Existential Depression: Explained

Step 1. What are the symptoms of an existential depression

An Existential Depression begins when some of the symptoms of and Existential crisis combine with some of the symptoms of a Major Depressive Disorder or a  Persistent Depressive disorder;

The symptoms of existential distress or crisis: Alienation, detachment, isolation disillusionment , dissociation and feelings of meaninglessness

Combine with

The symptoms of Major depressive disorder: Intense sadness most of the time, little pleasure in most things, decreased appetite, weight changes, sleep disturbances, agitation ,fatigue, inappropriate guilt , decreased ability to concentrate, indecisiveness and suicidal thoughts.

To cause

Serious impairment in daily cognitive, emotional behavioral functioning.

Step 2. Avoiding Misdiagnosis : secondary symptoms  often associated with existential Depression:

Existential Depressions often have other symptoms associated with them:

Symptoms that may be caused by  coexisting conditions

 symptoms that are secondary reactions to the existential depression

Understanding these distinctions helps avoid misdiagnosis

Common symptoms that can occur with symptoms of Existential Depression

Anxiety and episodes of panic -misdiagnosed as a type of anxiety disorder

Mood swings – misdiagnosed as  a type of Bipolar disorder

Obsessive fixations and rituals – misdiagnosed as an Obsessive compulsive disorder

Physical complaints with no clear medical causes- misdiagnosed as a somatic disorders or hypochondriasis –( a false belief in a serious illness when none exists)

Memory and processing disorders – misdiagnosed as a type of learning disorder

Distractibility and decreased ability to stay focused and concentrate-inattentiveness – especially during periods of intense creativity – misdiagnosed as attention deficit disorder

Step 3. Making the diagnosis : Factors in the Assessment 

What are the existential symptoms ?

What are the depressive symptoms ?

A recent history of the symptoms of existential depression

When did the symptoms of existential depression first appear?

Are the symptoms an intensification of long standing pattern of existential symptoms?

Was there a precipitating event or circumstance that preceded the symptoms of existential depression?

           An event related to giftedness: spectacular success or spectacular failure, rejections ,

           Missed opportunities                            

           Preoccupations with Big existential questions: the nature of life and its meaning

           Preoccupations with personal existential questions: the how and why  of my own  

           Giftedness and my discomfort with it

           non-gifted related issues: loss or death of important people, pets,  Financial reversals,     

           medical illnesses, trauma ,accidents ,natural disasters

What makes  the symptoms of existential depression better or worse ?

Developmental history : when did the elements of giftedness emerge 

Advanced physical abilities

When did h/s teach themselves to read , acquire advanced vocabulary ,start  talking in full sentences ?

Intense curiosity : what are the specific areas of interest : are these pursued with passion and ambition: is the child a polymath?

Special sensitivities : sounds ( is there perfect pitch) Fabric, food , temperature, light

Special intensities and passions

 Reactions to the giftedness:

  • The child’s reactions to h/h advanced abilities
  • The parents reaction to their child’s  giftedness : confusion, excitement ,support and encouragement or ambivalence and neutrality
  • School’s response to giftedness: Was giftedness recognized and supported by teachers or restricted and discouraged. Were there any skipped grades

Academic performance : specific areas of advanced performance or underachievement

Spectacular Successes followed by dramatic unexplained failures

Extra curricular activities to help develop giftedness

Giftedness in Relationships:

  • With parents: early signs of independence: refusal to accept certain kinds of parenting or dependence
  • With peers: initiating peer relationships or passively accepting them or ignoring them:  Are there Soul mates and an appropriate peer group
Family history:

Parents experience with their own giftedness; marital history; current state of the marriage

Sibling issues:

Rivalry, guilt

Adolescence:

Gender issues

Step 4: Pulling it all together – Establishing the cause of an Existential Depression 

What are the primary causes and secondary contributing factors of the existential depression.

Is the depression primarily about existential issues surrounding giftedness

Is the existential depression primarily about non-gifted issues

  • Where do the other symptoms: anxiety, mood swings and obsessive thinking fit into the diagnostic picture ?
  • A  brief narrative – the formulation -describes how all factors – primary and secondary-combine to cause a particular existential depression

No narrative statement of the causes of an gifted individual’s existential or other type of depression can be complete without describing the gifted individual’s emotional response to h/h giftedness and how h/s has chosen to use or not use the elements of giftedness :

Has this  gifted  person  embraced and accepted this part of their personality or neglected, disavowed, denied or rejected it ?

This more ,than any other factor, is often the key to an in-depth psychological understanding  any depression -existential or other type of depression- in gifted individuals.

This narrative statement of the cause for an existential depression provides a focus for where and how the treatment should begin

Treating Existential Depression

Step 1. Evaluating the severity of the symptoms

  • If the symptoms seriously compromise aspects of daily function, frequent and intensive talk sessions may be indicated
  • Proper selection and use of medication can provide the quickest symptom relief so that a daily health activities routine can be restored.

Step 2. Focus on the central problem

  • Is it a practical problem : do the current circumstances, Or relationships need to be changed
  • Is the central problem primarily a depressive one :
    • Unresolved grief from loss of an important person or job that is separate from issues of giftedness?

Step 3. Focus on issues about giftedness itself

  • Is the  problem one of accepting giftedness  and/or a problem developing and  using giftedness

Step 4. Barriers to the  successful  treatment of Existential Depression in gifted individuals

  • Once symptoms have improved, gifted individuals often are reluctant to dig deeper into the issues about  giftedness and are reluctant to continue with the  temporary reliance on another person – even one with obvious expertise.

Contact Us

Jerald Grobman M.D.

646-872-6842

Madelon Sann L.C.S.W.​

646-354-0907