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Anxiety, Depression, and Narcissism

Uploaded 8/19/2012, approx. 13 minute read

My name is Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.

A woman wrote to me to ask, My husband is a narcissist, and is constantly depressed. Is there any connection between these two problems, narcissism and depression?

Well, the answer is that there is no necessary connection. There is no proven high correlation between narcissism and enduring bouts of depression, but depression is a form of aggression. It is transformed. This aggression is directed at the depressed person rather than at his environment.

And this regime of repressed and mutated aggression is a characteristic of both narcissism and depression.

Indeed, narcissism is sometimes described as a form of low-intensity depression.

Back off a little.

Originally, the narcissist experiences forbidden thoughts, forbidden urges, sometimes to the point of obsession. The narcissist's mind is full of dirty words, curses, the remnants of magical thinking.

Narcissist says to himself, If I think or wish something to happen, it just might.

As well as denigrating and malicious celebrations concerned with authority figures.

When he was a child, with his parents, later with his teachers, later with his bosses. So all these, this seething cauldron of resentment, of anger, of hatred, of maliciousness, they are all prescribed, they are all prohibited by the superego, what we call conscious.

This is doubly true if the individual possesses a sadistic, capricious superego, the result of their own kind of parenting. These thoughts and wishes do not fully surface. The individual is only aware of them in passing and vaguely.

But they are sufficient to provoke intense guilt feelings and certain motion, a chain of self-flagellation and self-punishment.

So, prohibited thoughts, forbidden thoughts, punishing superego or conscience, and then self-punishment. Amplified by an abnormally strict sadistic and punitive superego, these prohibited thoughts result in a constant feeling of imminent threat.

And this is what we call anxiety. It has no discernible external triggers, therefore it is not fear.

It is, but it is, an echo of a battle between one part of the personality which viciously wishes to destroy the individual through excessive punishment and his or her instinct for self-preservation.

Anxiety is not, as some scholars have it, an irrational reaction to internal dynamics involving imaginary threats.

Actually, anxiety is more rational than many types of fear.

The powers unleashed by the superego, by the conscience, are so enormous. The superego's intentions are so fatal.

The self-loathing and self-degradation that it brings with it are so intense that the threat is absolutely real.

Overly strict superegos are usually coupled with weaknesses and vulnerabilities in all other dimensions of the personality.

Thus, there is no psychological structure which is capable of fighting back, of taking the side of the depressed person against the superego.

It is more wonder that people with depression have constant suicid litigation. They toy with ideas of self-mutilation and suicide, or worse, they commit them.

Confronted with such a horrible internal enemy, lacking in defenses, falling apart at the seams, depleted by previous attacks, devoid of the energy of life, depressed people wish to die.

Their anxiety is about survival, the alternatives being usually self-tonement or self-annihilation.

Depression is how this kind of patient experiences his overflowing reservoir of aggression.

The depressed patient is a volcano which is about to erupt and bury him under his own ashes.

Anxiety is how the patient experiences the war raging and waged inside him, his inner conflict.

Sadness is the name that he assigns to the resulting wariness, to the knowledge that the battle is lost and personal doom may well be at hand.

Depression is the acknowledgement by the depressed individual that something is so fundamentally wrong that there is no way he can win.

The individual is depressed because he is fatalistic.

As long as he believes that there is a chance and we are slim to better this position, the patient moves in and out of depressive episodes.

But when he gives up, it's only depression.

It's true that anxiety disorders and depression, mood disorders, do not belong in the same diagnostic category, but they are very often co-morbid.

In many cases, the patient tries to exercise his depressive demons by adopting ever more bizarre rituals.

These are the compulsions which, by diverting energy and attention away from the bad content in more or less symbolic or totally arbitrary ways, these compulsions bring temporary relief and an easing of the anxiety.

It is very common to meet or form mood disorder and anxiety disorder and obsessive-compulsive disorder and a personality disorder in one patient.

Depression is the most varied of all psychological illnesses. It assumes a myriad of guises and disguises.

Many people are chronically depressed without even knowing it and without discernible corresponding cognitive or affective content.

Some depressive episodes are part of cycles or a cycle of ups and downs, the bipolar disorder, the milder form, the cyclothymic disorder.

Other forms of depression are built into the characters and personalities of the patients, for instance, distematic disorder, or what used to be known as depressive neurosis.

One type of depression is even seasonal and can be cured by phototherapy, or gradual exposure to carefully fine artificial lighting.

We all experience adjustment disorders with depressed moods. These used to be called reactive depression. They occur after a stressful life event and is a direct and time-limited reaction to it.

These poisoned garden varieties are all pervasive. Not a single aspect of the human condition escapes them. Not one element of human behavior avoids their grip.

It is not wise, there is no predictive or explanatory value, to differentiate good or normal classes of depression from pathological ones. There are no good depressions. Whether provoked by misfortune or endogenously from the inside, whether during childhood or later in life, they are all one and the same.

Depression is a depression is a depression. No matter what is precipitating, causes are or which stage in life it occurs.

The only value distinction seems to be phenomenological.

Some depressive patients slow down. Psychomotor retardation sets in. They are appetite, sex life, libido, and sleep, known together as the vegetative functions.

They all are notably perturbed. They all slow down.

Behavior patterns change or disappear altogether. These patients feel dead. They are unhedonic, they find pleasure or excitement in nothing, and they are dysphoric, they are sad.

The other type of depressive is psychomotorically active or at times hyperactive. These are the patients that I described above.

They report overwhelming guilt feelings, anxiety, even to the point of having delusions, not grounded in reality, but in a thwarted logic of an outlandish world.

The most severe cases, severity is also manifested physiologically in the worsening of the above-mentioned symptoms.

So the most severe cases exhibit paranoia, the secondary delusions involving them in systematic conspiracies, and seriously entertained ideas of self-destruction or the destruction of others in holistic delusions.

These people hallucinate. Their hallucinations reveal their hidden content, self-deprecation, the need to be self-punished, humiliation, bad or cruel or permissive thoughts, about authority figures, and so on.

Depressives, people with depression, are almost never psychotic.

Psychotic depression does not belong to this family, in my view.

Depression does not necessarily entail a marked changing mood, though.

Masked depression is therefore difficult to diagnose if we stick to the strict definitions of depression as a mood disorder.

There are depressions in which the mood does not change. Depression can happen at any age, to anyone, with or without a preceding stressful event. Its onset can be gradual or dramatic.

The earlier in life it occurs, the more likely it is to recur.

And this apparently arbitrary and shifting nature of depression only enhances the guilt feelings of a patient.

The patient refuses to accept that the source of his problems is beyond his control, at least as much as his aggression is concerned, and that it could be biochemical or genetic.

The depressive patient blames herself for events in her immediate past or her environment.

And this is a vicious and self-fulfilling prophetic cycle.

The depressive feels worthless, doubts his future and their abilities, and feels guilty.

And this constant brooding alienates his nearest and nearest.

Her interpersonal relationships become dysfunctional and this in turn exacerbates her depression.

It's a cycle.

The patient finally finds it more convenient and rewarding to avoid social interactions altogether.

He resigns from his job, shies away from social occasions, sexually abstains, and shuts out his few remaining friends and family members.

Hostility, avoidance, histrionics all emerge, and the existence of personality disorders only makes matters worse.

Freud said that the depressive person has lost a love object, was deprived of a properly functioning parent.

A psychic trauma suffered early on can be alleviated only by inflicting self punishment, thus implicitly penalizing, devaluing the internalized version of the disappointing love object.

In other words, the patient internalizes the parent in his childhood and then seeks to punish the parent by punishing this internalized object and in other words by punishing himself.

The development of the ego is conditioned upon a successful resolution of the loss of these love objects, a phase we all have to go through.

When the love object fades the child, the child becomes furious, revengeful and aggressive.

Unable to direct his negative emotions at the frustrating parent, the child directs them at himself instead.

And so we come full circle to narcissism.

Narcissistic identification means that the child prefers to love himself, direct his libido at himself rather than loving, rather than to love an unpredictable, abandoning parent, mother in most cases.

When the child is confronted with a capricious, arbitrary or even malicious parent, the child prefers to love himself rather than the parent.

From that moment on, this learned self-love becomes malignant.

The child becomes his own parent and directs his aggression at himself, at the parent that he had become.

Throughout this wrenching process, the ego feels helpless, and this is another major source of depression.

When depressed, the patient becomes an artist of sorts. He tires his life, paper around him, his experiences, places and memories with a thick brush of schmaltzy, sentimental and nostalgic longing.

The depressive endures everything with sadness, a musical tune, a sight, a color, another person, a situation or a memory.

In this sense, the depressive is cognitively distorted. He interprets his experiences, evaluates his self and assesses the future totally negatively.

He behaves as though constantly disenchanted, disillusioned and hurting, according to the dysphoric effect.

And this helps him to sustain these distorted perceptions.

No success, no accomplishment or support can break through this cycle, because this cycle is so self-contained, so dramatic, so self-enhancing.

The dysphoric effect supports distorted perceptions, which enhance dysphoria, which encourages self-evading behaviors, which bring about failure, which justify depression.

Again, this vicious self-enclosed cycle.

And this is a cozy little circle, charmed and emotionally protected, because it is unfailingly unpredictable.

Depression is addictive because it is a strong love substitute.

Much like drugs, it has its own rituals, its own language and worldview.

Depression imposes a rigid order and behavior patterns on the depressive.

And this becomes learned helplessness.

The depressive professes to avoid even situations which hold the promise of improvement in his harrowing condition.

The depressive patient has been conditioned by repeated aversive stimuli to freeze in his tracks.

He doesn't even possess the requisite energy to end this world predicament by committing suicide.

The depressive is devoid of the positive reinforcements, which are the building blocks of our self-esteem.

He is filled with negative thinking about his self, his lack of goals, his lack of achievements, his emptiness, his loneliness and so on.

And because his cognition and perceptions are deformed, no cognitive or rational input can alter the situation.

Everything is immediately reinterpreted to feed the paradigm of depression.

People around the depressed patient, especially around the narcissist, often mistake depression for emotion.

They say about the narcissist, but he is sad. And what they mean to say is, but he is human, but he has emotions.

And this, of course, is wrong.

It's true that depression is a big component in the narcissist's emotional makeup.

But it mostly has to do with the absence of narcissistic supply. It mostly has to do with nostalgia for more plentiful days, for your adoration and attention and applause.

It mostly occurs after the narcissist has depleted his secondary sources of narcissistic supply.

He spout his maid, girlfriend, colleagues. After he drove them away with his constant demands for reenactment of his days of glory.

Some narcissists even cry. But they cry exclusively for themselves and for their lost paradise.

And they do so conspicuously, ostentatiously and publicly, in order to attract attention.

The narcissist is a human, human pendulum, hanging by the thread of the void, that is, his forced self.

The narcissist swings from brutal and vicious abrasiveness to malicious modeling and saccharins and immortality.

It is all a simulacrum, a verisimilitude and a facsimile. It's enough to fool the casual observer, enough to extract the narcissist's drug, from passers-by.

Other people's attention and the reflection that somehow sustain his house of cards can all be derived safely.

But the stronger and more rigid the defenses, and nothing is more resilient than pathological narcissism, the stronger these defenses are, the greater and deeper the hurts the narcissist aims to compensate for.

One's narcissism stands in direct relation to the seething abyss and the devouring vacuum that one harbors in one's true self.

Perhaps narcissism is indeed, as many say, a reversible choice. But it is also a rational choice, guaranteeing self-preservation and survival.

The paradox is that being a self-loathing narcissist may be the only act of true self-lamb that the narcissist ever commits.

If you enjoyed this article, you might like the following:

Raging Narcissist: Merely Pissed-off?

Narcissistic rage is a phenomenon that occurs when a narcissist is frustrated in their pursuit of narcissistic supply, causing narcissistic injury. The narcissist then projects a bad object onto the source of their frustration and rages against a perceived evil entity that has injured and frustrated them. Narcissistic rage is not the same as normal anger and has two forms: explosive and pernicious or passive-aggressive. People with personality disorders are in a constant state of anger, which is effectively suppressed most of the time, and they are afraid to show that they are angry to meaningful others because they are afraid to lose them.


Narcissist's Constant Midlife Crisis

The midlife crisis is a much-discussed but little understood phenomenon. There is no link between physiological and hormonal developments and the mythical midlife crisis. The narcissist is best equipped to tackle this problem as they suffer from mental progeria and are in a constant mid-life crisis. The narcissist's personality is rigid, but their life is not. It is changeable, mutable, and tumultuous. The narcissist does not go through a midlife crisis because they are forever the child, forever dreaming and fantasizing, forever enamored with themselves.


Depressive Narcissist

Pathological narcissism is often considered a form of depressive illness, with the life of a typical narcissist punctuated with recurrent bouts of dysphoria, sadness, hopelessness, anhedonia, loss of the ability to feel pleasure, and clinical forms of depression. Narcissists react with depression not only to life crises but to fluctuations in narcissistic supply and to the internal dynamics that these fluctuations generate. There are several types of dysphoria and depression in pathological narcissism, including loss-induced dysphoria, deficiency-induced dysphoria, self-worth dysregulation dysphoria, grandiosity gap dysphoria, and self-punishing dysphoria. Many narcissists end up delusional, schizoid, or paranoid to avoid agonizing and knowing depression.


So, Is My Narcissist a Covert Narcissist? Nonsense vs. Scholarship

Covert narcissists are individuals who suffer from an in-depth sense of inferiority, have a marked propensity towards feeling ashamed, and are shy and fragile. They are unable to genuinely depend on others or trust them, suffer from chronic envy of others, and have a lack of regard for generational boundaries. Covert narcissists are not goal-orientated, have shallow vocational commitment, and are forgetful of details, especially names. Inverted narcissists are a subspecies of covert narcissism and are self-centered, sensitive, vulnerable, and defensive, sometimes hostile and paranoid.


Misinformation: Covert vs. Classic Narcissist

Covert narcissists are not cunning or manipulative, but rather suppress their true nature due to a lack of confidence. They are their own worst critics and often feel guilty and ashamed of their aggressive urges. Covert narcissists team up with classic narcissists but secretly resent and envy them. Inverted narcissists are a type of covert narcissist who are self-centered, sensitive, vulnerable, and defensive, and crave relationships with narcissists despite any abuse inflicted on them.


Old-age Narcissist

Narcissists age without grace, unable to accept their fallibility and mortality. They suffer from mental progeria, aging prematurely and finding themselves in a time warp. The longer they live, the more average they become, and the wider the gulf between their pretensions and accomplishments. Few narcissists save for rainy days, and those who succeed in their vocation end up bitterly alone, having squandered the love of family, offspring, and mates.


Narcissist: Is He or Isn't He?

Narcissism is a spectrum of behaviors, from healthy to pathological, and the Diagnostic and Statistical Manual specifies nine diagnostic criteria for narcissistic personality disorder (NPD). A malignant narcissist is someone who has NPD and wreaks havoc on themselves and their surroundings. They feel grandiose and self-important, exaggerate accomplishments, and demand recognition as superior without commensurate achievements. They require excessive admiration, adulation, attention, and affirmation, and are interpersonally exploitative, devoid of empathy, and constantly envious of others.


Narcissist's Cycles of Ups and Downs

Narcissists go through cycles of mania and depression, which are caused by external events or circumstances known as triggers. The cycles are different from manic depressive cycles in bipolar disorder, which are endogenous. The narcissist is addicted to narcissistic supply and seeks admiration, adoration, approval, attention, and so on. The narcissist goes through ups and downs, including a depressive phase, a hibernation phase, and a manic phase, which are all part of the process of obtaining and securing narcissistic supply.


Inverted Narcissist (Narcissist Codependent)

Inverted narcissists are a type of codependent who exclusively depend on a narcissist. They are self-effacing, sensitive, emotionally fragile, and sometimes socially phobic. They derive all their self-esteem and sense of self-worth from the outside and are pathologically envious. Inverted narcissists are narcissists, and it is possible to compose a set of criteria for them by translating the criteria available in the Diagnostic and Statistical Manual for the classical narcissist.


Bipolar Disorder Misdiagnosed as Narcissistic Personality Disorder (NPD)

The manic phase of bipolar disorder is often misdiagnosed as narcissistic personality disorder due to the similarities in symptoms. However, the manic phase of bipolar disorder is limited in time and followed by a depressive episode, whereas narcissistic personality disorder is not. The source of the bipolar patient's mood swings is brain biochemistry, not the availability or lack of availability of narcissistic supply. Additionally, the bipolar patient is dysfunctional, while the narcissist is functional.

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