Existential and emotional depression

Existential and emotional depression

When we talk about  depression  we refer to a generic disorder characterized by a  sad, empty and / or irritable mood  , accompanied by somatic (fatigue, heavy limbs …) and cognitive (pessimism, bias and sprains) alterations, however little attention is paid to the  content of the depressive experience .

On the contrary, when we talk about anxiety , DSM V makes extensive references to the different dimensions of anxiety disorders, in fact we have:

  • Social anxiety
  • Specific phobias
  • Agoraphobia
  • Panic attack
  • Post Traumatic Stress Disorder
  • Generalized anxiety

The  Depression  seems to be viewed by clinicians as one galaxy  that includes all  forms of pathological suffering  but also some forms of unhappiness related to the perception of the distance between what is and what you would like to be .

Yet, the quality of the depressive experience can be very relevant not only for diagnostic purposes but also and above all  for the purposes of therapeutic intervention . In short,  not all depressions are the same  and not all depressions should be treated with the same therapeutic approach.

The inner experience of the depressed

Everyone can describe depression as something that anguishes, grips, demeans and annihilates … but few really dwell on the inner experience of the depressed. What exactly does a depressed person feel? What causes all that pain?

It is from these questions that we can speak of existential depression and affective depression . Note: the terms “existential depression” and “affective depression” have no connection with the diagnostic manual, they have been used in this article to underline the clear emotional difference between two different depressive dimensions.

In a 2007 study (M. Keller, M. Neale and K. Kendler *) they found an association between the type of  adverse event that triggered a depressive reaction and depressive symptoms .

In particular, from the studies it emerged that events concerning affective life (mourning, separations, losses, end of relationships …) could be better connected to depressive symptoms such as sadness, lamentation, desire for support, emptiness, depressed mood … On the contrary, events negatives concerning the personal sphere (failures, bankruptcies, layoffs …) were better connected to depressive symptoms such as demotivation, anhedonia, chronic fatigue

In fact, the symptoms described by Keller and colleagues were the two key criteria that DSM V still uses to diagnose depression today, however the authors found the two symptoms in depressive reactions related to different adverse events.

Subsequent studies showed that it was not so much the events themselves that caused the different symptoms of the depressive reaction as the compromised goals **. There is therefore research evidence that supports the hypothesis of the existence of at least two different  major depressive disorders .

Affective depression and existential depression

At the root of affective depression would be the compromise of affective-sentimental purposes .

The ancestral pain of abandonment experienced in childhood could re-emerge in similar circumstances in adult life … more generally, any issue related to abandonment, separation and emotional loss would be connected to symptoms such as:

  • Emotional pain
  • Emotional emptiness
  • Tendency to cry and lament
  • Desire for support
  • Loss of appetite

The theme of the failure, the failure to reach a goal, inferiority, of personal rejection of ‘ uselessness of self …  can play a crucial role in  existential depression . Associated with depreessive symptoms such as:

  • Guilt
  • Despair
  • Fatigue
  • Pessimism
  • demotivation

The  major depression , therefore, is not a  unitary phenomenon . On the one hand it seems to emerge as a ferocious  threat to self-esteem  and on the other as a threat to the affective / interpersonal sphere .

Depressive vulnerability

Resilience (the ability to adapt to any change), a high sense of self-efficacy and the presence of good social support, would seem to be the elements that protect against depression.

What are the elements that make vulnerable to depression? Factors related to pre-existing characteristics (perfectionism, self-criticism, attribution style with external or internal focus of control …) could play a crucial role in determining depressive vulnerability .

General characteristics are: self-criticism, low self-esteem, rigidity, tendency to rumination, the inability to get distracted, the pursuit of a single purpose … More generally, depression (as well as anxiety) has been linked to a trait known as “neuroticism”.

Neuroticism can be described as an individual’s tendency to experience negative emotions in response to external events (especially of a stressful nature). Why are some individuals more sensitive to abandonment issues and others to personal failure issues?

Although research has shown numerous links between  depressive symptoms  and impaired goals, relatively few studies have examined the  underlying cognitive mechanisms  .

Beck and Blatt’s models of depressive vulnerability leverage individual differences in cognitive and psychodynamic constructs.

It is the value that the individual attributes to the affective sphere or autonomy to determine how significant some events can be in inducing depressive symptoms .

The way  adverse events are interpreted may or may not trigger depression.

The individual who presents a sociotropic personality is oriented towards interpersonal relationships and evaluates his own value on the basis of emotional relationships . It is understandable, an individual who evaluates his own value on the basis of his emotional relationships with greater possibility could experience a depressive syndrome following an experience of separation or  interpersonal loss .

On the contrary, the individual who aspires to an autonomous personality, who is oriented towards his independence and success and is afraid of being controlled and dependent on others, invests all his personal value in success and productivity .

The “autonomous personality” can experience depressogenic thoughts such as “if I do not pass the exam, I will be a failure” or “if I am sad, I am weak!” or, at the extreme “I don’t need anyone, if I need someone I am weak!”.

Those with an “autonomous personality” are more likely to develop a depressive reaction after an event that somehow calls for personal failure. Paradoxically, for the autonomous personality even some apparently “happy” events can represent a  threat : having children and getting married, two threats to autonomy and productivity .

Clinical evidence shows that depressed patients, especially with autonomous personalities, are keen to set excessively high goals on the basis of which they regulate self-esteem. It is clear that with high standards the possibility of experiencing a failure  becomes highly probable, triggering a vicious cycle that always keeps the depressive symptoms active.