Trigger warning: This article includes themes of suicide, self-harm and depressive thoughts.
I'm a manic depressive. Getting out of bed most days is a chore, at weekends I sit at home staring at the wall for hours at a time, sometimes I even forget to eat. And every so often, usually once a fortnight, I fly into a blind rage over the smallest of things.
Growing up, I was pretty angry. I spent the first few years of my life in the care system before being adopted, and carried my childhood trauma into adulthood. During adolescence, my fits of rage (throwing furniture, swearing, screaming) were dismissed as teenage angst, my inability to empathise with anyone put down to being an egocentric teenager.
In the mid-2000s, mental health issues weren't talked about as much as they are now. My family had never considered mental illness as the cause of my behaviour, despite the fact I self-harmed at the age of 14. It wasn't until I was raped, five years later, that my mental state was finally acknowledged. I became a recluse for six months. I didn't eat or speak to anyone and I tried to end my life multiple times.
I had directed all of my anger inwards, trying to harm myself at any given opportunity as punishment for what had happened to me. Yet fast-forward seven years and I'm still here (hurrah) and wondering why the connection was never made between my anger and depression.
According to Dr Dimitrios Paschos, consultant psychiatrist at Re:Cognition Health, depression and anger work in tandem. "It is often said depression is 'rage spread thinly' and there is some evidence that depression is a significant factor in young male violence. But there are certain mental health conditions that can make explosive anger outbursts more likely." Dr Paschos says these outbursts can be episodic, for example in bipolar affective disorder.
It is often said depression is 'rage spread thinly' and certain mental health conditions can make explosive anger outbursts more likely.
Dr Dimitrios Paschos, Psychiatrist
Rakhi Chand, a psychotherapist based in east London and an accredited member of the British Association for Counselling and Psychotherapy, agrees: "Often depression is linked to feeling powerless, and anger is useful for this."
Chand adds: "The link between the two emotions is even messier and exacerbated in expectations of women, and it's unlikely to be worked through in a healthy way, and eventually leads to depression."
Over the years, we've seen women's anger dismissed time and time again. When Serena Williams broke her tennis racket and called the umpire a "thief" in response to her US Open defeat in 2018, the 'angry black woman' trope re-emerged and Williams was fined £13,000 for her behaviour. It's not the first time a woman of colour has had their emotions policed. Michelle Obama has been accused by right-wing press of having a "chip on her shoulder" and earlier this month the UK Labour MP Rosena Allin-Khan, who is an A&E doctor, was told to "watch her tone" by the health secretary, Matt Hancock. Her response? "If Matt Hancock found [my tone] difficult, that's on him." Right on.
On television, angry women are finally being depicted in thoughtful and nuanced ways. In Netflix's Dead To Me we meet recent widow Jen (Christina Applegate) whose intense grief and unfortunate circumstances fuel her anger. Her emotions manifest as everything from scream-crying to shouting at her neighbour and clients, and even the mistreatment of her new friend Judy (Linda Cardellini).
Elsewhere, Paramore's Hayley Williams recently addressed her rage, which was often expressed through her music. In an interview with The Guardian in March, Williams admitted that she didn't want other people to be able to use her anger as ammunition. "It's not becoming, you know?" she said. "One of my biggest healing moments was realising that a lot of my depression was misplaced anger. I really forced it inward, on myself, and it made me feel shame all the time."
Sometimes I scream at the top of my lungs, steam coming out of my ears as my eyeballs bulge from their sockets. Afterwards I sit on my bed, awash with shame, guilt weighing heavily on my shoulders.
After an angry episode, I too feel shame and guilt, because my behaviour shocks me. I consider myself one of the calmest, most collected and least confrontational people I know, so it surprises me that sometimes I scream at the top of my lungs, steam coming out of my ears as my eyeballs bulge from their sockets. Afterwards, knowing I have behaved like this, I sit on my bed, awash with shame, guilt weighing heavily on my shoulders.
Such behaviour is very unlike me and I go around in circles wondering how I allowed myself to go that far. How could this young woman who I've known all my life turn into this monster I don't even recognise? It feels like an out-of-body experience that I can't control.
I've lost count of the time I've spent on Google, typing in 'what it means if you burst into anger' or 'how to manage outbursts' because all I want to do is 'fix' it, and I don't know how.
"It is often hard for people to ask for help for an anger issue," Dr Paschos tells me. "They may believe they are right to get angry in the first place because people 'insult them all the time'. This may be true or may be a type of cognitive bias. Other times the person may feel ashamed about their anger and try to minimise the problem."
While I am managing my depression and anxiety with a concoction of pills, my anger seems to be the symptom that has been left behind.
According to Dr Paschos: "Medication to treat an underlying mental health problem may help [with anger symptoms] if used carefully and under specialist guidance." He also recommends giving up or reducing alcohol if that is a factor. "If the anger is fuelled by easily triggered feelings of being ignored and betrayed, then cognitive behavioural therapy and individual psychotherapy may help."
Dr Paschos continues: "There are of course many other ways to improve mood, build self-confidence, learn how to relax better, learn how to recognise our emotions, and all that contributes to more ability to control volatile and explosive anger. As with most mental health problems, early intervention is more effective and the first step remains for the person to realise it is a problem and seek some help."
Mind, the UK's largest mental health charity, suggests looking out for warning signs – a faster heartbeat, your body becoming tense, if you're clenching your fists or jaw or tapping your feet – as these can give you a chance to think about your reaction before you act.
The charity also recommends taking a short walk to blow off some steam and talking to a trusted person who isn't connected to the situation, like a friend or counsellor or peer support group.
Anger is a perfectly valid emotion and we should not deny ourselves the right to experience it. We shouldn't have to feel guilty for feeling anger towards injustices, our jobs, our environments. Anger isn't a negative emotion; it can be extremely useful in learning how and what bothers us, it can help us effect change and achieve goals and it can keep us safe in vulnerable situations when our fight or flight response kicks in.
I have managed to curb my rage in the last few years, turning to my Calm app for Take:90 and Deep Sleep meditation sessions, tracking my outbursts in my bullet journal (this is said to improve accountability and awareness) and exercising five times a week to get my blood pressure and levels of cortisol (the stress hormone) down. I've also tried closing my eyes, counting to 10 and walking out of a toxic environment if I feel myself coming close to exploding.
Now that I have identified my anger as another symptom of my depression, it has allowed me to gain control and to own who I am. I've accepted that I'm not perfect and my mental health issues will remain with me, like an unwanted house guest that never leaves. But I live in hope that now I understand myself more, I can address the issues head-on. No one has to live in silence or suffer alone: it's okay to be vulnerable and to reach out when you need help.
If you or anyone you know is experiencing suicidal thoughts, please contact Lifeline (131 114) or Beyond Blue (1300 22 4636) for help and support. For immediate assistance, please call 000.