Connection between Narcissism and Depression



The narcissistic orientation is one in which one experiences as real only that which exists within oneself, while the phenomena in the outside world have no reality in themselves, but are experienced only from the viewpoint of their being useful or dangerous to one.

 The Art of Loving, Erich Fromm




Narcissism and Narcissistic Personality Disorder

The label of “narcissist” comes from a Greek myth about the hunter named Narcissus who was so proud of his own physical attractiveness that he showed great disdain for anyone who loved him. According to this myth, Nemesis, the goddess of divine retribution, decided that Narcissus was a tad too arrogant for her liking. The story goes that Nemesis enticed Narcissus to a pool of water where he saw his own reflection and fell in love with it. Not understanding that this was his own reflection, Narcissus pined for the beautiful being he saw before him. But alas, his reflection could not return love. Narcissus ends up dying next to the reflecting pool, unable to separate himself from his own image.

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Nowadays we use the term, “narcissistic” to describe someone who is arrogant and full of him or herself. But there can be more to this type of personality than just a big ego. Some individuals meet the criteria for a psychiatric label of Narcissistic Personality Disorder (NPD).

To be diagnosed with narcissistic personality disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Criteria for narcissistic personality disorder to be diagnosed include:
·         Having an exaggerated sense of self-importance
·         Being preoccupied with fantasies about success, power or beauty
·         Believing that you are special and can associate only with equally special people
·         Requiring constant admiration
·         Having a sense of entitlement
·         Taking advantage of others
·         Having an inability to recognize needs and feelings of others
·         Being envious of others
·         Behaving in an arrogant or haughty manner

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Narcissism and Depression

Narcissism and depression are believed to sometimes occur together, probably because the narcissistic personality is incapable of developing true feelings of self-worth or intimacy with others. Some experts believe that narcissism can easily occur simultaneously with bipolar disorder, a type of depression. People with narcissism generally rely heavily on the care and attention of others for their feelings of self-worth, such that when that attention is withdrawn, they might fall into depression. The causes of narcissism are believed to stem from neglect or abuse in infancy or very early childhood, so narcissism and depression might occur together due to the irreparable damage these early experiences might have had on the narcissist person's self-esteem. Some believe that the narcissist's extreme sense of self-involvement makes it difficult for him, not only to experience empathy with another's needs, but to fully perceive the existence of other individuals at all.

Freud said that the depressive lost a love object (was deprived of a properly functioning parent). The psychic trauma suffered is curable only by inflicting self-punishment (thus implicitly "punishing" and devaluing the internalized version of the disappointing love object). The development of the Ego is conditioned upon the successful resolution of the loss of the love objects (that all of us have to go through). When the love object fails – the child is furious, revengeful, aggressive. Unable to direct these negative emotions at the deserving parent – the child resorts to directing them at himself. Narcissistic identification means that the child prefers to love himself (direct 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 is). Throughout this wrenching process, the Ego feels helpless and this is another major source of depression.

The typical narcissist believes that his own opinions and beliefs are always the correct ones, and that he is generally perfect in just about every way. Most psychologists believe, however, that the narcissist's extremely high self-opinion is just a facade covering deeply-held feelings of low self-esteem and low self-worth. It is therefore generally believed that the narcissist seeks to surround himself with people who will praise and flatter him, agree with all of his opinions and beliefs, and attend to all of his needs, even to the exclusion of their own. The average narcissist, however, is usually incapable of realizing that other people have valid feelings, needs, opinions, and beliefs of their own, which can make the narcissist a very difficult person for others to be around, especially in an emotionally intimate fashion.

Most psychologists believe that it is only a matter of time before the narcissist's friends, relations, and romantic partners assert their own needs. In order to do so, these individuals must typically reject the narcissist's delusions of personal greatness. Without the constant, unrelenting validation and support of those close to him, the narcissist is usually left without the inner resources to prop up his own sense of self-esteem and well-being. Narcissism and depression therefore might occur together because the narcissist may often find himself alone, without the strong social support he typically needs to continue feeling superior to others.

The typical narcissist cannot comprehend that he is not in some way superior to those around him. Symptoms of narcissistic personality disorder are believed to grow worse as the narcissist ages. The younger narcissist typically respects only those he sees as authority figures, such as parents or mentors, and only these are believed capable of keeping his often contrary personality in check. Psychologists believe that, as the typical narcissist reaches middle age and older, these authority figures usually die off, leaving the narcissist able to think as highly of himself as he likes and treat others as badly as he likes. As the aging narcissist grows harder and harder to deal with, he may find himself more and more socially isolated, such that narcissism and depression may be more likely to occur together as the individual reaches old age.

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Depressive Narcissism Types


The life of the typical narcissist is, indeed, punctuated with recurrent bouts of dysphoria (ubiquitous sadness and hopelessness), anhedonia (loss of the ability to feel pleasure), and clinical forms of depression (cyclothymic, dysthymic, or other). This picture is further obfuscated by the frequent presence of mood disorders, such as Bipolar I (co-morbidity).

While the distinction between reactive (exogenous) and endogenous depression is obsolete, it is still useful in the context of narcissism. Narcissists react with depression not only to life crises but to fluctuations in Narcissistic Supply.

The narcissist's personality is disorganized and precariously balanced. He regulates his sense of self-worth by consuming Narcissistic Supply from others. Any threat to the uninterrupted flow of said supply compromises his psychological integrity and his ability to function. It is perceived by the narcissist as life threatening.

1.       Loss Induced Dysphoria

This is the narcissist's depressive reaction to the loss of one or more Sources of Narcissistic Supply – or to the disintegration of a Pathological Narcissistic Space (PN Space, his stalking or hunting grounds, the social unit whose members lavish him with attention).

2.       Deficiency Induced Dysphoria

Deep and acute depression which follows the aforementioned losses of Supply Sources or a PN Space. Having mourned these losses, the narcissist now grieves their inevitable outcome – the absence or deficiency of Narcissistic Supply. Paradoxically, this dysphoria energizes the narcissist and moves him to find new Sources of Supply to replenish his dilapidated stock (thus initiating a Narcissistic Cycle).

3.       Self-Worth Dysregulation Dysphoria

The narcissist reacts with depression to criticism or disagreement, especially from a trusted and long-term Source of Narcissistic Supply. He fears the imminent loss of the source and the damage to his own, fragile, mental balance. The narcissist also resents his vulnerability and his extreme dependence on feedback from others. This type of depressive reaction is, therefore, a mutation of self-directed aggression.

4.       Grandiosity Gap Dysphoria

The narcissist's firmly, though counterfactually, perceives himself as omnipotent, omniscient, omnipresent, brilliant, accomplished, irresistible, immune, and invincible. Any data to the contrary is usually filtered, altered, or discarded altogether. Still, sometimes reality intrudes and creates a Grandiosity Gap. The narcissist is forced to face his mortality, limitations, ignorance, and relative inferiority. He sulks and sinks into an incapacitating but short-lived dysphoria.

5.       Self-Punishing Dysphoria

Deep inside, the narcissist hates himself and doubts his own worth. He deplores his desperate addiction to Narcissistic Supply. He judges his actions and intentions harshly and sadistically. He may be unaware of these dynamics – but they are at the heart of the narcissistic disorder and the reason the narcissist had to resort to narcissism as a defense mechanism in the first place. This inexhaustible well of ill will, self-chastisement, self-doubt, and self-directed aggression yields numerous self-defeating and self-destructive behaviors – from reckless driving and substance abuse to suicidal ideation and constant depression. It is the narcissist's ability to confabulate that saves him from himself. His grandiose fantasies remove him from reality and prevent recurrent narcissistic injuries. Many narcissists end up delusional, schizoid, or paranoid. To avoid agonizing and gnawing depression, they give up on life itself.

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Adolescence

Nowadays, the close-knit social groups that at one time surrounded and supported the individual are lacking. Equally lacking in post-modern society are clear-cut perspectives of adulthood for the adolescent to see. The search for identity has become harder for the adolescent. They may, therefore, sometimes resort to extremist groups that will give them a grandiose identity and self-worth, especially when they are confronted with the demands of an ideal ego. This becomes especially pressing when they abandon the world of dependency upon their parents. Coming into contact with reality, without the sense of parental support, the adolescent suffers narcissistic injury, experiencing weakness because stripped of fantasies of omnipotence. Under certain conditions of internal or external pressure, it is often exceptionally hard for the adolescent to construct a self-image while under pressure from the mental pain of disharmony between the real and the ideal self.

Adolescents are more prone to depressive reactions, precisely because of their narcissistic vulnerability. Although the incidence of major depressive disorder is no higher amongst adolescents than adults, depression in adolescence is associated with higher rates of suicide and serious psychosocial deficits. It also greatly increases the probability of depression or substance abuse during young adulthood.

Adolescents are subjected to instinctual and environmental demands at the same time as losing parental protection and moving towards forming external object relations. It might not be irrelevant that at this age we see a more severe picture without the prognostic consequences that the same clinical picture would have in adulthood. In addition, there are parental narcissistic demands that implicitly or explicitly, consciously or unconsciously tend to idealize their children, impelling them to achieve more and more.

In adolescents often see the hedonistic, self-destructive characteristics that their narcissistic type of depression might take on. These are the moments when, through acting out, they feel they become grandiose, tragic heroes because they cannot be the heroes that the ego-ideal is pressing them to be. Ladame (1987) noted that depressive and narcissistic adolescents lack a balanced self and object representation, which would help them to regulate their relationship with external objects, and tend to make archaic primary identifications where self and object are more or less fused. Lorand (1967) emphasized the formation of ego-ideal disturbances in the development of depressive conditions in adolescents and the effect this has on the construction of an identity. In the depressed adolescent, we see a connection between the confused identity of self and the early identifications, which play a decisive part in the quality of the ideal of the ego as it is being formed.

Anthony (1970) distinguished two types of depression in adolescence:
1) Mostly pre-Oedipal psychopathology with a disharmony of the ego and ideal of the ego and the consequential effects on self-esteem, shame, inferiority, insufficiency, weakness and narcissistic object relations, orality and dependency (narcissistic in nature).
2) Mostly Oedipal with guilt and moral masochism, linked to the punishing superego, introverted aggression and hatred (neurotic in nature).

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