Depression and the Narcissist

Question:

My husband is a narcissist and is constantly depressed. Is there any connection between these two problems?

Answer:

Assuming that these are clinically established facts, there is no necessary connection between them. In other words, there is no proven high correlation between suffering from NPD (or having even a milder form of narcissism) - and enduring bouts of depression.

Depression is a form of aggression. Transformed, this aggression is directed at the depressed person rather than at his environment. This regime of repressed and mutated aggression is a characteristic of both narcissism and depression.

Originally, the narcissist experiences "forbidden" thoughts and urges (sometimes to the point of an obsession). His mind is full of "dirty" words, curses, the remnants of magical thinking ("If I think or wish something it just might happen"), denigrating and malicious thinking concerned with authority figures (mostly parents or teachers).

These are all proscribed by the Superego. This is doubly true if the individual possesses a sadistic, capricious Superego (a result of the wrong 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 to set in motion a chain of self-flagellation and self-punishment.

Amplified by an abnormally strict, sadistic, and punitive Superego - this results in a constant feeling of imminent threat. This is what we call anxiety. It has no discernible external triggers and, therefore, it is not fear. It is the echo of a battle between one part of the personality, which viciously wishes to destroy the individual through excessive punishment - and the instinct of 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 fears. The powers unleashed by the Superego are so enormous, its intentions so fatal, the self-loathing and self-degradation that it brings with it so intense - that the threat is real.

Overly strict Superegos are usually coupled with weaknesses and vulnerabilities in all other personality structures. Thus, there is no psychic structure able to fight back, to take the side of the depressed person. Small wonder that depressives have constant suicidal ideation (=they toy with ideas of self-mutilation and suicide), or worse, commit such acts.

Confronted with a horrible internal enemy, lacking in defences, falling apart at the seams, depleted by previous attacks, devoid of energy of life - the depressed wishes himself dead. Anxiety is about survival, the alternatives being, usually, self-torture or self-annihilation.

Depression is how such people experience their overflowing reservoirs of aggression. They are a volcano, which is about to explode and bury them under their own ashes. Anxiety is how they experience the war raging inside them. Sadness is the name that they give to the resulting wariness, to the knowledge that the battle is lost and personal doom is 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 - however slim - to better his position, he moves in and out of depressive episodes.

True, anxiety disorders and depression (mood disorders) do not belong in the same diagnostic category. But they are very often comorbid. In many cases, the patient tries to exorcise 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 (though totally arbitrary) ways - bring temporary relief and an easing of the anxiety. It is very common to meet all four: a mood disorder, an anxiety disorder, an 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 corresponding cognitive or affective contents. Some depressive episodes are part of a cycle of ups and downs (bipolar disorder and a milder form, the cyclothymic disorder).

Other depressions are "built into" the characters and the personalities of the patients (the dysthymic disorder or what used to be known as depressive neurosis). One type of depression is even seasonal and can be cured by photo-therapy (gradual exposure to carefully timed artificial lighting). We all experience "adjustment disorders with depressed mood" (used to be called reactive depression - which occurs after a stressful life event and as 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 behaviour avoids their grip. It is not wise (has no predictive or explanatory value) to differentiate "good" or "normal" depressions from "pathological" ones. There are no "good" depressions.

Whether provoked by misfortune or endogenously (from the inside), whether during childhood or later in life - it is all one and the same. A depression is a depression is a depression no matter what its precipitating causes are or in which stage in life it appears.

The only valid distinction seems to be phenomenological: some depressives slow down (psychomotor retardation), their appetite, sex life (libido) and sleep (known together as the vegetative) functions are notably perturbed. Behaviour patterns change or disappear altogether. These patients feel dead: they are anhedonic (find pleasure or excitement in nothing) and dysphoric (sad).

The other type of depressive is psychomotorically active (at times, hyperactive). These are the patients that I described above: they report overwhelming guilt feelings, anxiety, even to the point of having delusions (delusional thinking, not grounded in reality but in a thwarted logic of an outlandish world).

The most severe cases (severity is also manifest physiologically, in the worsening of the above-mentioned symptoms) exhibit paranoia (delusions of systematic conspiracies to persecute them), and seriously entertain ideas of self-destruction and the destruction of others (nihilistic delusions).

They hallucinate. Their hallucinations reveal their hidden contents: self-deprecation, the need to be (self) punished, humiliation, "bad" or "cruel" or "permissive" thoughts about authority figures. Depressives are almost never psychotic (psychotic depression does not belong to this family, in my view). Depression does not necessarily entail a marked change in mood. "Masked depression" is, therefore, difficult to diagnose if we stick to the strict definition of depression as a "mood" disorder.

Depression can happen at any age, to anyone, with or without a preceding stressful event. It can set on gradually or erupt dramatically. The earlier it occurs - the more likely it is to recur. This apparently arbitrary and shifting nature of depression only enhances the guilt feelings of the patient. He refuses to accept that the source of his problems is beyond his control (at least as much as his aggression) and could be biological, for instance. The depressive patient always blames himself, or events in his immediate past, or his environment.

This is a vicious and self-fulfilling prophetic cycle. The depressive feels worthless, doubts his future and his abilities, feels guilty. This constant brooding alienates his dearest and nearest. His interpersonal relationships become distorted and disrupted and this, in turn, exacerbates his depression.

The patient finally finds it most convenient and rewarding to avoid human contact altogether. He resigns from his job, shies away from social occasions, sexually abstains, shuts off his few remaining friends and family members. Hostility, avoidance, histrionics all emerge and the existence of personality disorders only make matters worse.

Freud said that the depressive person had lost a love object (was deprived of a properly functioning parent). The psychic trauma suffered early on can be alleviated only by inflicting self-punishment (thus implicitly "punishing" and devaluing the internalised version of the disappointing love object).

The development of the Ego is conditioned upon a successful resolution of the loss of the love objects (a phase all of us have to go through). When the love object fails - the child is furious, revengeful, and aggressive. Unable to direct these negative emotions at the frustrating parent - the child directs them at himself.

Narcissistic identification means that the child prefers to love himself (direct his libido at himself) than to love an unpredictable, abandoning parent (mother, in most cases). Thus, the child becomes his own parent - and directs his aggression at himself (=to the parent that he has 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 tars his life, people around him, his experiences, places, and memories with a thick brush of schmaltzy, sentimental, and nostalgic longing. The depressive imbues everything with sadness: a tune, a sight, a colour, another person, a situation, 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 (dysphoric affect) and this helps to sustain the distorted perceptions.

No success, accomplishment, or support can break this cycle because it is so self-contained and self-enhancing. Dysphoric affect supports distorted perceptions, which enhance dysphoria, which encourages self-defeating behaviours, which bring about failure, which justifies depression.

This is a cosy little circle, charmed and emotionally protective because it is unfailingly predictable. Depression is addictive because it is a strong love substitute. Much like drugs, it has its own rituals, language and worldview. It imposes rigid order and behaviour patterns on the depressive. This is learned helplessness - the depressive prefers to avoid situations even if they hold the promise of improvement.

The depressive patient has been conditioned by repeated aversive stimuli to freeze - he does not even have the energy needed to exit this cruel world 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 and 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 fit the paradigm.

People often mistake depression for emotion. They say about the narcissist: "but he is sad" and they mean: "but he is human", "but he has emotions". This is wrong. True, depression is a big component in the narcissist's emotional make-up. But it mostly has to do with the absence of Narcissistic Supply. It mostly has to do with nostalgia for more plentiful days, full of adoration and attention and applause. It mostly occurs after the narcissist has depleted his secondary Sources of Narcissistic Supply (spouse, mate, girlfriend, colleagues) with his constant demands for for the "re-enactment" 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 and publicly - to attract attention.

The narcissist is a human pendulum hanging by the thread of the void that is his False Self. He swings between brutal and vicious abrasiveness - and mellifluous, maudlin, and saccharine sentimentality. It is all a simulacrum. A verisimilitude. A facsimile. Enough to fool the casual observer. Enough to extract the drug - other people's attention, reflection that somehow sustains this house of cards.

But the stronger and more rigid the defences - and nothing is more resilient than pathological narcissism - the greater and deeper the hurt the narcissist aims to compensate for. One's narcissism stands in direct relation to the seething abyss and the devouring vacuum that one harbours 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-love the narcissist ever commits.

next: Homosexual and Transsexual Narcissists