Depressive neurosis: symptoms, causes and treatment

Do you know what depressive neurosis is? It is a type of depression, which was originally linked to alterations in the nervous system, but which gradually evolved into what we now call dysthymia.

Although it is a term currently obsolete, at the time it had a lot of repercussions, in addition to coming from psychoanalysis, an orientation very well known in ancient times. In this article, we will know what depressive neurosis is, what symptoms it causes and what are the most common treatments used to treat it.

    What is neurosis?

    Before explaining what depressive neurosis is, let’s define what neurosis is. neurosis is a concept that was originally introduced by Scottish physician William Cullen in 1769.

    Cullen used this term to refer to all sensory and motor disturbances caused by certain diseases of the nervous system.

    However, later, and in the field of clinical psychology, the term “neurosis” has been used to refer to mental disorders which distort the rational thinking of the individual and which interfere with the functioning of all areas of his life.

    However, it is also true that a person can be neurotic (which has to do with obsessive thoughts, a negative state, feelings of guilt, “paranoia” …) without having to consider this neurosis as a disorder. mental. It all depends on the level of severity of the symptoms and their interference in daily life.


    The typical symptoms and signs of neurosis are:

    • Lack of interest in doing beautiful things
    • Constant emotional suffering
    • excessive worries
    • Sadness continues
    • irritability
    • Attacks of anger or rage in front of others
    • Alterations in interpersonal relationships
    • Intolerance of others
    • anxiety

    • Feelings of anguish and guilt
    • Inability to decide correctly
    • excessive shyness
    • Abulia
    • Anedonia

    • Repetitive rituals or behaviors

    At the psychophysiological level, the symptoms that appear son:

    • Excessive sweating (especially on the hands)
    • Sleep disturbances or problems
    • Headaches or migraines

    Depressive neurosis: what is it?

    Depressive neurosis (also called neurotic depression) is a term previously used in psychiatry. to designate these depressions, the origin was explained by an intrapsychic conflict. The origin of the description in this table is psychoanalytic.

    On another side, the term “neurotic depression”, in particular, was introduced by Sándor Radó, And was later replaced by dysthymia (currently dysthymic disorder). Thus, the term neurotic depression is no longer used, but the term dysthymia (they would be equivalent).

    Dysthymia, on the other hand, no longer alludes to psychodynamic or psychoanalytic concepts, and is defined (according to DSM-5, Diagnostic and Statistical Manual of Mental Disorders) as chronically depressed mood most of the day, Minimum duration of 2 years (1 year for children).

    Depressive neurosis, which can be characterized as a depression subtype or neurosis subtype (according to the author), is characterized by the following symptoms: sad mood most of the time, low self-confidence, low self-esteem, excessive self-criticism and physical alterations.


      Typical symptoms of depressive neurosis, Beyond those already listed, are:

      1. Depressed mood

      It is the main symptom of depressive neurosis, just like depression.

      2. Loss of energy

      There is a loss or decrease in energy.

      3. Slow cognitive processes

      Mostly speech and thought are slowed down. In addition, there is an additional difficulty in concentrating.

      4. Apathy

      Apathy is a state of widespread disinterest associated with a lack of motivation to get things done. In patients with depressive neurosis, moreover, there is also a decrease in productivity in all directions.

      5. Abulia

      Abulia is the lack of will, or energy, to do things or move. Thus, the individual with depressive neurosis usually does not want to do “anything”, it is very difficult for him to start or to do something, such as getting up in the morning, avoiding social activities, etc.

      6. Despair

      They also appear frequently feelings of hopelessness.

      7. Low self-esteem

      Self-esteem is generally low, as in other types of depression or neurosis.

      8. High self-criticism

      The patient too frequently expresses self-critical thoughts (or messages) about himself.

      9. Feeling of anger

      There is a feeling of anger which can cause the patient to “explode” in certain situations.

      10. Difficulties in deciding

      The patient is unable to decide for himself, And it can happen even in the face of “easy” or daily (daily) decisions.

      11. Lack of appetite

      Hunger is also impaired, with excess hunger or self-deficit.

      12. Feelings of guilt

      Another very characteristic symptom of depressive neurosis is feelings of guilt. (Which also appears frequently in depression).

      13. Sleep disturbances

      Finally, sleep disorders or disturbances also appear, such as insomnia or the inability to get good rest (non-restful sleep).

        the causes

        Depressive neurosis has a multifactorial origin. Psychoanalysis is one of the orientations of psychology which has attempted to address the causes of depressive neurosis (in addition to being the orientation from which the term is born).

        According to this orientation, the origin of depressive neurosis would be linked to unpleasant experiences from the outside, With certain traumatic circumstances and stressors. The external factors which could be at the origin of this neurosis would be of great importance for the individual.


        With regard to the mentioned stressors, we find two groups within them:

        1. Individual performance

        These would be the factors that they have to do with the development of the individual; if he makes different “mistakes” or “mistakes” in different facets of his life, he may develop an overly critical sense of himself (and even of his own life).

        2. Facts of emotional deprivation

        According to psychoanalysis, and as the second group of stressors that could be at the origin of depressive neurosis, we find the so-called “facts of emotional deprivation”.

        An example of such facts would be to separate from our loved ones by chance, And not having the necessary resources (emotionally) to deal with the situation in a healthy way.


        The treatments usually used in depressive neurosis are:

        1. Psychological treatment

        When treating depressive neurosis (remember, current dysthymic disorder), there are different options against the background of psychological therapy. Cognitive Behavioral Therapy (CBT) Is The Most Effective Treatment Today in this sense (also to treat other types of depression).

        Some of the most commonly used tools or techniques for CBT are:

        • Cognitive techniques (for example, cognitive restructuring)
        • Programming of enjoyable activities
        • Environmental modification techniques (for example, control of stimuli)
        • Social skills training (EHS)

        On the other hand, some studies, such as that of Besteiro and García (2000), suggest that hypnosis could also be considered one of the most effective treatments for depressive neurosis, along with relaxation (second).

        The goal of psychological therapy in these cases, and generically, will be improve the patient’s mood and work with his most intimate conflicts.

        2. Pharmacological treatment

        Regarding the pharmacological treatment of depressive neurosis, it should be mentioned that there is no drug which “cures” this disorder (because practically no mental disorder), and that the best will always be to go to multidisciplinary treatment which also includes psychological therapy.

        However, antidepressants are mainly used, in particular SSRIs (selective serotonin reuptake inhibitors), which are the pharmacological treatment of choice. Examples of SSRI drugs are: fluoxetine, sertraline, paroxetine, and fluvoxamine.

        Bibliographical references:

        • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
        • Besteiro-González, JL and García-Cueto, I. (2000). Use of hypnosis in the treatment of major depression. Psicothema, 12 (4): 557-560.
        • Laplanche, J. and Pontalis, JB (1996). Dictionary of Psychoanalysis (Fernando Gimeno Cervantes, trad.) [Vocabulaire de la Psychanalyse]. Directed by Daniel Lagache. Buenos Aires: Paidós.
        • Pérez, M., Fernández, JR, Fernández, C. and Amic, I. (2010). Guide to effective psychological treatments I and II :. Madrid: Pyramid.
        • Vallejo J. and Menchón, JM. (1999). Dysthymia and other non-melancholic depressions. In: Vallejo J, Gastó C. Affective disorders: anxiety and depression (2nd ed). Barcelona: Masson.

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