2 types of depression (and what to do about them)
They say knowledge is power. If you’re suffering from depression, it might be useful to know what kind of depression you’re suffering from. This can help you to then know what to do about it.
Many people who live in regional areas such as Warrnambool and South West Victoria more generally struggle with depression, yet do not have access to resources for help. At South West Mind + Body we want to provide education and resources for you.
In recent years there has been a lot of research that’s gone into understanding depression. One of the more interesting findings coming out of the psychodynamic tradition is that depression occurs, broadly speaking, across two dimensions:
Dependent/anaclitic depression
Self-critical/introjective depression
In this blog we are going to examine both the dependent and the self-critical forms of depression before discussing things you might able to do to support yourself.
Dependent Depression
A dependent depression involves being pre-occupied with themes of being unloved, unwanted and abandoned. If your mind is organised in this way, you may have had early experiences of being neglected. You may have had a fundamental need to be comforted and protected which was not adequately met. You may view yourself as someone unlovable, and this lonely stance over time has become more and more intolerable. Perhaps you also feel very intense levels of anxiety which stem from chronic fears of abandonment.
Some of the features of a dependent depression include:
Loneliness
Helplessness
Feelings of weakness
Intense fear of abandonment
Deep, unfulfilled longings to be loved, nurtured, protected
Often precipitated by loss (relationship, job, lifestyle etc.)
People who enter into this depression may also be thinking and feeling some of the following:
“I'm empty”
“I'm hungry”
“I'm lonely”
“I need a connection”
Self-critical Depression
On the other hand is the self-critical depression. In this experience there manifests extreme concerns about self-worth and a sense that you are fundamentally guilty, and a failure. There may be a chronic fear of criticism, and a strong sense of being unworthy. Often there have been early experiences of being dominated, having excessive demands placed on you, and having been told that your self-worth is not intrinsic, but dependent on achievement and “success”.
If you have a self-critical depression, one part of your mind attacks another part of your mind, and you feel as if you can never live up. Your internal standards may be extremely high.
Some of the features of a self-critical depression include:
Unworthiness
Inferiority
Failure
Guilt
Chronic fear of criticism and losing the approval of others
Intensely competitive and productive with little satisfaction
Could equally be labelled "self critical perfectionism"
People who enter into this depression may also be thinking and feeling some of the following:
"I'm not good enough”
“I'm flawed”
“I'm self-indulgent”
“I'm evil"
Now what?
The work of Sidney Blatt in identifying these personality structures is useful both personally and clinically. What Blatt discovered was that both types of depression represent a basic imbalance in your personal psychology.
As human beings, we have 2 fundamentals drives:
Self-definition, and
Relatedness
From this perspective, mental health involves a balance between these 2 poles. This means being able to sacrifice for others and have meaningful relationships (relatedness) whilst at the same time being able to say no, pursue personal goals and be confident in yourself (self-definition). What Blatt found was the following:
If you have a dependent depression, you are likely excessively focused on relationships, to the detriment of your autonomy, self-definition and individuality. In this instance, you need to focus on developing your unique capacities and to stabilise your sense of self.
The inverse is also true.
If you have a self-critical depression, you are likely to be excessively focused on yourself to the detriment of your relationships and your sense of connection and comfort with others. In this instance, you need to focus on developing your interpersonal relationships as a source of support.
Of course, we may not fall nearly into either category, and that’s ok too. We are always a complex mixture of psychological tendencies. At times I think about our clinic as a depression clinic. It is that common.
Understanding these dynamics is a great start and beginning to recover from your depression. Whether it’s through increasing insight into your own mind or developing closer and better relationships, psychotherapy has evolved to become a vehicle to do just that.
Fabian Storer is a Clinical Psychotherapist and Co-owner of South West Mind + Body. He holds dual bachelor degrees in Psychology/Psychophysiology (Science) as well as Psychotherapy & Counselling. He has a particular interest in working with trauma and depression and enjoys writing about the intersection of mental health and society.
