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When Passive Aggression Could Be Something Worse

Difficult behavior may dovetail with other issues or more serious disorders.

Key points

  • Passivity and procrastination may look passive aggressive but be symptomatic of a mood disorder.
  • Those who implode often explode, but their outbursts could occur more often if they have ADHD or other neurological conditions.
  • Counseling can help one discern the causes of problematic behavior.

When you have a tool, like a book, it's natural to want to use what you’ve learned. When I spot behaviors that I cover in Overcoming Passive Aggression, I remind myself of how hidden anger spoils relationships, careers, and happiness. But not all instances of passive aggression or anger are the same. I might have a handy hammer but not everything I see is a nail. Here's when passive-aggressive behavior or persistent anger may, indeed, represent other concerns:

A sense of helplessness or passivity frustrates employers, spouses, and parents. Not doing a requested task serves as payback for the resentful, entitled, or immature. It can, however, also signify depression, especially if coupled with hurt and negativity, a lack of confidence, or isolation.

Inquire, if it seems appropriate, about self-care habits. Is the person sleeping and eating well? Exercising? Do you notice a more disheveled appearance or fatigue? If the passive person has lost interest in the hobbies that bring them joy, suffered a trauma or loss, or seems unusually down on themselves, depression should not be ruled out, and treatment encouraged.

Anger or irritability may manifest as part of depression. In fact, it's a frequent presentation among males in a society that has often overlooked this symptom and normalized it all too often. Lost opportunities during the pandemic may have caused frustrations to bubble over, and abrupt life transitions may have made many feel like fish out of water.

Ambivalence frustrates people, for instance, if forced to retire early or when they are lonely. Even those who have chosen to break off relationships suffer ambivalence and irritability. This is only made worse if their communication style veers toward the indirect rather than honest, open, and face-to-face.

Counseling can help in all of these scenarios to allow a person to get in touch with their core values. It can foster the ability to tolerate conflict while working things out, rather than letting them linger.

Inattention may go hand in hand with passivity at first glance, but if you notice a pattern of distraction, trouble organizing one's activities, flitting from one task to another, or a hyper-focus when there's an activity that truly captures the person's fancy, hold off labeling these behaviors as passive-aggressive. They may represent attention deficit hyperactivity disorder, or ADHD.

One might not always appear to be "driven by a motor" or so hyperactive as to meet the diagnostic criteria that a licensed mental health professional or medical doctor could assess far better than a layperson. ADHD (inattentive type, hyperactive or combined type) is a neurological condition, as written about in ADHD & the Nature of Self-Control (Barkley) and Delivered from Distraction (Hallowell and Ratey).

Putting things off could also be a part of perfectionism, which we know comes from anxiety. Control and manipulation could signify deeper anger, with personality problems, ranging from borderline personality disorder to paranoia, to what we call the dark triad behaviors (narcissism, Machiavellianism, and psychopathy).

Quick leaps to anger or edginess could be a sign of bipolar disorder, or in the elderly, sometimes dementia. The layperson, unqualified to label these concerns, is rightly curious since they're the recipient of the behavior. Our purpose here is not to diagnose but to delay unnecessary judgment and encourage people to seek help.

Though passive aggression isn't an official diagnosis in the current DSM psychiatric guide, when many of the hallmark boxes get checked, clinicians know that the behaviors may veer toward disordered territory. This is especially true when there's evidence of self-absorbed traits, putting others down, and an over-emphasis on the needs of one person in a relationship rather than the other.

When your needs have been overlooked in favor of another's, if your contributions amount to nothing but the other party boasts about theirs, or if you feel put down in obvious or subtle ways (such as back-handed compliments) the person might be demonstrating self-absorption or narcissism.

Self-absorbed people distance themselves from others largely to protect ego and cover insecurity, sometimes to mask ambivalence. While vain people seem to have all the answers, inside they lack confidence and solutions. Indeed, their problem-solving skills are compromised, so they go on the attack, bullying or intimidating to get their way, which further reinforces their self-absorption. They don’t accept feedback well and often double down on irrational beliefs.

To work through conflict, people must acknowledge the needs of others as they listen and care. Empathy is not a strong suit for the vain, who tend to surround themselves with people who build them up. They lack the skill for giving. Exposure to other views proves to be too threatening to their fragile sense of self and decision-making.

They may be deeply unhappy, yet their coping mechanisms, such as irritable behavior, keeping score, or becoming defensive, do not help to summon a sense of vulnerability, which is key to forming intimate friendships or lifelong, romantic relationships.

No one person can change another person. We each can, however, manage our own reactions and responses.

Counseling is key to discerning what’s really going on in, and often, points people toward solutions and better interpersonal relationships. Sessions may demonstrate how to sponsor conversations that lead to proper diagnosis and treatment, improving the outcomes for all involved.

To find a therapist near you, visit the Psychology Today Therapy Directory.


Overcoming Passive Aggression: How to Stop Hidden Anger from Spoiling Your Relationships, Career and Happiness (2016)

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