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My husband is a narcissist and is constantly depressed. Is there any connection between these two problems?


Assuming that these are clinically established facts, there is no necessary connection between them. In other words, there is no proven high correlation between suffering from NPD (or having even a milder form of narcissism) - and enduring bouts of depression.

Depression is a form of aggression. Transformed, this aggression is directed at the depressed person rather than at his environment. This regime of repressed and mutated aggression is a characteristic of both narcissism and depression.

Originally, the narcissist experiences "forbidden" thoughts and urges (sometimes to the point of an obsession). His mind is full of "dirty" words, curses, the remnants of magical thinking ("If I think or wish something it just might happen"), denigrating and malicious thinking concerned with authority figures (mostly parents or teachers).

These are all proscribed by the Superego. This is doubly true if the individual possesses a sadistic, capricious Superego (a result of the wrong kind of parenting). These thoughts and wishes do not fully surface. The individual is only aware of them in passing and vaguely. But they are sufficient to provoke intense guilt feelings and to set in motion a chain of self-flagellation and self-punishment.

Amplified by an abnormally strict, sadistic, and punitive Superego - this results in a constant feeling of imminent threat. This is what we call anxiety. It has no discernible external triggers and, therefore, it is not fear. It is the echo of a battle between one part of the personality, which viciously wishes to destroy the individual through excessive punishment - and the instinct of self-preservation.

Anxiety is not - as some scholars have it - an irrational reaction to internal dynamics involving imaginary threats. Actually, anxiety is more rational than many fears. The powers unleashed by the Superego are so enormous, its intentions so fatal, the self-loathing and self-degradation that it brings with it so intense - that the threat is real.

Overly strict Superegos are usually coupled with weaknesses and vulnerabilities in all other personality structures. Thus, there is no psychic structure able to fight back, to take the side of the depressed person. Small wonder that depressives have constant suicidal ideation (=they toy with ideas of self-mutilation and suicide), or worse, commit such acts.

Confronted with a horrible internal enemy, lacking in defences, falling apart at the seams, depleted by previous attacks, devoid of energy of life - the depressed wishes himself dead. Anxiety is about survival, the alternatives being, usually, self-torture or self-annihilation.

Depression is how such people experience their overflowing reservoirs of aggression. They are a volcano, which is about to explode and bury them under their own ashes. Anxiety is how they experience the war raging inside them. Sadness is the name that they give to the resulting wariness, to the knowledge that the battle is lost and personal doom is at hand.

Depression is the acknowledgement by the depressed individual that something is so fundamentally wrong that there is no way he can win. The individual is depressed because he is fatalistic. As long as he believes that there is a chance - however slim - to better his position, he moves in and out of depressive episodes.

True, anxiety disorders and depression (mood disorders) do not belong in the same diagnostic category. But they are very often comorbid. In many cases, the patient tries to exorcise his depressive demons by adopting ever more bizarre rituals. These are the compulsions, which - by diverting energy and attention away from the "bad" content in more or less symbolic (though totally arbitrary) ways - bring temporary relief and an easing of the anxiety. It is very common to meet all four: a mood disorder, an anxiety disorder, an obsessive-compulsive disorder and a personality disorder in one patient.

Depression is the most varied of all psychological illnesses. It assumes a myriad of guises and disguises. Many people are chronically depressed without even knowing it and without corresponding cognitive or affective contents. Some depressive episodes are part of a cycle of ups and downs (bipolar disorder and a milder form, the cyclothymic disorder).

Other depressions are "built into" the characters and the personalities of the patients (the dysthymic disorder or what used to be known as depressive neurosis). One type of depression is even seasonal and can be cured by photo-therapy (gradual exposure to carefully timed artificial lighting). We all experience "adjustment disorders with depressed mood" (used to be called reactive depression - which occurs after a stressful life event and as a direct and time-limited reaction to it).

These poisoned garden varieties are all-pervasive. Not a single aspect of the human condition escapes them, not one element of human behaviour avoids their grip. It is not wise (has no predictive or explanatory value) to differentiate "good" or "normal" depressions from "pathological" ones. There are no "good" depressions.