Types of Depression

Depression is more heterogeneous than other mental disorders, and the causes and symptoms of the condition can vary greatly from person to person. It has therefore been difficult to classify depression, but psychodynamic theorists have attempted to do so by dividing it into two types based on the role of everyday events in its development. This distinction has been supported by other theorists, such as cognitive-behavioral theorists. According to psychodynamic theorists, the first type of depression is related to the childhood experiences and is called anaclitic or dependent depression, while the second type is related to the superego and is called introjective or self-critical depression (Blatt,2015).

Anaclitic or dependent individuals generally experience feelings of loneliness, helplessness, or weakness, and have deep, unfulfilled longings for love, care, and protection. They may have chronic fears of being abandoned, left unprotected, or neglected. As a result of these feelings and fears, they often seek comfort, proximity, and satisfaction from others, and react to situations of separation or interpersonal loss with significant anxiety, fear, and concern, often through denial and/or a search for alternative sources of satisfaction and support. Depression is often triggered by a loss of an object. Anaclitic individuals frequently express their depression through somatic complaints, such as fatigue and pain, and often seek the care and attention of others, including doctors. (Blatt, 2015).

Anaclitic depression can also be divided into submissive and needy subtypes. Submissive anaclitic individuals are more conciliatory and sociable in their attempts to gain approval from others, experience intense feelings of hopelessness and helplessness, and hold beliefs that everything is a path to happiness and that their own self is bad and damaged. They do not worry about their own needs, and may be prone to mistrust and fear of being harmed, deceived, or betrayed by others. Needy anaclitic individuals, tend to be needy and dependent due to their fear of rejection and abandonment, and may form intense and rapid attachments, idealize others, and choose inappropriate or potentially harmful partners or associates. They may also be prone to feeling misunderstood or victimized(Rost et al., 2019).

Introjective or self-critical individuals often experience feelings of worthlessness, inferiority, failure, and guilt. They tend to constantly question, criticize, and evaluate their own actions and behaviors, and experience fear of losing the approval of others and being criticized during these processes. They work extremely hard for excessive achievement and perfection, impose high demands on themselves, are highly competitive, and make extreme demands on themselves. They may use excessive repair to obtain and maintain approval and recognition, such as by taking on the most difficult tasks in group projects, and have a strong need to be successful. They avoid being criticized, seen as flawed, and humiliated by others, and are extremely vulnerable to criticism, scrutiny, and judgment from others and themselves (Blatt, 2015). Introjective depression can be divided into dismissive and self-critical subtypes.

Dismissive individuals have little need for human relationships, have few or no friends, and show little empathy or concern for the needs of others. They may be overly dismissive and critical, and may tend to blame others, leading to confrontational and rebellious attitudes. They feel entitled and privileged, and have exaggerated feelings of self-importance. Self-critical individuals, on the other hand, feel inadequate and inferior, but present themselves as strong and controlled to the outside world, often denying their need for comfort and care, while seeking relationships that provide protection and care. They are absorbed in their work, and are productive. They intensely criticize themselves and constantly expect perfection from themselves. They struggle to experience pride, pleasure, or joy (Rost et al., 2019).

These characteristics associated with these four subtypes of depression may be experienced by many people at certain times and circumstances, but this does not necessarily mean that they have been diagnosed with depression. For a diagnosis of depression to be made, these characteristics must cause significant dysfunction and be accompanied by other symptoms of depression, such as sleep disturbance, inability to enjoy life, hopelessness, etc.