While depression can increase the risk for adverse outcomes, this does not mean that people with depression are violent. Instead, mental health conditions along with other risk factors such as substance use, trauma, stress, and domestic violence may increase the risk of violent behavior. However, the vast majority of people who have depression or other mental health conditions do not engage in violence.
Depression & Violence
An example that tends to be widely covered by the media are violent crimes that occur when a person commits a murder, then commits suicide. Although depression has been identified as a contributing factor in some cases of murder-suicide, the association does not mean people who have depression are dangerous. The vast majority of people with depression do not commit violent crimes. In fact, experts generally do not associate depression with violence unless a person has symptoms of psychosis that increase the risk of violent behavior. A 2015 population study in Sweden found that people diagnosed with depression were roughly three times more likely than the general population to commit violent crimes including robbery, sexual offenses, and assault. Seena Fazel, who led the study, pointed out that rates of violent crime in people diagnosed with depression were “below those for schizophrenia and bipolar disorder, and considerably lower than for alcohol or drug abuse.”
Public Perceptions of Depression and Violence
A 2013 review of literature revealed that mental illness stigma is widespread in the United States. The review found that negative perceptions are held by both children and adults; the most common of which is that people with mental illness are more likely to be violent—even dangerous. Surveys conducted around the world have found similar results, indicating that the perception of people with mental illness as being violent is a global one. The public may see a clear link between mental illness and violence, but the research reveals a much more complex relationship.
The Effect of Media Coverage
One reason for the disconnect between the research and public perception of the relationship between mental illness and violence is media coverage. For example, when a violent tragedy such as a mass shooting occurs, the initial information available to the public that forms perceptions is often incomplete and can be inaccurate. Research has also indicated that using these perceptions to motivate action or justify policy won’t necessarily improve public safety. Law enforcement and mental health professionals often want to determine if a person who has committed a violent crime has a history of violence. A person’s mental health may be routinely assessed in the course of an investigation. However, these actions do not imply violence and mental illness have a fully causal relationship. Crimes may be committed by someone who has a mental illness, but crimes are also committed by people who are not mentally ill. Violent thoughts and behaviors can be a sign of an underlying mental illness, but they are not unique to people with a mental health disorder. People who do not have a mental illness can have violent thoughts, display violent behaviors, and engage in criminal activity.
What the Research Says
Research on potential links between violence and mental illness is ongoing, but results have been mixed. One reason for this is that it can be difficult to design studies that accurately assess and measure violent behaviors, as many rely on self-reporting. Most studies consider multiple factors that could influence violent behavior in any person, including people with mental illness. Researchers have examined the effect of everything from gun sales to video games on violent behavior. Although guidelines have, and continue to be, created based on the results of these studies, the potential link between mental illness and violence is not as clear or as well-understood compared to other risk factors.
Co-Occurring Disorders & Other Risk Factors
The characteristics of certain mental illnesses may make a person more likely to demonstrate violent behavior. Research has indicated that people who experience paranoia, hallucinations, or delusions are more likely to become violent than people with mental illness who do not have these symptoms. When people with depression do commit a crime, mental illness is typically not the only contributing factor. More often, it’s a combination of certain risk factors that make a vulnerable person feel that violence is necessary. Such factors include:
Experiencing domestic violence Exposure to violence in childhood Socioeconomic stress Substance use
Other studies have supported the findings. For example, a 2010 study of people diagnosed with bipolar disorder found that 8.5% had been convicted of at least one violent crime, which wasn’t much higher than the group of controls. Mental illness combined with other factors may elevate this risk. The rate of people with bipolar disorder and a substance use disorder who had been convicted of violent crime was significantly higher: 21.3%. Also of note, they found that unaffected siblings of individuals with bipolar disorder were at an increased risk for committing violent crime. This suggests a contribution of genetic or early environmental factors contributing to violent crimes in families with bipolar disorder.
Public Perception & Stigma
There are many different types of violent crime, but some are more likely to make headlines. For example, murder-suicides are more likely to be covered in the news, which makes them seem more frequent than they really are. Surveys have shown that these perceptions are even common among people who regularly work with people who have a mental illness such as doctors and even among people with mental illness themselves.
Issues With Public Awareness
Suicide rates are underestimated by not only the general public but also by healthcare professionals. In one study, researchers found that:
When asked about the most common causes of firearm death in their state, only 20% of health care professionals surveyed in one study correctly identified suicide as being more common than homicide. Of the adult respondents who reported a history of mental illness, just 12.4% gave the correct answer.
A disproportionate amount of media coverage can make it seem like murder-suicides are common and frequently committed by a narrow range of people (specifically pointing to people with a history of mental illness). However, statistics show that murder-suicides are quite rare. A 2009 literature review found the incidence to be in the range of 0.2–0.3 persons per 100,000.
Stigma as a Risk Factor for Violence
Studies have shown that the stigma attached to mental illness may itself be a risk factor for criminality and violence. A 2018 study found that stigma can be a barrier to treatment for people with mental illness. Stigma can also make a person with mental illness reluctant to seek treatment. A person may not even feel they can openly discuss mental illness, as societal stigma can reinforce feelings of shame or guilt. Society’s attitude about mental illness can also make people fear retaliation or prejudice at school or work, making it less likely they will seek support from their community.
Mental Illness & Gun Violence
Of the acts of violence most widely covered by the media, and most often discussed in relation to mental illness, is the possible connections between gun violence and mental illness. In a 2019 study, researchers looked at cases where people with diagnosed mental illness had engaged in gun violence. Specifically, the researchers wanted to know if certain behaviors associated with mental illness could predict gun violence. A 2011 study that looked at specific disorders considered “serious” or “severe” mental illness found that there was a small, but notable, increase in risk for violence in people who had one of these disorders compared to people who had no mental illness. The risk was highest when someone had both mental illness and issues with substance use. As with previous research, the authors of the study stated that other factors, such as abuse and neglect in childhood or current social stressors, were also of importance when determining a person’s risk for violent behavior. Research on the incidence of all types of violence on a national level estimates only 3% to 5% of violent acts are directly attributable to serious mental illness. Furthermore, guns were not used in the majority of those acts.
Suicide & Self-Harm
Research has indicated that people who are depressed are particularly vulnerable to being victims of violent crimes. They are also more likely to self-harm rather than harm others. This includes being more likely to commit suicide than homicide. According to the National Institute of Mental Health, in 2017 there were twice as many suicides as homicides in the United States (47,173 suicides vs. 19,510 homicides).
Risk of Experiencing Violence
People with mental illness may be at a higher risk of experiencing multiple forms of violence. During the MacArthur study, the researchers asked mental health patients taking part in the research about their lived experiences with three different forms of violence: For more mental health resources, see our National Helpline Database.
Self-directed violenceHarming othersBeing harmed by others
Over half of the patients (58%) reported experiencing at least one form of violence, 28% experienced at least two forms, and 7% experienced all three forms of violence.
A Word From Verywell
People with mental illness face stigma that can affect all aspects of their lives and well-being. One of the most persistent and damaging stigmas is that people who have a mental illness such as depression are more likely to be violent. Research has not supported assertions that people diagnosed with mental health conditions are violent. What studies have shown, however, is that people with mental illness are vulnerable to experiencing violence at the hands of others. Furthermore, when individuals with mental illness do become violent, they are at a substantially greater risk for self-harm—which directs the violence toward themselves rather than others.
