Recognizing Low-Grade Depression
Reader’s Question
As a young child (2-5), I threw frequent tantrums, had rages, pulled out my hair, cursed at my parents and made suicide threats and notes. I only had these problems around my parents, never at school or with Grandparents. A psychologist determined that it was unlikely I would ever follow through on my suicide threats and that I would eventually grow out of my temper problems.
From the ages of 5 to 17, I continued to have problems controlling my anger and cycled through bouts of depression ranging from mild to suicidal. During that time, my parents’ marriage became increasingly unstable and I was often treated as a scapegoat for their marital problems and general unhappiness. When I was not being blamed for their problems, they were unloading their problems on me the same way you would a therapist. Verbal abuse and sporadic mild physical abuse were my Father’s preferred methods for discipline. My mother (a functional alcoholic) was never directly abusive, but she never put a stop to any of the inappropriate activities that occurred in the house. At her worst, she would say things along the lines of “if I had it to do over again, I would never marry or have children”. Both my Mother and Father insist that I “owe them an apology for being the most difficult/worst child ever”.
At 27, I am professionally successful, have learned to control my emotions and have a good network of friends, yet I still feel like something is off in my life. I am not depressed like I was as a teenager, but It often feels like I am just going through the motions of life. I’ve never had a long term relationship with a member of the opposite sex. I date and have had three short-lived sexual relationships.
My current therapist thinks that most of my dissatisfaction and my lack of close/long term romantic relationships is a result of intellectualizing emotions and emotional barriers that were built during childhood. I do agree with both points, but it does not seem like a complete explanation.
Are my dissatisfaction and lack of long term romantic relationships simply due to emotional barriers? Is there a specific type of counselor that is best suited to help me with these issues? Are there any books or reading materials that might be helpful?
Psychologist’s Reply
Given your father’s abusive approach to parenting and your mother’s rejection, your current difficulty achieving an intimate adult relationship is understandable. You seem to have experienced intense depression as a child as a result of your home life, which may be the reason that the anhedonia, or inability to fully experience joy in the positive aspects of your life, does not seem like depression now.
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In fact, anhedonia is a symptom of Dysthymia, or what we might think of as a long term low-grade depression. Unlike the intense suicidal lows you experienced while young, Dysthymia can sometimes express itself in a general emotional numbing. Your personal history, including your mother’s alcoholism, puts you at greater general risk for depression as an adult. A combination of pervasive depression and a history of parental abuse and rejection could easily account for your current inability to comfortably experience emotional and physical intimacy with a loving partner.
Given that you are currently in therapy, I would urge you to ask your therapist about the possibility that you have a Dysthymic disorder. Dysthymia can often be very successfully ameliorated with antidepressant medications, so a consultation with a psychiatrist would also be an important step to take.
Regarding your question about counselors, I have two thoughts. The first is that, if you are asking this question, you may be having second thoughts or a lack of trust with your current therapist. If that is the case, remember that you are always entitled to see someone else. A therapeutic relationship relies on trust between the therapist and patient, so make sure you feel comfortable. Secondly, however, given that relational intimacy is at the heart of your work in therapy, I would urge you to consider whether your reaction to your therapist is a way of avoiding an intimate relationship with them. This could be a great topic to bring up in your next session, and may guide your decision about whether this is the right therapist for you.
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https://askthepsych.com/atp/2013/03/13/recognizing-low-grade-depression/