That characteristic of sadness, loss of energy and interest, has surely been experienced by most human beings. We are emotional beings, and therefore, when a situation of displeasure or frustration comes into our lives, it hurts us, hurts us, and makes us feel empty or without purpose and hope; That state of meditation and introspection that sadness allows us leads many people to reject it because it causes pain and discomfort.
Many people flee from that period of introspection for fear of all those thoughts that arise, and so we look for distractions for years without paying attention to what truly drives our behavior. Neurotic depression is recognized by a chronic state of affective disturbance, that is, an emotional disturbance for more than two years. In Psychology-Online we explain more about What is neurotic depression, its symptoms, causes and treatment.
Neurotic depression is one that is characterized by a chronic depressive state and what clinically causes very serious disability in the person who suffers from it.
The established duration of this depression is more than two years. The person experiencing this depression also manifests intermediate periods of normal mood that rarely last a few weeks without becoming episodes of hypomania, an elevated and euphoric mood that is clearly pathological due to its overflowing optimism.
According to the International Classification of Diseases (ICD-10), the symptoms of neurotic depression are the following:
Constantly recurring depressive mood and with a presence of at least two years and at least three of the following symptoms:
- Decreased energy or activity.
- Easy crying.
- Difficult to focus.
- Insomnia.
- Loss of self-confidence or feelings of inferiority.
- Loss of interest or satisfaction in sex and other pleasurable activities.
- Feelings of hopelessness or despair.
- Social isolation.
- Decreased talkativeness.
- Pessimism about the future or ruminations about the past.
- Perceived inability to cope with the routine responsibilities of daily life.
If you feel identified, you can do this to find out if you have depressive symptoms that may be a problem in your daily life.
An analysis with a psychoanalytic approach refers to this type of depression as having an etiology like other neuroses for a intrapsychic conflictthat is, due to an internal struggle within the same person.
In the text “mourning and melancholy” by Sigmund Freud (1917), reference is made to this type of depression, referred to as melancholy. Freud describes the following similar symptoms between mourning and melancholy:
- Loss of interest in the world.
- Loss of the capacity for love.
- Inhibition of all productivity.
The negative self-concept
But Freud also mentions that there is a symptomatic element in melancholy that will not be observed in mourning and it is a series of self-reproaches and self-denigration:
- I am of no use
- I don’t know why I exist
- I don’t know why my wife got married and is still with me.
- I’m rubbish
Loss
Below we quote Freud verbatim to explain what the work of mourning consists of:
The examination of reality has shown that the loved object no longer exists and from it now emanates the exhortation to eliminate all libido with the links of that object. This is opposed by an understandable renunciation; this renunciation can reach such intensity that it produces an estrangement from reality and a retention of the object through a hallucinatory psychosis of desire.
So reality shows us that The object is no longer there, either because it has died or because the situation that gives us comfort can no longer continue (work, partner, freedom, ideals). One becomes very reluctant to accept the loss (frustration tolerance) and we begin to deny and reject it, one tries to choose estrangement from reality, that is, to stop seeing reality and satisfy the need for the object to be in harmony. a hallucinatory way.
The unresolved grief
What is normal for Freud is that once the work of mourning is completed, the ego becomes free again, that is, the libido that had been deposited in the object is withdrawn (for example, energy is withdrawn from the lost job, to the former romantic partner). So the grieving process involves realizing that the object is no longer there, removing all the libido put into the object, putting one’s self into it, and then releasing that libido again into another object.
This is the explanation that Freud offers, and at that point is where the difference between mourning and melancholy is observed, since The problem with melancholy is that it is an extended mourning..
Freud said that the neurotic subject knows who he lost but does not know what he lost in him, thus it is understood that melancholy is an unconscious loss.
What happens in melancholy is that all that libido (energy) that was left floating when the object was lost, returns to the ego and it absorbs it, thus begins narcissism, which is also part of Freud’s theory. On the other hand, in grief, when it is resolved, the libido returns once again to the objects. (For example, where others see that a person is going through a grieving process and has no interest in things or events that would normally attract their attention: going out with friends, working, playing sports. Other people can observe it. as something abnormal or atypical but as they finally relate it to the recent loss and come to consider it normal “it is normal that it is like this due to the loss of…”).
For this reason, there is almost a temporal issue at stake that in clinical practice should not be lost sight of. Although we are aware that it is naive to believe that normal grief lasts between five and seven months and pathological grief lasts longer. It is not possible to structure a calendar or manual for the duration of grief but it is important to take this point into account (for example, a patient who reports being very sad about breaking up with a partner for ten years is not the same as another who reports that it has been for a month).
narcissism
When we mention narcissism we must discard the erroneous idea that it is someone who believes himself to be very much or superior, but rather narcissism implies that the center of the problem is always in them. In melancholy, all the libidinal energy is placed on oneself. There is something in libidinal energy that even though in a negative sense it generates a feeling of specialness – being the worst in the world – the discourses of being people with depressive neurosis always end up falling back on oneself (for example, I am always so rubbish). , I am worth very little, I am of no use). We see then that things always go towards a narcissistic system.
A key point in melancholy (depressive neurosis) is that these people are not ashamed in the presence of others – they do not hide their self-reproaches, they are not ashamed that others know how “bad” they are – they even give the impression that if The more people hearing how bad they are, the better.
self-criticism
Freud described that in melancholy (depressive neurosis) there is an extraordinary lowering of ego feeling – you feel very little – and this characteristic will not manifest itself in grief. We know then that in grief there is sadness, regret, pain, but it is not related to blaming all of this on oneself.
In mourning, the world has become poor and empty, in melancholy this happens to myself. The patient describes his ego to us as unworthy, sterile and morally despicable, he reproaches himself, denigrates himself and expects repulsion and punishment. Freud (1917)
So in grief, it is the world that is poor and empty (for example, I am not interested in what happens outside, I am not interested in what others are going to do, I am not interested in whether they get together to eat, I am not going to go. because I don’t care). In melancholy, what happens to the world happens to the self, so patients they begin to think themselves unworthy and despicable in a moral sense – what he expects from others is repulsion. Thus, in the clinical development of melancholy we can analyze that the patient thinks that some type of alteration has not occurred, but that he extends this self-criticism to the past, that is, he was always trash and was never worth anything.