Depressive neurosis (dysthymia)

Currently, mental health is taking center stage thanks to how our knowledge in this field has advanced over the last few decades.

The volume of research on different disorders is increasing, such as depressive neurosis, highlighting the symptoms and the way to manage them; all this, in order to minimize the impact it can have on the person who suffers from them.

In this case, we will focus on depressive neurosis or neurotic depression. A disorder that has changed over time, disappearing from the main diagnostic manuals and giving way to dysthymia. Somehow, for have less intense and disabling symptoms than depressiondysthymia has been considered its little sister.

A mistake without a doubt. Perhaps the condition is less pronounced, less disabling.. However, what at first may seem like an advantage to us may actually be very bad news. This is because the person frequently carries their depressive neurosis or dysthymia for very long periods, without considering the need for intervention.

What is neurosis?

Before defining the symptoms and characteristics of depressive neurosis, it is pertinent to take into account what the neurosis consists of. This is a concept introduced by the Scottish doctor William Cullen, in 1769, which referred to all those sensory and motor disorders caused by some alteration of the nervous system.

However, with the passage of time, clinical psychology appropriated the term “neurosis” to designate the mental disorders that distort a person’s rational thinking and interfere with their optimal functioning in different areas of your life (social, work, academic, etc.).

Although, it is pertinent to mention that currently A person can be considered neurotic without the need for their condition to be a mental disorder.. In these cases, we are talking about individuals who tend to develop ruminative thinking, feelings of guilt, anxiety, among others. What defines suffering from a mental disorder will be the severity of the symptoms and the interference with your daily life.

What is depressive neurosis?

Depressive neurosis is considered as a psychopathological disorder characterized by the constant presence of a sad mood. In addition, it is included within depressive disorders.

The clinical picture causes physical activity and execution speed to significantly decrease. Unlike other depressive disorders, the person is not prevented from carrying out many of their daily activities; In return, we see that he does them less frequently and more slowly. Likewise, your level of initiative also decreases.

Causes

It is important to clarify that, like all depressive disorders, has a diverse etiology. Among its precipitants or causes, the personal situation of the subject, genetic inheritance and the social conditions in which it develops can be considered.

Characteristics of depressive neurosis

As it belongs to depressive disorders, it usually has characteristics and symptoms similar to other types of depression. Even so, it is important to clarify that it has implications on a physical and psychological level. These significantly affect the quality of life of the person who suffers from it and that of the people closest to them.

A first characteristic is a state of mind in which the sadness. This affectation usually lasts over time (minimum two years). Although it is not constant, it presents crises that last for two months; Then an improvement may appear, only to return to a new crisis. That is, it has a periodic nature.

Additionally, there is a close relationship with genetic vulnerability. That is, there is a high probability that some close or distant relatives have had some type of depression.

Some personality traits can make you more susceptible to the development of depressive neurosis. These traits also help maintain some of the symptoms.

Symptoms of depressive neurosis

There are multiple symptoms that can be characteristics of depressive neurosis, but without a doubt has a particular and characteristic triad. It includes:

Decreased vitality and energy. Mood related to sadness and depression. Decreased speed of thought and speech.

Apart from this triad, there is a much broader picture of symptoms that include emotional, cognitive and behavioral symptoms.

One of them is the loss of interest and motivation in daily activities, including work and leisure. Also, feelings of sadness and despair should be included due to the sensations that are reflected in the person during the depressive neurosis crisis.

Likewise, there are presence of fatigue and lack of energy for daily activities. Likewise, the decrease in self-esteem increases the person’s own insecurity. This, added to the rest of the manifestations, reduces the quality of life of the affected person.

On the other hand, it is easy for a change in eating and sleeping habits that affect your routine.

Regarding cognitive symptoms, they have been found difficulties in attention, especially in focused, sustained and selective attention. This implies problems in carrying out non-automated activities, affecting tasks related to work and/or studies.

They are also given difficulties in decision making, which is associated with a decrease in productivity.

Finally, note that the person can be very self-critical, leading to frequent feelings of guilt. All of this occurs as a result of the difficulties that arise when doing the activities. Furthermore, the person usually distances themselves from their social support circle, ceasing to enjoy the interactions that occur in this context.

Perspective from psychoanalysis

The explanation from a psychoanalytic perspective of neurotic depression is related to an affectation of the self. Specifically, there is a affectation of narcissism in which the ego ideal is increased and exacerbated.

The symptoms would occur due to an inhibition of the vital force, especially a loss of instinctual tension. This would be what would cause fatigue, decreased psychomotor drive, thought paralysis, inability to decide, loss of initiative and reduction of emotional relationships.

Therefore, the onset of any type of depression It is located in a region of the personality where self-image and the desire for power come together..

In the case of neurotic depression, there is a collapse of the ideal perspective of one’s self. This creates a feeling of emptiness in the person and a loss of meaning in life..

Multidisciplinary treatment

Currently there are different ways to work on depressive neurosis. Even so, it is important to emphasize the importance of a multidisciplinary and integrated approachwhich includes pharmacological treatment and psychotherapy.

For pharmacological treatment, selective serotonin reuptake inhibitor (SSRI) medications are mainly used. It should be noted that, despite its almost systematic use, it has been found that the effectiveness is below 60% in patients with neurotic depression.

On the other hand, there are interventions that are carried out on a psychological level. First of all, there is the cognitive-behavioral therapy. With this type of therapy, notable results have been achieved in quality of life.

Among the most used techniques are training in social skills and symptom management, behavioral activation, environmental modification and cognitive restructuring.

There is also the psychoanalytic therapy, in which unresolved relationships and conflicts are worked on. In addition, a work on grief; Here aspects such as the loss of trust or the reinforcement of narcissism are worked on. The idea is that this intervention reduces or ends the depressive neurosis.

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