Depressive Neurosis: Symptoms, Causes And Treatment
Do you know what depressive neurosis is? It is a type of depression, which originally had to do with alterations in the nervous system, but which little by little has evolved to become what we know today as dysthymia.
Although it is a term currently out of use, at the time it had a lot of impact, in addition to the fact that it came from psychoanalysis, an orientation that was highly recognized in previous times. In this article we will learn what depressive neurosis is, what symptoms it causes and what are the most frequently used treatments to treat it.
Before explaining what depressive neurosis consists of, let’s define what neurosis is. The neurosis It is a concept that was originally introduced by the Scottish doctor William Cullen in 1769
Cullen used this term to refer to all those sensory and motor disorders that were caused by certain diseases of the nervous system.
However, later, and in the field of clinical psychology, the term “neurosis” was used to designate those mental disorders that distort the rational thinking of the individual, and that interfere with the functioning of all areas of their life.
However, it is also true that a person can be neurotic (which has to do with obsessive thoughts, a negative state, feelings of guilt, “paranoia”…) without needing to consider this neurosis a mental disorder. It all depends on the level of severity of the symptoms and their interference in daily life
Symptoms
Typical symptoms and signs of neurosis are:
At a psychophysiological level, the symptoms that appear are:
Depressive neurosis (also called neurotic depression) is a term previously used in psychiatry to designate those depressions whose origin was explained by an intrapsychic conflict. The origin of the description of this painting is psychoanalytic.
On the other hand, The term “neurotic depression”, in particular, was introduced by Sándor Radó, and was later replaced by dysthymia (currently dysthymic disorder). So, currently the term neurotic depression is no longer used, but rather dysthymia (they would be equivalent).
Dysthymia, for its part, no longer refers to psychodynamic or psychoanalytic concepts, and is defined (according to the DSM-5, Diagnostic and Statistical Manual of Mental Disorders) as a chronically depressed mood most of the day on most days with a minimum duration of 2 years (1 year in the case of children).
Depressive neurosis, which we can say is a subtype of depression or a subtype of neurosis (depending on the author), is characterized by the following symptoms: sad mood most of the time, low self-confidence, low self-esteem , excessive self-criticism and physical alterations.
Symptoms
Typical symptoms of depressive neurosis beyond those already listed, are:
1. Depressed mood
It consists of the main symptom of depressive neurosis, like that of depression.
2. Loss of energy
A loss or decrease in energy occurs.
3. Slowed cognitive processes
Mostly, speech and thinking are slowed In addition, there is an added difficulty in concentrating.
4. Apathy
Apathy is a general state of disinterest, coupled with a lack of motivation to do things. In patients with depressive neurosis, in addition, a decrease in productivity in all senses also appears.
5. Abulia
Avolition is a lack of will or energy when doing things or moving Thus, the individual with depressive neurosis usually does not feel like doing “anything”, it is very difficult for him to start or do something, such as getting up in the morning, he avoids social activities, etc.
6. Despair
They also frequently appear feelings of despair
7. Low self-esteem
Self-esteem is usually low, as in other types of depression or neuroses.
The patient also frequently expresses self-critical thoughts (or messages) towards oneself
9. Feeling of rage
A feeling of anger appears that can make the patient “explode” in certain situations.
10. Difficulties in deciding
The patient is unable to decide for himself and this can occur even with “easy” or day-to-day (everyday) decisions.
11. Lack or excess of appetite
Hunger is also altered, and an excess of appetite or a deficit may appear.
12. Feelings of guilt
Feelings of guilt are another very characteristic symptom of depressive neurosis (which also frequently appears in depression).
13. Sleep disturbances
Finally, sleep alterations or disorders also appear, such as insomnia or the inability to rest well (non-restorative sleep)
Causes
Depressive neurosis has a multifactorial origin. Psychoanalysis is one of the orientations in psychology that has tried to answer what the causes of depressive neurosis are (in addition to being the orientation from which the term was born).
According to this orientation, the origin of depressive neurosis would be related to unpleasant experiences from abroad, with certain traumatic circumstances and stress factors. The external factors that could be causing said neurosis would be of great importance for the individual.
Stressors
Regarding the stressors mentioned, we find two groups within them:
1. Individual performance
They would be the factors that have to do with the individual’s own performance ; If he makes different “mistakes” or “failures” in different facets of his life, he can develop an excessively critical feeling of himself (and even of his own life).
2. Facts of emotional deprivation
According to psychoanalysis, and as a second group of stressors that could be at the origin of depressive neurosis, we find the so-called “acts of emotional deprivation.”
An example of this type of event would be separating from our loved ones accidentally and not having the necessary resources (on an emotional level) to face the situation in a healthy way.
The treatments that are usually used in depressive neurosis are:
1. Psychological treatment
When treating depressive neurosis (remember, current dysthymic disorder) there are different options in the context of psychological therapy. Cognitive-behavioral therapy (CBT) is the most effective treatment today in this sense (also to treat other types of depression).
Some of the most used tools or techniques in the context of CBT are:
Cognitive techniques (for example cognitive restructuring)
Programming pleasant activities
Environmental modification techniques (for example stimulus control)
Social skills training (EHS)
On the other hand, some studies, such as that of Besteiro and García (2000), suggest that hypnosis could also be considered one of the most effective treatments for depressive neurosis, along with relaxation (in second place).
The objective of psychological therapy in these cases, and in a generic way, will be improve the patient’s mood and work with their most internal conflicts
2. Pharmacological treatment
Regarding the pharmacological treatment of depressive neurosis, it is worth mentioning that there is no drug that “cures” this disorder (like practically no mental disorder), and that the most ideal thing will always be to go to a multidisciplinary treatment that also includes psychological therapy
However, antidepressant drugs are mainly used, especially SSRIs (Selective Serotonin Reuptake Inhibitors), which constitute the first choice pharmacological treatment. Examples of SSRI drugs are: fluoxetine, sertraline, paroxetine, and fluvoxamine.
American Psychiatric Association –APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
Besteiro-González, JL and García-Cueto, E. (2000). Use of hypnosis in the treatment of major depression. Psychothema, 12(4): 557-560.
Laplanche, J. & Pontalis, J.B. (1996). Dictionary of psychoanalysis (Fernando Gimeno Cervantes, trans.) (Vocabulaire de la Psychanalyse). Under the direction of Daniel Lagache. Buenos Aires: Paidós.
Pérez, M., Fernández, JR, Fernández, C. and Amigo, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pyramid.
Vallejo J. & Menchón, JM. (1999). Dysthymia and other non-melancholic depressions. In: Vallejo J, Gastó C. Affective disorders: anxiety and depression (2nd ed). Barcelona: Masson.
