Beware of a diagnosis with aggression

Question: What is aggressive depression and how can it be treated?


Depression is best understood as a broad spectrum of psychological conditions ranging from ‘the blues” through normal responses to grief and trauma, to major depressive disorders such as clinical depression. Clinical depression is diagnosed when there is no obvious external cause sufficient to explain the subsequent response.
The term ‘aggressive/anxiety depression” was coined by the Dutch psychiatrist Herman van Praag in 1996. It is a proposed subtype of depression but the term is not in general use.
The exact nature and cause of the wide-ranging condition known collectively as depression is subject to a variety of interpretations. The work of organisations such as beyondblue is important in raising awareness but it should not be supposed that all forms of aberrant human behaviour are inherently due to depression in one form or another.
The Panel is of the view that aggression in any form is not excusable. There is a danger that the proliferation of diagnostic categories used to describe certain responses can run the risk of providing justification for behaviours (for example, domestic violence) that are unacceptable in any circumstances. If a person excuses their violence on the basis that they are suffering from ‘aggressive depression”, this is unacceptable.
Treatment for depression can include a range of psychological therapies designed to reduce stress and improve self-efficacy, or psychoactive medications that enhance or inhibit chemicals in the brain that are out of balance.
However, the exact mechanisms of the cause and effect of depression are still open to debate. Does aggression cause depression or depression cause aggression? A biopsychosocial approach is most likely to be successful in treating such a complex multi-factorial condition.
Treatment is best sought from professionals specifically trained in the management of depression.

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