Neurotic depression (a critical review)

In the following article we will address the issue of neurotic depression, some of its characteristics and also discover if there is any difference with “typical” depression. 

Neurotic depression

The neurotic depression is a definition of depression in a person characterized by emotional instability.

That is, it is not a particular type of depression, but rather a characteristic that occurs in people with that trait.

For example, depression secondary to major personality disorder, neuroses, or substance abuse.

There is some debate about the use of this term.

Neurotic depression is a term that is not often used today.

In the past, however, it was part of how different types of mood disorders are classified, in this case, those related to decreased life energy and a feeling of low mood and interest in general. 

Neurotic depression: what does the term refer to? 

Although in general terms it is an “old” term, it is currently used by some professionals.

For example, Dr. Gregg Henriques Ph.D. advocates the use of the term, as well as its differentiation from another type of depression he calls “melancholy.

Next, we will look at the characteristics of neurotic depression, according to Dr. Henriques’ point of view. 

The Dr. mentions that neurotic depression is found in clinical work constantly and that, as with all mental illnesses, it is characterized by a set of particular symptoms, among which we will mention and discuss below. 

A general feeling of distress and intensified negative emotion

As the first characteristic symptom of neurotic depression, Dr. Henriques refers to this one that is related to mood specifically.

He says that these are some feelings and/or emotions that appear more frequently than others.

On the one hand, he mentions sadness, a symptom without which it would be difficult to talk about depression.

That is one of the typical symptoms that comprise depressive disorders.

On the other hand, irritability, generalized disappointment, futility, and agitation or anxiety appear very frequently. 

As the doctor points out, these are all emotions that are more prone to a negative mood, and they often present in an intensified form, making patients very unhappy and making their daily activities difficult.

Just imagine that you experience these emotions very intensely and almost all day long, for several days or even weeks?

That would be very difficult, wouldn’t it? 

Neurotic depression: general dissatisfaction with life 

This is another symptom that patients report, they mention that they don’t feel comfortable and it is as if the world is “not designed for them”.

Dissatisfaction often appears when our goals and objectives are not met when there are extended periods of time when we feel we have not achieved anything. 

What happens in the case of a disorder is that this feeling is abnormally intensified, and in many occasions, it does not correspond clearly to the objective facts.

That is, it may be that the person, from a certain point of view, has good living conditions in general, but his internal experience is one of failure and dissatisfaction. 

This is one of the great challenges in the treatment of mental problems. In many cases, what happens is that internally, the person has certain beliefs, thinking habits and ways of “reading” the world that end up generating much discomfort.

It may be that from the outside things look good, but the particular reading that the person does is negative or aversive. 

Low self-esteem and identity difficulties

This is another characteristic that would appear in neurotic depression and they go very much together.

Self-esteem has to do with how a person values himself, his appearance, skills, ideas, etc.

When this is negative, there are also often questions about one’s own identity. Why am I like this and not like that? 

Who am I? Why does everyone else’s life seem so clear and defined?

When there are difficulties with identity, the person does not know his place or the meaning of being around a group of people.

Within the family, for example, the person may feel that they do not know their role, feel lost or out of place. 

In neurotic depression, this symptom is acute and appears as one of the main complaints referred by the patient in the clinical consultation.

Low self-esteem and identity difficulties are also related to the fulfillment of personal goals and values. 

We all have things that we consider more important than others, some ideas that we defend or activities that we consider essential.

For people under the symptoms of neurotic depression, this may not be so clear, so that they feel lost and are unable to find answers that give them satisfaction. 

On the other hand, when talking about self-esteem and identity, it is necessary to touch on the issue of validation.

What is validation? It is an element that is usually present in interpersonal relationships.

Validation refers to how accepted, understood, someone feels about another person. 

For example, some people with mental disorders report that their families do not understand them or sometimes treat them badly.

There may be some invalidation there.

The person with the mental disorder may be very sad at times, and their family’s reaction may be one of rejection because they are “sad again 

This may even lead to the person rejecting their own emotional reactions and seeking to behave differently at all costs.

The person may spend a lot of time thinking about the best way to be pleasant to other people. 

Neurotic depression: problems of daily life

On the other hand, there is a set of problems mentioned by Dr. Henriques that are usually presented by the people he names under the name of neurotic depression.

These are life problems, which may happen to all of us at some point, but for people with depressive symptoms, they become much bigger challenges that are difficult to deal with. 

These problems are usually related to relationships, in which loneliness is experienced or different types of conflicts arise.

There are also problems at work, such as high levels of stress and the feeling that the work being done does not make sense. 

On the other hand, they can also refer to problems related to financial matters, because there are for example low resources.

Finally, it is common for people to report a lack of interests or activities they enjoy and a lack of purpose in life. 

Neurotic depression: some additional features 

On the other hand, under Dr. Henriques’ characterization of neurotic depression, some additional characteristics are also included that are worth mentioning for a better understanding of this way of naming depression in some patients in particular. 

It is common for people with neurotic depression to behave in a defensive manner, that is, they usually perceive “attacks” from other people, and many times there is simply questioning, as there might be for anyone else.

For this reason, they are very difficult to deal with on an interpersonal level, and getting to know their feelings in an honest way is sometimes difficult. 

On the other hand, there is also often a lot of pessimism and avoidance-based coping strategies.

That is, the person knows that he or she has some problems and experiences a lot of internal discomforts, but the way he or she deals with situations is by avoiding them. 

He may pretend that there is no problem to be faced, or it may become a common strategy to “run away” and avoid facing difficulties directly.

Avoidance, in the context of emotional regulation, becomes a very difficult problem when people resort to it on a regular basis. 

Let’s be honest, we have all at some point in our lives avoided some problem.

Because it creates stress or fear, or because we simply do not want to deal with it directly.

However, at some point, we end up accepting that something needs to be done about it and that avoidance won’t serve us indefinitely. 

What happens in people with neurotic depression is that they use the strategy of avoidance very often, over and over again, and it becomes the standard way of reacting to the situations they encounter. 

On the other hand, as with other mental illnesses, a history of psychological trauma is common.

People often manifest some type of damage they suffered in the past that has generated particular difficulty in assimilating, which continues to cause them much emotional activation and discomfort. 

Finally, it is worth mentioning that people with neurotic depression can go unnoticed.

That is, they can relatively easily go about their lives without others noticing that they are experiencing much discomfort and some depressive and other symptoms.

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Conclusion 

Neurotic depression refers to a way of naming depressive disorders when they occur in a particular type of patient, those who have many signs of emotional instability or dysregulation.

Thus, it is not a subtype of depression, but a way of highlighting that, given the characteristics of the patient, some symptoms are more evident or intense. 

When talking about neurotic depression, you only have to consider the “typical” symptoms of depression to get an idea of what is going on.

In this, there is usually a low mood, a feeling of constant emptiness, loss of enjoyment of previously enjoyed activities, sleep disturbances, there may be weight loss.

The person may behave in a lonely way and be isolated from the people with whom he or she has spent the most time.

Frequently asked questions (FAQs) about neurotic depression 

What is a neurotic person?

Neuroticism is a personality trait that refers to the tendency people may have to have a negative or anxious mood.

It is not a mental disorder, per se, but a personality trait. 

What are the signs of a neurotic person?

Some of the signs that might appear in a person with a highly neurotic personality trait are constant anxiety, sadness, anger, a lot of irritability, constant surveillance or monitoring behaviors, sometimes impulsive behaviors, occasional disturbing thoughts, among others. 

What is dysphoric mood?

A dysphoric state is one that is usually reported by patients as sadness, feeling “too heavy”, and sometimes irritability and sudden changes in mood. 

How do you help a neurotic person?

Some ways you can help when you are with a person with a high degree of a neurotic personality trait: provide constant reassurance, behave positively and provide constant support, share your own stories and feelings, among others. 

What are the 5 main personality traits?

According to a long tradition of studies in psychology and personality measurement, the following five main personality traits have been defined: extraversion, neuroticism, openness to experience, conscientiousness and kindness. 

Recommended resources

  1. Depression: Comparative Studies of Normal, Neurotic, and Psychotic Conditions
  2. Chronic Depression: Diagnosis & Treatment for Dysthymic Disorder
  3. Greatness and Limitations of Freud’s Thought

What we recommend for depression

Professional counselling

If you are suffering from depression then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

References

  1. Neurotic depression: a diagnosis based on preexisting characteristics.
  2. Neurotic and Melancholic Depression: A Key Distinction
  3. The positive diagnosis of neurotic depression as an etiological category

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