Characteristic of lack of character and interest of anguish

28.05.2020

What is neurotic depression

Neurotic depression is one that is characterized by a chronic depressive state and that 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 going through this depression also manifests intermediate periods of normal mood that rarely last a few weeks without becoming episodes of hypomania, a high and euphoric mood clearly pathological by their overwhelming optimism.

Symptoms of neurotic depression according to ICD-10

According to the International Classification of Diseases (ICD-10), the symptoms of neurotic depression are as follows:

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 with sex and other pleasurable activities.
  • Feelings of hopelessness or despair.
  • Social isolation.
  • Decreased loquacity.
  • Pessimism about the future or brooding over the past.
  • Perception of inability to face the routine responsibilities of daily life.

Causes of neurotic depression from the psychoanalytic approach

An analysis with a psychoanalytic approach refers to this type of depression an etiology as the other neuroses due to an intrapsychic conflict, that is, due to an internal struggle in the same person.

In the text "mourning and melancholy" by Sigmund Freud (1917), this type of depression is referred to, referred to as melancholy. Freud describes the following similar symptoms between grief and melancholy:

  • Loss of interest in the world.
  • Loss of the ability to 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 denigrations of oneself:

  • I am useless
  • I don't know why I exist
  • I don't know why my wife married and is still with me
  • I'm rubbish
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Loss

Below we quote Freud verbatim to explain what the work of mourning consists of:

The examination of reality has shown that the beloved object no longer exists and from it now emanates the exhortation to remove all libido with the links of that object. An understandable renunciation opposes it, that renunciation can reach such intensity that it produces an estrangement from reality and a retention of the object by means of a hallucinatory psychosis of desire.

Thus 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, couples, freedom, ideals). One becomes very reluctant to accept the loss (tolerance to frustration) and we begin to deny and reject it, one tries to choose the estrangement from reality, that is, stop seeing reality and satisfy the need for the object to be a hallucinatory form.

The unresolved duel

The normal thing for Freud is that once the work of mourning has been completed, the self becomes free again, that is, the libido that had been deposited in the object is withdrawn (for example, energy is withdrawn from lost employment, to the old loving couple). So the mourning process involves realizing that the object is no longer there, all the libido put on the object is taken out, the self is put on, and so then release that libido again in another object.

This is the explanation that Freud offers, and it is at this point that 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, so it is understood then that melancholy is an unconscious loss.

What happens in melancholy is that all that libido (energy) that remained floating when the object was lost, returns to the self and absorbs it, thus begins narcissism that is also part of Freud's theory. On the other hand, in the duel, when this is resolved, the libido returns once more to the objects. (For example, where others see that a person is going through a process of mourning and has no interest in things or events that - normally - would attract their attention: going out with friends, working, playing sports. Other people can observe him 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 so because of the loss of ...").

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