00:01Good evening everyone, I welcome you to the ongoing series on psychoanalysis and I am
00:09Vulket and clinical psychologist at Wimhans and today's talk will touch upon depression.
00:17You know, depression is a very very broad term.
00:21So it is used in everyday terms, we also see it in terms of personality, we also see it as
00:34a specific disorder.
00:36So I will just take a few moments to clarify what particular form of depression we are talking about today.
00:47Which interestingly I also have not written so much on my slides, you know, so I will just stay here
00:55only.
00:56It just stuck my mind right now.
01:00See, one very important thing is that we may use the term depression in our everyday understanding, communication and feelings.
01:08You know, one very obvious meaning when I say that I am depressed, it simply means that I am feeling
01:13low.
01:15Something has happened at the moment that I am feeling low, so I say that I am depressed.
01:21So that's one meaning of depression which is simple, like the normal sadness which comes and goes, which does not
01:29stay on.
01:30Right?
01:31There is a second form of depression which is more personality based.
01:38We are going to actually touch upon this second form of depression.
01:42Now, this kind of depression has its roots pretty early in childhood.
01:47There are people who develop in a certain way, that they, you know, grow up with a very quality sense
01:54of self.
01:54They feel that there is something wrong with them, right from a very early stage of life and they, very
02:03easily they get, you know, sad or unhappy.
02:08And their entire life is, they are somewhere scared that, you know, no one would love to be with them.
02:16And so their entire life is organized around those themes, you know, so you would be in detail talking about
02:23this.
02:24Second type is the depressive personality.
02:26There is third, which we, you know, see depression as a psychiatric disorder.
02:33There are many medical causes also which may lead to the onset of depression in a very, you know, in
02:42any person at any stage.
02:44It could be, you know, something, you know, it could be related to a hormonal imbalance or it could be
02:51something else also.
02:52But the difference between a depressive personality and a psychiatric depression is that a psychiatric depression would come and, you
03:03know, with treatment it could go and then it may, it usually does not come back.
03:09But the interesting part about a depressive personality is because it's a part of who you are, so it stays
03:15on with you, you know.
03:16Even if you have anti-depressants and everything, it stays on with you.
03:20You may feel a little better, you may feel a little lepped up, but the emotion stays on with you.
03:26And I just kind of take some more time to clarify this.
03:34As I said, it's very important, you know, because what happens in our country and in our set of will
03:41is that we actually are confused between the three.
03:45So if someone comes and says that I'm feeling very depressed, so we may think of it as, you know,
03:51that it's something which is, you know, which is very transitioning, just pass right away kind of thing.
03:58So it's important to be able to distinguish between this normal sadness and other forms of depression.
04:07As I said, it is actually also very confusing because, you know, you can also have three things at times,
04:16you know, it's not that you can have either of them.
04:18But as I said that the depressive personality about which we are talking today specifically, it includes repetitive personality themes.
04:26Like, which are in some ways very lifelong, that they would not leave you, you know.
04:30They are not the things which will come and go.
04:33It's not like this that every, you know, that now you are feeling very fine and after eight months you,
04:38you know, feel low.
04:41It's not like that. It's like this that, yeah, in your life you are feeling, you know, at times a
04:46little normal, at times a little high, at times a little low.
04:48But at the back of your mind these low feelings are almost always there kind of thing.
04:55And they would include that they are, you know, the ways in which the person thinks, the ways in which
05:01the person feels, behaves and relates to others.
05:05And they typically intensify under stress, you know, so if everything is going on fine for that person, he or
05:13she may be able to manage through life,
05:15may be able to work, may be able to, you know, it's like any one of us.
05:19But if, you know, there's an experience of stress, any kind of stress, you know, positive stress, negative stress,
05:27then, you know, the personality themes start intensifying during that time.
05:35Yeah, and the interesting point of differentiation, one has been between the depressive personality and the psychiatric depression is that
05:45you may not see very severe vegetative symptoms, you know, because when you have a psychiatric depression,
05:51it would be like this, that your appetite would drastically go down, your sleep would be drastically low,
06:00you would be like, you know, you would not, you know, the person may be quite restricted in their movements
06:09and there would be a decreased sense of pleasure.
06:12But a depressive personality is able to actually carry on the day to day tasks kind of thing.
06:19It's somewhere inside, deep down, that they have these feelings.
06:26As I again said, the anti-depressant or any mood stabilizing medications do have an impact on the depressive illness,
06:37on symptoms of depression, but if someone has that kind of a personality, they may have actually a very little
06:44impact on that.
06:47Because in order to heal the, if someone has a depressive personality, they will require a great deal of self
06:55-awareness and some kind of working through all their inner conflicts,
06:58about which we are going to touch in today's talk.
07:04Right, so we've come to this, you know, since we are talking about depressive personalities,
07:12so let me kind of talk a little bit about who is a depressive personality.
07:26So let's first of all go through some very typical signs and symptoms that we see in these people.
07:39So in general, you know, that's the hallmark of depressive personality, in general across situations, across situations.
07:46It's not one situation, like if someone, if you, if someone has a breakup, then everyone is depressed inside.
07:54You know, if you are not depressed inside, you know, if you are not depressed inside, if you have a
07:56breakup, then you are normal, clear that.
07:58So, or you are really defending a lot against the pain.
08:04But the hallmark of depressive personality is that whether it's a, you know, good situation or a bad situation,
08:10the person is not, you know, the mood remains likely, you know, kind of thing.
08:18You know, the, it's very typical for such people to say, you know, like,
08:24I remember, you know, this patient who, who had, who was not driving for the last five years,
08:32and after five years he started driving, so he came to the session and he shared,
08:37I started driving, but he said it in a very, very, you know, very cold manner.
08:42He just came and in a very mad lot of fact, he said, oh, you know, last week I started
08:46driving.
08:47So there was no joy, no elation, you know, that he has resumed driving after five years or something like
08:53that.
08:55And another thing, you know, like, you, you know, that you would kind of, if you have seen people like
09:02this,
09:02you would almost always wish that they should be a little more happy.
09:05You would always go and ask the people, aren't you happy?
09:08You should be slightly more happy, you know.
09:11You know, you are getting married or this thing is happening, where is the joy?
09:15These people, you know, very mad to the fact that they, yeah, it's okay, if that's happening, it's okay.
09:22I'm, I'm, I'm happy, you know, kind of thing.
09:25But you never see that kind of, you know, overwhelming joy.
09:30And another thing is that even if anything slight goes wrong, it's very easy for these people to slip down
09:38into a low state, you know, just at the drop of a hat.
09:42You know, that anything small that happens which upsets them and they may start feeling low.
09:49And when they are feeling low, it's not as easy for them to come out of that hole.
09:55For a normal person, if something happens and you feel low, you can bounce back a little easily.
10:01But these people, even if something small happens and they start feeling low, so they may be like, you know,
10:10they would be in that state.
10:11And, you know, a lot of effort would be required from their side and from other people's side to pull
10:16them out.
10:18At times you may find them fearful.
10:20Another interesting thing is, which you may see in a select group of these people, that at times you may
10:26not find them fearful or sad, but you may find them irritable, you know, shot fused.
10:30You know, that anything which is not according to them and they would be irritated very easily with you and
10:42so those things.
10:47Another interesting dimension when we are talking about sadness is, you know, that one can be objectively sad, subjectively sad
10:55for both, you know, now what do you mean by that?
10:57It's like this, that at times these people may actually tell you that I am feeling sad, you know, which
11:04is that they have a subjective experience of sadness.
11:07So in one sense that I am feeling sad, you know.
11:09Though on the whole, when you see them from, you know, the outside, you may find them normal, you know,
11:15or you may find them slightly inhibited for that matter.
11:20But they are sad, so subjective sadness means that a few of these people feel that kind of sadness and
11:28so they say that I am sad.
11:31But there is a other category which may, either may be feeling the subjective sadness which is too shy or
11:40too reserved to say it or they may also, you know, they may be in denial of their low feeling.
11:46So they may not say or they may not consciously, you know, register the fact that they are feeling sad
11:52but you as an observer may be able to make it out from their behavior.
11:57That there is something wrong with this person, that this person perpetually looks slightly unhappy.
12:03So those dimensions are there.
12:07Yeah, as I said, even when there are occasions to be happy, the person either may show very little happiness
12:13or the happiness does not seem to last long, you know.
12:19One school going girl, you know, whom I had seen a few years ago, with her the thing was that
12:25she was very good at debating and she would win, you know, like,
12:31she would go for these debating competitions and she would win them and she would get, you know, very interesting
12:37colourful certificates and trophies like you get in schools.
12:41So she would be very happy for a day or two that she has achieved something and she has done
12:45something.
12:46But the third day she would once again start having this feeling that, you know, she is not good, there
12:52is something, you know, wrong somewhere and she needs to do something, you know.
12:57So she would again start seeking an experience, you know, to reassure herself, you know, that she is good.
13:05So this thing may happen.
13:09Correct.
13:11And, yeah, these people also may have markedly diminished pleasure or interest in various activities.
13:20They could have it in one group of activities or they could have it in many spheres.
13:24But it does not mean that, what I mean to say is that they are doing those activities, they are
13:29doing those things,
13:31but they are unable to give that kind of a hundred percent or they are unable to feed a hundred
13:37percent, you know, for these things.
13:38So, like another friend actually, which comes to my mind, so he had, he was interested in several, several things,
13:50you know,
13:51very gifted person interested in several things in life.
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