Why depression is a healthier reaction than paranoia

It is a general view among psychotherapists that depression is typically a sign of a relatively well preserved healthy core of the personality of the sufferer. To develop depression as a reaction to loss or to unbearable life experiences requires a complexity in the person’s sensibility and an acknowledgement of the Other: the other people, the other world, the other things, interests, values, etc. The person withdraws before the Other, because, having suffered a defeat in life, she questions one’s own value. Individuals who suffer from depression usually have issues with self-love and self-worth, and this means that they attach value to the Other and Others. Such persons require support, warmth and love in order to rehabilitate their sense of own value and to be able to engage again in what can be a fantastic emotional exchange with their significant others.

On the other hand, a manic or paranoid reaction to discouraging life experiences is the opposite: it devalues the Other, the world and the other people, especially the significant others, and attaches excessive importance to one’s own hurt. Paranoid ideation is also a compensation of psychosis and is by no means the worst the person can do in trying to map their way out of an existential impasse; however, paranoia depicts the Others as malignant and malevolent, as challenges to the (unquestioned) self-worth of the sufferer. Thus, some paranoid persons will withdraw, however in a way which portrays Others and the world as sources of threat before which one withdraws, while other paranoid persons will become aggressive and engage in a quest to prevent the threat the Others represent to the (again unquestioned) self-worth of the person herself. Thus, to show empathy for paranoia or mania is a different thing than to show empathy for a person who is depressed. In the former case, it is usually a better idea to focus on re-establishing structure and self-discipline of thought (except in manifest psychosis), while in the latter case the cure is simply human touch and support.

Now, things are usually not as simple as what I have said so far. There is a danger for depressed persons after they have surfaced from their depression: they may easily develop an overly emphasized focus on themselves which may present as a degree of narcissism. This is a huge danger, which intelligent depressed persons must recognize and must fight against. It is best recognized through the language. A language that is starkly absorbed in first person statements, a speech that is constantly about oneself, is a sure sign that the hurt from depression is being processed as a post-depression narcissism.

Again, the deeper-seated personality traits determine how we will behave under different conditions, including ‘disorders’. A resourceful, intelligent person will  fight off the post-depression narcissism, while someone with fewer symbolic resources may become relatively easily sucked into narcissistic ideation and, more fundamentally, into narcissistic sensibility.

Aleksandar Fatić