Several of the most widely used clinician-rated measures of depression, including the Hamilton Depression Rating Scale (Hamilton, 1960) and the Montgomery-Åsberg Depression Rating Scale (Montgomery & Asberg, 1979), do not directly assess anger or irritability. Psychoanalysts have long believed that anger directed toward the self contributes to depression (Busch et al., 2016). Freud (1917) modified Abraham’s view in his paper "Mourning and Melancholia" but kept anger directed inward as a central component. Thus, anger becomes directed toward the self, creating a further reduction in self-esteem, fueling a cycle of rejection sensitivity and anger. How to Use Psychodynamic Understanding of Anger and Depression in Treatment InterventionsAs noted above, when depression is identified, patients should be evaluated for the presence of irritability and conflicts with anger.