Depression is horrible, and also tricky. Because while we’re conditioned to look for depression symptoms of lethargy or feeling sad, that’s not the whole picture. There’s another strong indication a person might be suffering from depression that’s not so obvious, nor does it figure in the common portrayals of this prevalent mood disorder. That oft-overlooked symptom is anger. And whether you are prone to depression yourself or concerned about a loved one, you should not ignore this sign.

A Lesser-Known Indicator Of A Debilitating Illness

Depression is quite common in modern society, striking women twice as often as men. The incidence of teen depression has skyrocketed in recent years as well. No one wants to dwell on the ailment, but left untreated it can cause debilitating mental anguish and thoughts of suicide. Depression also contributes to a host of physical ailments, from a lack of concentration to a compromised immune system to heart disease and even cancer.

With so much at stake, everyone should be on the lookout for symptoms of depression. Typical warning signs include feelings sad and changes in sleep patterns, but a 2014 study indicated people who are often angry can also be signaling depression. And it’s worth noting that such anger can present as disproportionate rage in everyday life, or as destructive anger turned inward, where it makes the depression more severe.

Why Men’s Depression May Masquerade As Anger

Men are the most likely to lash out when they’re suffering from depression, an act that tends to push other people away and further fuel the depression. Depression also puts adults at higher risk of deadly cardiovascular incidents and is a key risk for suicide, the cause of death for almost four times more men than women, according to Harvard Medical School.

Women are more likely to experience depression with symptoms that include weight gain or anxiety. In contrast, anger, irritability and aggressiveness top the National Mental Health Institute list of signs and symptoms of depression in men. While females also present rage (suppressed or overt) as a sign of depression, men are far more likely to experience this symptom.

When To Reach Out

Everyone blows off a little steam from time to time, so how can you tell if you (or your teen, or elderly parent) are reasonably mad or actually using angry outbursts to cope with depression? It’s a two-part process. First, the person affected or the loved ones watching should watch for symptoms of agitation, restlessness or even physical aggression on a frequent basis. Something as simple as frequent road rage is a good example. If the person in question has an increasingly low tolerance level and a shorter and shorter temper, depression could be the underlying issue.

But it’s also likely that some of the other better-known symptoms of depression will be fueling this anger. A few examples include a feeling of hopelessness, troubles concentrating, physical aches and pains without an obvious origin and self-loathing. If any of these are present, in tandem or separately, it’s a good idea to reach out to a health care professional or one of the many active mental health advocacy groups. Keep in mind that anger symptoms can also indicate other health problems and a doctor or clinic can help you sort that out.

Most importantly, no matter what form the depression takes, it’s good to remember that the feelings of being helpless are never the reality. And if irritation or aggression is one of the key indicators, recognizing the interplay between depression and anger can be the first step in a patient’s battle to start feeling better. Once this potent symptom is out in the open, the process of diminishing the hold of depression can begin.

For Immediate Help

If you’re feeling depressed or even suicidal and don’t feel like the problems will right themselves quickly, call 1-800-273-8255 in the U.S. or visit Suicide.org to find a helpline.