Is Anger Depression Turned Outward?
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The Sociology of Pathology
If you read, you're probably aware that clinical depression is currently at epidemic levels. Right now, about 17.5 million Americans are affected by some form of depression. Women are roughly twice as likely to develop the disease, and increasingly depression is beginning to hit children and adolescents as well.
At the same time, antidepressant medications are being more and more widely prescribed, even for mild or situational depression (like grief related to an actual death or tragedy, or a passing period of stress that is tied to an actual but transitory situation).
Between 1988 and 1994, the use of antidepressant drugs nearly tripled. According to the CDC, between 1994 and 2002, the use of antidepressant drugs rose again by 48%.Today antidepressants are the most commonly prescribed drugs in America (the second most common class of prescription is high blood pressure medication).
Out of the 2.4 billion drugs that were prescribed in 2005, 118 million were antidepressants.
17.5 million Americans with depression, 118 million prescriptions in a single year.
While many psychiatrists and mental health professionals cheer this development, believing that those numbers reflect the actual prevalence of the disease in the general population, and a more vigorous (and warranted) response to it, that is, by any count, a hell of a lot of drugs.
Antidepressants are now widely believed to be the treatment of choice for the epidemic illness of depression, which, before the advent of effective antidepressant drugs was often referred to in psychotherapeutic circles as "anger turned inward."
Now, before I launch into this, let me clarify what I'm NOT saying here:
- I'm not saying antidepressant medications are 'bad'. No, in fact they can literally be lifesaving. Depression is a dangerous illness, especially major depression, which puts the sufferer at very high risk for all manner of other serious illnesses, such as heart disease, cancer, and worst of all, suicide. So I'm not saying let's chuck antidepressant drugs and gut it out.
- I'm not saying stop taking your antidepressant drugs. That would irresponsible and insane on my part. I'm not a doctor. If you have been prescribed these drugs, PLEASE keep taking them. If you have concerns, talk to your doctor, not me.
- I'm not saying depression isn't real or that it isn't serious. It's very real. It's very serious. It can be crippling and sometimes fatal. I speak from experience here, so it's personal, not theoretical.
Having made these disclaimers however, I have been wondering for some time now how an emotional pathology could attain such epidemic proportions that it is now approaching the 'norm' for working people in America. The question now is not, "Have you been diagnosed with depression?" but "What kind of depression have you been diagnosed with?" or "Which drugs are you on?" or "Who's your shrink?" or "You need a diagnosis so we can get you on meds."
You get my drift.
How many people do you know personally who are currently on antidepressant meds and are actively in treatment for the disease?
How ever many people you think you know (and it is probably quite a few), double that, and that might come close to how many people actually you know. You probably still know more people than that. It isn't as if everyone wants to chat about it. A stigma remains.
But here's the thought that dogs me:
If depression is anger turned inward to the point it makes people ill, is anger depression turned outward? Is anger pathological or necessary? If we have a population plagued by depression, do we also have a population unable to appropriately express legitimate anger? If we were able to listen to anger before it becomes pathology, could we prevent both depression (or at least some depression) and the kind of workplace and family meltdowns we've recently been seeing all too often (usually committed by men who have been let go or laid off)?
If we medicate legitimate anger (turned inward), are we not (maybe) perpetuating the very social conditions that are contributing to the depression epidemic?
These are not easy questions. We don't really know what causes depression. We know that depression causes changes in brain chemistry, but this is not a full explanation. Eating brownies causes changes in brain chemistry. Having sex causes changes in brain chemistry. Almost anything a human being does or feels causes changes in brain chemistry.
So yes, we can treat the brain chemistry with meds now that change it back to 'good' brain chemistry, and this is helpful for many, many people who suffer with this debilitating illness. That's good. But we still don't understand why so many of us come down with it, or why doctors seem to be passing meds out willy nilly to people who are overly stressed at work or in the midst of marital problems or just lost a spouse.
What if some cases of depression are triggered (sic: caused) by social conditions that are extremely toxic and provoke anger that cannot be expressed without severe negative consequences? If that is the case, wouldn't it be better if we changed those social conditions wherever possible so as to avoid pushing people into a major psychiatric illness?
I personally believe our lifestyle in America has become quite insane. We ask people to sit in front of computer screens for 10-12 hours per day in 4x4 foot grey cubicles under unbelievably stressful conditions, feed them poison, give them too much to do at home, not enough rest, no time with family or friends or just to relax and be who they are, push them to produce more and more for less and less money, and then medicate them when they become depressed or ill so they can keep right on doing that.
I'm not saying all depression is caused by such social factors.There are many kinds of depression. Some are hereditary, some are clearly unrelated to the environment.
I don't want to oversimplify the issue.
I'm just saying, maybe we could stand to do a thorough review of how we live as a society, and have an open and real discussion of how we want to live; especially now that so many of us are out of work and in touch with our anger anyway.
I have the sense that anger is not something we know how to deal with right now on a social level; and that more than that, we don't want to hear it or see it at all in certain groups. That is perhaps why women are depressed at twice the rate of men: it's less acceptable for women to be angry at all much less express anger. As a society, we tend to drive anger inside some people more than others, where it festers and turns into disease.
Maybe, instead of rushing to medicate anger away, we ought to listen to it.
Maybe it would tell us where we need to go.
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Comments
I agree...solve the root of the problem and you solve the problem...funny thing is that I think the same powers that be that encourage the anger are connected to the ones who medicate the anger that has become depression...
Having sufferered from major depression, I strongly agree with you about the anger part. You're especially right about women being less likely to get angry as men, because I really believe that is what contributed to my illness. My inablility to let myself get angry and I still struggle with it, despite therapy. I guess our social conditioning teaches women to be the calm ones or the peacemakers and we end up getting trapped in that image.
Another point I'd like to make is I do believe many people in this country are overly medicated or diagnosed inadequately. The truth is there's not enough behavioral health professionals to helped them, so it's left up to primary care doctors, Physician Assistants or Nurse Practioners. I'm not doubting the compentency of these professionals, I just believe it should be experienced psychiatrists or licensed therapists who should make the evaluations, diagnoses and treatment. Great article.
Thanks Patty for your comment.
Enlydia, I agree: The same people causing the anger are making money off the drugs and from medicating the problem so people will stay in bad situations and be 'compliant,' but I still think that we can choose to make a stink instead of just putting up with it. Or, failing that, we can just choose to take care of ourselves and get what we need even if it means making major changes. Thanks for commenting!
D Cortez--I have similar issues myself. I've been on antidepressants and I've successfully taken myself off of them. I also struggle with expressing instead of stuffing anger. Just learning to ACKNOWLEDGE anger has been a big part of feeling better and getting and staying well. But I don't think we as women are encouraged to do this. It's only after trying everything else that we realize how important it is. Thank you for being so candid and for sharing your experience.
I love this statement: "If we medicate legitimate anger (turned inward), are we not (maybe) perpetuating the very social conditions that are contributing to the depression epidemic? "
You're right. I've been looking at the stressors in an "average" or "normal" life and agree with this -- and so do many mental health professionals if they're any good at it.
It's a lot socially safer to displace anger and perpetuate abuse than it is to confront the reasons for the anger. A person who's abused at work and perceives him or herself as economically dependent on that job is going to wind up enduring it badly, not admitting anything's wrong there, come home and start complaining about their spouse's fat rear end or micromanage areas of personal life and bring that cycle home -- and then from there that aggravated spouse brings it into the next workplace to poison it with behaviors that have now become normal and accepted in both offices, thus impacting other people's marriages.
Kids being kids will test boundaries and find out they dissolve under pressure but get imposed arbitrarily in unlivable ways, that the rules of how to live depend much more on Mommy or Daddy's mood than on anything they actually do. So they carry it on and their behavior goes into school, where it gets reinforced by how prevalent it is.
Good therapists and psychiatrists insist that drugs are only effective when combined with therapy to deal with the actual problems -- the conflicts that depressive behavior causes. Because depressed people do lash out. The same person who can't face her real anger at the unlivably bullying supervisor is going to feel self righteous about her mate's dropping laundry on the bathroom floor and go on a full moral righteous crusade against a minor bad habit instead of anything that'd be effective in resolving that problem, like discussing it reasonably as a pattern and working out something that'll make it livable -- including a compromise that may mean picking up that laundry but getting a concession in another area as appreciation for that. Or giving a concession on video gaming in order to get cooperation on the laundry, or his taking on the laundry chore himself and not complaining about the way he does it which includes picking it up when he's ready to do it.
People growing up in abusive families have no patterns for reasonable egalitarian living-together. They both have patterns that show abuse is the familiar and therefore secure way to get along with people and get on the Dysfunctional Waltz. It's not always the workplace that starts it -- it can start at home with a subordinate's coming from an abuse home and passing on the pattern to a supervisor by driving them round the bend with passive-aggression and successful social displacement. Granted that passive-aggressive joker may manipulate well enough to get promoted and beat a competent supervisor in rank rapidly, then boot them out because their habits make the abuser look bad. Then wail about being the victim of the abuse of course.
Abuse propagates itself as a repeating pattern, a meme, a social virus. Alcohol and substance addiction is perceived socially as allowing this pattern of behavior pure. Become a drunk and you have blotted out your problems -- and solved them, because now you can become an abuser without many more social consequences. All your bad habits get attributed to the drink and everyone around you will adapt to it and you need the drink to cope with how rotten life is because your codependent enablers are picking on you constantly when it's their turn in the Victim-Persecutor-Rescuer dance.
I don't think it's the substance that does it. I don't think the drugs do much on their own except for biological depression, where they work miracles -- but the patterns of abuse and displaced anger and bullying are there in what's left of society when all culture is stripped away.
America is not a culture, it's a superstate.
People have too much to do at home. Absolutely. They also have too little to do at home and very little purpose to what they do at home. I can look into an abuse-pattern household and see pure ignorance at work too -- one gender-conflict pattern that goes on constantly in marriages and may be the kernel of real conflict that breaks them is something I hope, honestly hope well trained marriage counselors can spot.
My daughter and son in law, by being good at conflict resolution and mature enough to apply it in their marriage, discovered it. He was raised as a traditional male, mommy did all the women's work in the house, he doesn't believe that's right... and a lifetime of skills that my daughter got from her mother and evolved to cope with her mother's perfectionism, she is an extremely good housekeeper, led to her being unhappy with his results every time he honestly tried to keep up his end of the chores.
He didn't know how to do them and the big public social perception is that housekeeping is a no-brainer that requires no training. Most guys that learn it do so in the military where a slightly simplified, rote, consistent version of cleaning and self care skills gets taught to all the recruits in Basic and generally sticks with them throughout life. This can make life a bit easier for women who marry military men but carry the opposite logistic -- he's used to it being A Certain Way, specifically The Army Way and she grew up a civilian with her own set of skills and ways of doing things that she's expected to abandon in order to live with the military man.
He expects to rank her because he's the man and then tries to do so outside his expertise. Whether he's capable of it or not. The military man can sometimes make the military wife feel useless with that self sufficiency, since she may not actually be better than he is at the skills that this culture defines as a major element of womanhood. Unless he actually is a drill sergeant, he doesn't know how to teach those skills either.
You rarely get people admitting that the problem is the housework and how much time it takes and that they could actually just brainstorm a shared goal of making it as easy and fast as possible so they can get on with things they'd rather be doing.
And this is where culture and the lack of it come in -- because these two people who married, military or not, are going to be coming from different cultures, are foreign to each other, are not speaking to half their respective families for sanity's sake (it is healthier to cut off an abusive household in many many cases, you can endanger your marriage by too-close contact with an abusive in-law) and the domestic warfare reaches a pitch where work, even with a bad boss, is a refuge from going home long before the divorce comes.
My generation was ethnically different from our parents. Their ways of life didn't fit the world in the sixties and we did form a mass movement, we did make profound changes in society. I have to laugh sometimes to hear a serious conservative going on about things and not mention that he or she would have been a flaming radical when I was a kid and suspected of being a Commie.
Social values have shifted to an amazing degree. Technology changes the patterns of living -- and some conveniences make life harder while seeming to make it easier. I don't spend a lot of time on the phone to reduce stress. I had to be brutal in eliminating stressors from my life because I like to be able to function. I've got fibromyalgia so the dubious benefits of any stressor that doesn't help me function are not worth the cost.
Television commercials take that desperately needed relaxation time and turn it into something where after the kids have gone to bed, the story you are following is interrupted every two or three minutes by a screaming, demanding change of topic with the relentlessness of a stubborn toddler. It's easy to have consumer resistance and reject the immediate content of the commercial -- no, we can't afford Red Lobster -- but seeing that and four other food com
Brilliant! Can you hear me applauding... You have hit the nail on the head. Several years ago, I was grieving over the lost of my grandfather. He was the first close relative that passed away and I was learning how to grieve. It was difficult time and I was single at the time, so i did not have a partner to share what I was feeling with. I didn't feel like burdening my friends with my grief. After about 3 months of not being able to share the deep sadness that I was feeling, I decided to go to the doctor to talk with her about how I was feeling. She immediately prescribed antidrepression medications. I got the medication but decided not to take them. I opened up to other family members who were also going through similar feelings. I chuck the meds and went to the gym.
You are so right, while medication is great to treat depression, I believe other options should be explored. We are all different so what works for one may not for another.
Thanks for addressing such a pertinent and important matter especially in light of our current economical situation.
Brilliant Hub. I do beleive that if used in a proper way, anger can help you achieve alot what you desire, because the fire within is neccessary to succeed in life
Great hub Pam. It reminds me of the famous line from Network with Peter Finch: "I'm mad as hell and I'm not going to take it any more." You're not just churning these out are you? You're coming up with some really interesting stuff at the same time. How many is this now?
You have my vote. You know my views. Anger turned inward - totally. Why do we get angry? Because for whatever reason we are not able to achieve or attempt to achieve something we want to. If the drive of our own will is tempered continually toward something we do not want, and feel we are unable to get - we go against our innate sense of worth. Someone or something else is getting the use of our bodies, and soul, and we seem not able to take back control. Anger is that socially unaccepted emotion, along with hate. 'I hate my job, but best I not get angry about it', which creates hurt. But what can I do about it? Feelings of uselessness or hopelessness lead to depression. The two emotions - hate and anger - are not socially acceptable and as a species we have not been taught or given the proper playground or environment to deal with them. It has to change before we become complete zombies. I bet that at the crux of the depression epidemic is that the will of someone else is overpowering your own will and you feel useless to deal with it. The giving up is the pit we rest in. That on top of our diets and environmental pollution is the mix for our ever increasing dependence or solace on drugs.
Imagine if we all god as mad as hell and didn't take it any more!
robert--excellent points as always, thank you. Perfectionism is a curse for a lot of women. Your thought put me in mind of my mom going batshit and throwing shoes and schoolbooks and what not up the stairs in a meltdown over someone leaving something somewhere she didn't want it. She was such a perfectionist when it came to housework and it was so maddening that her daughters all went the other way with it, reacting against that. At this age, my home is somewhat orderly but not all that clean on any given day. It wouldn't scare small children but Better Homes & Gardens isn't rushing out here either any time soon. Bill and I pick up together when company is on the way. But it took three divorces to get it right, so I'm hardly one to brag. Thanks for your thoughts. :0
Dynamics--Thank you for sharing that. That's exactly the kind of example I was thinking of. Grief is totally normal, but as a society we don't want to even think about death--it's kind of taboo. We don't know how to act, we don't know how to support someone going through it. Even the Victorians gave you a time to wear black, so there was SOME structure for it, some recognition that you were in a special space with limited expectations. Thanks for your insight.
Jay--I think that is so true. Anger is just energy, and the key is what you do with it. If you just tamp it down or deny it, you lose your fire, your real self.
CJ--I'm up to 16 and already seriously questioning my decision. It keeps me busy though. Thanks for stopping in and looking this over! I love that Peter Finch scene in Network. It's about time for a national reenactment I think.
Jewels--Yes I think compliance is overrated. Sometimes I think "Brave New World" is already here. The world now is so different from the world I grew up in--and so surreal. It's not all good. Thank you for taking the time to voice your thoughts and support.
“What if some cases of depression are triggered (sic: caused) by social conditions that are extremely toxic and provoke anger that cannot be expressed without severe negative consequences? If that is the case, wouldn't it be better if we changed those social conditions wherever possible so as to avoid pushing people into a major psychiatric illness?”
You’ve found the core, the root, of not all but most of the problem. The society we have created is driving everyone nuts!
That’s no joke. There are so many fundamental ills, toxic conditions as you so accurately put it, built into the consumerist/capitalist paradigm that the effects are pandemic.
The situation is further exacerbated by the unconditional drive for profit pushing physicians and pharmaceutical corporations to actually foster conditions that perpetuate the need for the flood of drugs on the market.
This in turn, since it only addresses symptoms and not causes, adds to the pressures and increases the incidence of both anger and depression.
It becomes a self-perpetuating cycle created and sustained by the profit motive and the consumer culture it has spawned.
There’s no escaping the conclusion that the worship of wealth and power is the source of our dilemma and may well become the cause of our demise.
Hi CWB--Yeah that's kind of how I've been thinking about it. When I saw "Sicko" what freaked my out the most wasn't how expensive or uncaring our health care system has become--I mean, everybody knows that regardless of their political leanings. What freaked me out was seeing how more humane the lifestyle in other countries is--the stuff about France was especially depressing. If France can treat its citizens like human beings why can't we? I don't think it's asking so much, really. Thanks for your thoughts.
By the way, fantastic graphic. Where did you find it?
Flickr.com--I find a lot of stuff there. You can search for Creative Commons stuff at Flickr that is ok-ed for commercial use. Wikimedia has lots of good free stuff too. Sometimes I steal stuff I just find at Google under an image search even though I know it's not kosher. I am an image thief. There, now everyone know. :o
This is a good point. I have depression and Borderline Personality Disorder and on medication. I know many of the reasons behind my condition. I also know however that medication is not going to fix everything!!!! I think sometimes people want to take a pill and everything to be magically all better. I kind of did that with therapy so I'm not excluding myself. I just know that people also have to make choices.
I think I agree with the anger part - a lot of my "issues" are tied to anger. The environment I grew up on didn't really teach me to ways to express a range of emotions and now I struggle with anger. I'm a little different because of the bpd so I'm not sure I can comment strictly on depression.
I also appreciated your "disclaimers" because when I first saw the title and read a little I thought that I was going to read another article reducing my existence to being a lazy attention seeker. You did not do that. I just wish more people realized that drugs aren't going to fix everything! I have learned things that won't fix it. I have been/am (its been 12 days!) a cutter. I have done sleeping pills. I have tried everything to hide from the world. The meds only get me so far - make a choice! And to me this doesnt demean me or lessen the problem at all - its just part of it and part of life.
Okay so I have some pretty strong feelings about this and kind of got on a soap box there....hope it even makes sense:)
Thanks for the hub!
Thank you so much for your insight - this is from someone has had a loved one diagnosed for depression and then had the psychiatrist try every anti-depressant under the sun and recommended ECT as well when none of them affected the illness. Anger is at the root of many cases of depression - the lack of coping skills learned to deal effectively with anger and the general standards and restrictions that our society has placed on being able to express ANY emotion except in a PC manner has created this - IMHO. Thanks for giving me more insight into what my loved one is dealing with.
Hi SarahMichelle--Thank you for sharing your story. The treatment of mental illness cycles between mostly therapy and mostly pharmaceuticcals, and we are deep into a 'mostly pharmaceuticals' phase. Good mental health care was pretty much gutted by the Republican domination of the government for the past 30 years, and of course they love Big Pharma, so now we're all on drugs. I know what you say is exactly right--both are needed for most kinds of depression, and drugs without therapy are just harmful IMO. Too many GPs are dispensing psychotropic drugs like they were aspirin and not really listening or probing on what's really going on in their patient's lives. Write a scrip for Paxil today, see that patient in the cardiac ward next year--when talking it out, recommending a good therapist, and making some personal changes and better choices are really what's in order. And you're right, it's by no means easy to make better choices. I've used therapy extensively in my life and credit it with whatever sanity I've been able to retain. Thank you for your comments and your honestly.
Hi Nanny JOAT--Depression can be very hard to treat. Lots of people respond to drugs very well, but few keep working over time, which is why so often a good therapist who can help the person make changes is the key. Now therapy is more short term and action-oriented--there's not as much of this "Tell me about when you were five" stuff, and it can help tremendously. Thanks for sharing and all the best to you.
The therapy work I do involves allot of regression. It's amazing what stems from our early attempts at surviving in this world! I wish some fundamental survival skills were taught in schools. Not about being good and loving everyone, but what to do, how to act. And just plain have it explained that the world is a jungle and you may get trampled by elephants. I must have been really stupid cause I missed allot of stuff watching Disney Land.
Hi Jewels--Yes, it's weird how childhood is often portrayed as this innocent lovely time when for many of us it's just brutal. It doesn't help that, like is so often said, you need a license to buy a gun or a dog but anyone can go out and have a child, take it home, and barely get it to adulthood in one piece. And then here in the U.S., we don't even help people who need help parenting--we just call them names now, which as you know is not overly effective. Thanks for your thoughts.
Excellent hub, Pam. I specifically looked for hubs on depression and yours was the first I came across. Very well defined in all areas including chemical imbalance as well as situational. For women, the problem may be hormonal as well.
I'm in a crisis with my son at the moment. He's not in trouble - in fact he has a great wife, son, another on the way in July, great in-laws and a beautiful house.
An unexpected bombshell was dropped on me by email after I came home from a week's visit. In my innocence I thought everything was fine. He's had past hurts from me and I guess having his own son brought them back. I thought we'd worked them out many years ago.
I have some silly Hub friends who don't know about this situation but their comments on my stories and their general, happy attitude is helpful. I'm at a loss but have to know that it's his anger coming out. I'm glad for that.
The timing is a little weird. I don't feel welcome though he said differently at the end of the email. It felt simply patronizing.
Again, thanks for the wonderfully, insightful Hub.
Hi Jamie--That is a very tough situation. I think kids all go through this, and having a child can definitely yank out weird feelings toward parents. I can tell you though that when my daughter had a son, over time her anger toward me diminished because she saw how hard it really is. It was gradual, but we are quite close now.
I don't know what will happen with your son, but I do know when my kids have been upset with me, letting them just get it out and letting them know I loved them helped over time--if not immediately.
All the best to you on this. I know it's hard. I appreciate you taking a risk and sharing it here. Life is just hard sometimes isn't it? God, it really is.
Bravo Pam - a wonderfully written hub. You have made some interesting points that I will think further about and share with friends. I come from a family with Bipolar issues - so clinical depression is close to heart as is mania, but in that mix are family members with rage. I have always been more peaceful - rarely angry - I did not understand that expression until my hormones started to create havoc during perimenopause. Wow, anger is powerful and once I go through the burn I end in tears.
Some answered my request differently and did not see the connection. Thanks for making that connection with Anger and Depression and also for pointing out the real cause which I think is the way we live in our overly civilized, technological, easy existences that go beyond night fall.
Thanks Reggie, I'm glad there was something in there for you. Bipolar issues are tough. You sound like a pretty smart lady. All the best to you!
Anger is a powerful tool when directed in a positive way!
Sometimes listening to an angry depressed individual can be nauseating and emotionally defeating. Some of their negative emotions/abuse can affect your psyche.Listening has to be done in small doses to maintain your sanity and well-being. Then, there is the danger of not listening or saying words that will trigger a dangerous situation.
Patty Inglish, MS says:
7 months ago
Yes, I think anger can be well used to change bad situations.