Different shades of blue: individuation and depression

Depression is uniformly identified as psychopathology by diagnostic systems such as the DSM-IV-TR and the ICD-10 and is viewed as a negatively biased perception by cognitive theories. However, a number of psychological and spiritual perspectives propose that the experience of depression may have positive outcomes for some individuals in the form of psychological growth and individuation, including theories from within the psychodynamic and humanistic traditions. These perspectives informed the formulation of the individuation theory of depression explored in this thesis. One empirically based perspective from which growth is considered as a potential outcome of depression, is that of depressive realism. This psychological stance of diminished self-deception in depressed individuals compared with non-depressed individuals is viewed as an opportunity for new levels of self-awareness and growth. The newly burgeoning field of posttraumatic growth research provides another empirical model from which the individuation theory of depression is explored in this thesis. The current research examined the relationships among depression, selfdeception and psychological growth in two studies. The first study used selfreport methodology, incorporating measures of prior and current depression, selfdeception (in the form of denial and positive illusions) and psychological growth (in the form of self-actualisation, adversarial growth and level of egodevelopment). The sample consisted of 132 women and 58 men (M=36 years, SD=14.4) who were divided into previously depressed (n=51), currently depressed (n=45), and never depressed (n=87) groups. The hypotheses regarding the individuation theory of depressive realism were partially supported by the enduring nature of diminished denial and a greater sense of positive personal change as sequelae of depression. Results suggest that the patterns of negative thinking and diminished use of positive illusions that are typically found in depressed individuals, subside after recovery from depression, but that the diminished use of denial endures. Also as predicted, a sense of positive personal change was significantly greater in the previously depressed group as compared with the never depressed group, particularly in the forms of personal strength and appreciation of life. Self-actualisation scores, however, were similar between the two groups. Contrary to expectations, no sex differences were evident for either the self-deception or the growth variables. Self-actualisation was significantly higher at the highest levels of ego development compared with the lowest as expected, yet levels of growth and self-deception were not significantly different between the levels of ego development. Preliminary analysis of qualitative data derived from responses to open-ended questions about change as a result of depression, reflected predominately positive themes of adversarial growth and benefit from the experience, especially in those of high ego-development. This formed the basis for the focus of the second study, which was an in-depth qualitative investigation. The second study examined the individuation theory of depression further via interviews with 10 women and 6 men of high ego development who had experienced a significant depression in their lives. After describing their experiences of depression, the respondents were asked to elaborate upon the ways in which they felt they had been changed by their depression. Themes were overwhelmingly positive and the most commonly reported responses were those of a changed perception of self through a newfound inner strength, greater selfworth and self-acceptance. Enhanced empathy and compassion were also reported, as were changed priorities and a greater appreciation of life, especially in aspects of simplicity. Recognition of choices and acceptance of personal responsibility for the choices made were prominent themes in some accounts, and a number of interviewees reported the need to revise their approach to spirituality. Although less prominent in their accounts, negative changes included an increased sense of vulnerability and sensitivity as a mixed blessing, and the need for ongoing management of the risk factors for depression in their lifestyle. Some degree of cynicism about aspects of life was evident in a few respondents. Paradoxes emerged in the interviewees' material congruent with high levels of ego development. For example, some individuals' accounts included perceptions of increased strength in parallel with awareness of greater degrees of vulnerability. Results from the two studies provide plausible evidence for the notion that growth is not only possible, but is also a commonly experienced outcome of depression, especially in those at higher levels of ego development. The salutary nature of depression is discussed in relation to the theories presented and an argument is made for a more developmentally defined and differentiated understanding of depressive experience than cognitive definitions and pathological labels generally afford. Suggestions are made for directions for further research into the individuation theory of depression, including deepening our understanding of the potential for growth as a result of depression at other levels of ego-development.