Depression, with its many types and causes, is a complex subject. While most discussion focuses on either bipolar disorder or major depressive disorder (MDD), which is sometimes called "unipolar" depression, clinical references are also made to "agitated depression." However, researchers do not agree on how to classify it---in particular, whether it is related to MDD or strictly to bipolar. Specialists at the University of Rome consider mental and physical agitation to be "equally important" for defining agitated depression. A study at the University of California, La Jolla, found a strong "link with the bipolar spectrum," based on studies of family history. While a great deal of of work in this area remains to be done, most contemporary researchers appear to be moving away from connecting agitated depression to MDD.
Many of the symptoms of agitated depression can be signs of other disorders. Always consult a qualified medical professional for a competent diagnosis.
Physical Symptoms
Some physical symptoms typically seen in patients with agitated depression include wringing of hands, pacing or wandering, strong vocal outbursts, nonstop talking and an unwillingness to sit still. In some cases, the manifestation of tension extends to pulling or rubbing one's skin, hair or clothing.
Nonphysical Symptoms
In addition to physical symptoms, sufferers of agitated depression exhibit internal anxiousness and restlessness. This can be accompanied by difficulty in precisely defining their fears or problems.
Treatment Challenges
A University of California, La Jolla, study refers to a common "failure to recognize the bipolar nature" of agitated depression, and a resulting possibility of prescribing ineffective or even hazardous drug treatments generally used with MDD sufferers. The University of Rome study concludes that "treating agitated depression with antidepressants worsens the clinical picture," instead advocating electroconvulsive therapy (ECT), neuroleptics and anticonvulsants. Other professionals claim success in treating agitated depression with psychotherapy, often in combination with drugs.
Suicide Risk
A study cited in the Journal of Affective Disorders noted that reported increases in suicidal behavior among agitated depression sufferers are likely related to prescribing antidepressant drugs in error, because of an "unrecognized bipolar mixed state." However, the report recognizes that this idea cannot be proven without conclusive testing of the risks of suicide among MDD patients taking antidepressants. These tests are impossible, since no one wants to put test subjects at risk for actual temptation of suicide.
