN IN MY EYES. That bright celestial motherfucker! This might not be the drug for you.

(I pulled off and called my psychiatrist.)
posted by chesty_a_arthur at 3:30 AM on August 2, 2018 [8 favorites]

An alternative perspective: what your relative said may be true, depending on the degree. I am on methylphenidate (Ritalin): I do find it makes me more likely to have an angry outburst, but so far, all of that "venting" has been productive in that's it's helped bring to light longstanding problems in relationships or made me realize that I'm putting up with crap that I don't need to put up with. Keep in mind that I have a history of repressing emotions and "keeping the peace" in ways I recognize as unhealthy; YMMV.

What this lowered threshold hasn't done, though, is make it difficult to get through the day because of irritability — no road rage, frustration at everyday problems you can't fix or change, etc. If that's where it is at for you, I would think that yeah, it would take a detrimental amount of emotional energy to control that.

tldr; if you are the type of person who tends to repress or ignore your emotions, a lowered threshold for anger might help bring some things to light. If it's a level of irritation that's interfering with your daily function, then no, that seems like an intolerable side effect.
posted by fire, water, earth, air at 3:49 AM on August 2, 2018 [6 favorites]

This relative talked about how dhe perceived depression as anger turned on the self

I think that's an ancient psychoanalytic theory that has become part of pop psychology folklore; I have no idea if it's considered to have any credibility by people who know what they are talking about.
posted by thelonius at 4:38 AM on August 2, 2018 [2 favorites]

I reacted this way to Xanax; apparently it's not common but a known potential reaction.
posted by restless_nomad at 4:50 AM on August 2, 2018

Yeah I’m not sure about that theory. Kind of, I guess, if you think of depression as resignation after frustration. But I don’t think what’s happening with you is that the meds are improving things and releasing latent anger... it sounds much more like this medication isn’t working for you.

My anecdote is that on Paxil, my empathy dropped significantly, as did my inhibition (and response to art fwiw), while my apathy increased. It looked like me saying whatever TF I wanted to whomever and not giving a shit. It also felt like that.
posted by cotton dress sock at 5:36 AM on August 2, 2018 [1 favorite]

Popped in to say that this happened to me on Wellbutrin. I'd look for another antidepressant.
posted by Dressed to Kill at 7:43 AM on August 2, 2018

My one experience with antidepressants was a brief stint on Wellbutrin. I was very quick to anger on it, which is uncharacteristic for me. 17th-ing what everybody else said.

I quit cold turkey. Got a couple of what I can only describe as "brain zaps" after I quit. Obviously follow your doctor's recommendation for slowly coming off of it instead.
posted by clawsoon at 8:09 AM on August 2, 2018

The anger theory works for some people, it doesn't resonate for me. Depression is a physical illness and a mental condition. The medication is literally generating anger; I don't think it's releasing hidden anger, I think it's physiological. With some nuance. Sometimes anti-depressants allow you to start feeling better and having more energy, and the anger and pain might be right there, and the increased energy lets it out. Some people attempt suicide when they begin to feel better because they have the energy to act on the urge that was already there. So, be careful about that. Your doctor absolutely needs to take this seriously.

A brisk walk can help channel some of the angry energy. Good luck, this is hard.
posted by theora55 at 9:35 AM on August 2, 2018

I'm on Wellbutrin as well, and noticed I would get FURIOUS when my PMS started. The doc put me on a low dose of Prozac as well and that seemed to help a lot.
posted by The otter lady at 11:30 AM on August 2, 2018

Thank you all so, so much for sharing your thoughts and experiences with me. I'm not actually on wellbutrin but a low dose of buspirone. I've rarely heard good things about wellbutrin, so when my pcp suggested it, I opted for buspirone instead.

A side-effect of reading your responses made me realize that I'm not exactly angry per se, more just a ball of anxious energy that's looking for convenient outs. It's also probably connected to my increased anxiety about leaving my apartment (because I won't have a parking spot within 50 feet of my apartment when I get back, and this is obviously a life-and-death concern. thanks brain). So trying something else is definitely in the cards. This is my first time dinking around with my meds, so hearing about your experiences makes me feel better and braver about trying new solutions.
posted by snerson at 1:44 PM on August 2, 2018

Oddly, Buspar is FDA approved for anxiety, not for depression (though used off-label for it, I don't think many people would use it as a first-line anti-depressant). But keep trying. A lot of people have to shuffle through a few drugs til they find one that works. Good luck!
posted by praemunire at 3:22 PM on August 2, 2018

I'm not exactly angry per se, more just a ball of anxious energy that's looking for convenient outs.

The restlessness could be part of a side effect known as akithisia. You might read up on akithisia and see if that rings true for you.
posted by mermaidcafe at 9:39 PM on August 2, 2018

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