Talk:Depressive anxiety

Possible related terms (feel free to expand)

• obsessional defense, obsessional doubts, obsessional neurotics, obsessional neurosis

Topics left to explore, some notes

• In Paranoid-schizoid and depressive positions is depressive position equivalent to depressive anxiety? [suspect yes...]
• In many other areas of psychology Depression (mood) is felt to be unique and mostly independent from Anxiety.
• was the label depressive anxiety by Melanie Klein in Object relations theory a poor choice of of a label applied to a fundamentally different underlying concept? Be sure to understand (as best possible) what Klein was driving at in Paranoid-schizoid_and_depressive_positions#Depressive_Position
• If Depression (mood) and Anxiety are separate elements is "depression-anxiety" (the two fused together) somehow an entirely different compound? The current medical / drug researchers seem to be on this track.
• If anxiety and depression are not fused is it one then the other? Are they polar positions? Poles of the same thing? Possibly Bipolar disorder
• http://psychology.wikia.com/wiki/Mixed_anxiety-depressive_disorder
• Mixed anxiety-depressive disorder
• cothymia: mixed anxiety and depression as a single diagnosis http://bjp.rcpsych.org/content/179/3/191
• Comorbid Depression and Anxiety: When and How to Treat (Howland & Thase, 2006)
• Generalized anxiety disorder with depression (Thanse, Entsuah & Rudolf 2001)
• National Comorbidity Survey (2005)
• Given dx of Clinical depression
  • 58% had comorbid some anxiety disorder
    • 17.2% had Generalized anxiety disorder
    • 9.9% had Panic disorder
• Given dx of some anxiety disorder
  • many had comorbid depression
    • Given dx social phobia 22.4% had comorbid depression
    • Given dx agoraphobia 9.4% had comorbid depression
    • Given dx panic disorder 2.3% had comorbid depression
• setting up of obsessional defenses (specifically Intellectualization) against depressive anxiety see Intellectualization
• Neurotic Defenses (Vaillant, 1977) Psychological_defense_mechanisms#Level_3_-_Neurotic (in these, neurosis equates closely with anxiety, and process of defending may lead to a wearing down, depression. Perhaps the neurotic anxiety (fighting it) is alternating with depression / hopelessness (giving up)?)
  • Displacement (psychology)
  • Dissociation (psychology) (see also Depersonalization disorder)
  • Hypochondriasis see also Preoperational anxiety
  • Intellectualization
  • Isolation (psychology)
  • Rationalization (making excuses)
  • Reaction formation
  • Regression (psychology)
  • Psychological repression
• Psychotherapy of the Obsessional (Salsman, 1979) (Strikes me that obsession and depressive anxiety are close)
  

Obsessional behavior is a defensive effort to displace the focus of those thoughts, desires or intentions which the individual feels will threaten security. The obsessional experiences extreme anxiety about losing control and therefore attempts to forestall this loss through many tactics:

• • intellectualization Intellectualization
  • perfectionistic and superman efforts at absolute control Perfectionism (psychology)
  • avoidanc of feelings which cannot be completely controlled Isolation (psychology), Experiential avoidance, Avoidant personality disorder, Posttraumatic stress disorder, Ambivalence, Avoidance coping
  • procrastination and indecisiveness which avoid closure Procrastination, Ambivalence?
  • leaving the [other] person subject to error and criticism Rationalization (making excuses), Criticism (some elements), Anal retentiveness, Anal expulsiveness
  • obsessional or compulsive rituals which are rigid maneuvers to give one the illusion of control. Obsessive–compulsive personality disorder, Obsessive-compulsive disorder
• Repetition compulsion - must be both depressing and anxiety provoking
• Freud postulated that unconscious memories of sexual molestation in early childhood were a necessary precondition for the psychoneuroses (hysteria and obsessional neurosis), a formulation now known as Freud's seduction theory
• Psychoanalytic concepts of love and hate - quite related to Klein's object relations work and especially Paranoid-schizoid and depressive positions. Love and hate two poles of the same thing? The opposite being indifference? As you move out on the poles anxiety (passion?) increases? "he loves me, he loves me not" a possible type of Depressive Anxiety?
• Jaques, Elliott (1953). "On the Dynamics of Social Structure : A Contribution to the Psycho-Analytical Study of Social Phenomena

copy available at http://www.moderntimesworkplace.com/archives/ericsess/sessvol1/Jaquesp420.opd.pdf following are quotes:

• • The extensions to psychoanalytical theory made by Melanie Klein concern the early infantile or pre-oedipal phases of development. She has described two early developmental phases which correspond to two predominant types of anxiety—paranoid and depressive. The period when paranoid anxiety pre-dominates normally extends over the first three to four months of development. Depressive anxiety normally predominates for the subsequent months to the end of the first year. The terms paranoid-schizoid (or simply, paranoid) position and depressive position are used to connote the predominance of the particular pattern of impulses, anxieties and defenses which characterizes each of these phases in development.
  • the members of the army are temporarily freed from depressive anxiety be¬cause their own sadistic impulses can be denied by attributing their aggressiveness to the performance of their duty, that is, expressing the aggressive im¬pulses collected and introjected from all the community.
  • defenses against persecutory and depressive anxiety interacting with each other
  • DEFENSES AGAINST DEPRESSIVE ANXIETY
  • Let us consider now certain aspects of the problem of the scapegoating of a minority group. As seen from the viewpoint of the community at large, the community is split into a good majority group and a bad minority—a split consistent with the splitting of internal objects into good and bad, and the creation of a good and bad internal world. The persecuting group's belief in its own good is preserved by heaping contempt upon and attacking the scape-goated group. The internal splitting mechanisms and preservation of the internal good objects of individuals, and the attack upon and contempt for internal bad persecutory objects, are reinforced by introjective identification of individuals with other members taking part in the group-sanctioned attack upon the scapegoat.
  • The members of the persecuted minority commonly entertain a precise and defined hatred and contempt for their persecutors which matches in intensity the contempt and aggression to which they themselves are subjected.
  • must we not consider the possibility that one of the operative factors in this selection is the consensus in the minority group, at the phantasy level, to seek contempt and suffering. That is to say, there is an unconscious co-operation (or collusion) at the phantasy level between persecutor and persecuted.
  • Another way in which depressive anxiety may be alleviated by social mechanisms is through manic denial of destructive impulses and destroyed good objects, and the reinforcement of good impulses and good objects, by participation in group idealization. These social mechanisms are the reflection in the group of denial and idealization, shown by Melanie Klein (1948a) to be important defenses against depressive anxiety
  • [talking about mourning loss. Loss produces Depressive anxiety morning is the defense] As Melanie Klein has described the process, "It seems that every advance in the process of mourning results in a deepening in the individual's relation to his inner objects, in the happiness of regaining them after they were felt to be lost (Paradise Lost and Regained), in an increased trust in them and love for them because they proved to be good and helpful after all."
  • [splitting, projection, introjection and projective identification - to defend against depressive anxiety] Putting their good impulses into the managers in the work situation allowed the workers to reintroject the good relations with management and hence to preserve an undamaged good object and alleviate depressive anxiety. This depressive anxiety was further avoided by reversion to the paranoid position in the negotiating situation. As Melanie Klein has frequently pointed out, paranoid fears and suspicions are often used as a defense against the depressive position.
  • Hence there was some anxiety and guilt about damaging the good managers. The primary defense mechanism against the onset of depressive anxiety was that of retreat to the paranoid position
  • The greater the concessions given by management to the workers, the greater was the guilt and fear of depressive anxiety in the workers, and hence the greater the retreat to paranoid attitudes as a means of avoiding depressive anxiety
  • That is, there was again a retreat to the paranoid position while the managers' depressive anxiety continued to show to some extent in the form of depressive feelings that the Council would not work.
• Above discussion of depressive anxiety sound radically different at least on first pass and Mixed anxiety-depressive disorder, cothymia, Comorbid Depression and Anxiety, Mixed anxiety-depressive disorder, Generalized anxiety disorder with depression, etc. Pharmaceuticals the solution here?

Rick (talk) 00:56, 28 February 2013 (UTC)