Depression and Anger

Have you ever felt angry at someone but failed to express it, causing you to feel deeply sad? You are not alone.

A core belief of psychodynamic theory for depression is the avoidance of anger (Town et al., 2022, p. 326). Yet, prior research did not address how anger expressed during sessions may help the client. The conception of depression as a psychological condition of inverted anger is a primary principle when working with major depressive disorder (MDD) in psychodynamic therapies (Town et al., 2022, pp. 326–327). Studies have demonstrated that depressed clients often report suppressing anger and turning anger inwards, which correlates with greater levels of depressive symptoms. In their study, Towen et al. (2022) tested the effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for clients that were treatment resistant to depression. The authors aimed to test a psychodynamic theory of change in depression by examining the effect of a client experiencing and talking about feelings of anger during therapy sessions on degrees of depression symptoms at the next therapy session (p. 333). Theirs was the first study to display that in dynamic therapy for MDD, clients experiencing anger in-session positively determines the degree of reduction in depressive symptoms seven days later.

Psychodynamic theory suggests that experiences of real or perceived loss in relationships results in feelings of anger toward the other, and to unbearable guilt (Town et al., 2022). The individual attempts to cope with anger and guilt by directing the anger against the self, causing depressive symptoms. As a result, clients experience persistent irritability, self-reproach, and aggression directed to oneself. Feelings of sadness associated with the loss of a wished-for state may also fail to be appropriately acknowledged. Instead, an individual might experience a persistent state of hopelessness or pathological mourning that stops them from moving forward. A person’s subjective experience of loss and depression is connected to their self–other representations and to characteristics of their personality. The increased number of negative representations of oneself and others, and negative feelings such as anger, are themselves defended against, at high cost to the person.

I practice cognitive-behavioural therapy (CBT), which is also very effective in treating depression. Expressing anger and talking about it in session can help. I’ve had experience with clients who felt anger due to social isolation. By talking about their emotions, they were able to improve. If you feel you could benefit from talking about depression and anger, please reach out to book a free consultation session by emailing me at

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Town, J. M., Falkenström, F., Abbass, A., & Stride, C. (2022). The anger-depression mechanism in dynamic therapy: Experiencing previously avoided anger positively predicts reduction in depression via working alliance and insight. Journal of Counseling Psychology, 69(3), 326–336.