One of my jobs as a specialist in depression therapy is to help my patients make sense not only of the depression, but of the constellation of coping behaviors that have developed alongside it.
It’s not unusual for people with depression to hide their despair from friends, loved ones and family, even if the act of hiding makes the depression even worse. Interestingly, high achievers tend to be especially adept at this kind of “masking” behavior.
Why would someone hide such agonizing pain, when the benefits of reaching out and seeking help are so widely known? One case study captures the sentiments of many patients I have met:
It was clear that Jared was acutely ill with depression, but he also despaired for another reason: He blamed himself for his lack of control and for not being able to “figure it out.” He had always had a sense of interdependence, with a concern for the welfare of others. He therefore worried about how revealing his depressive state would affect his parents, concerned that they would feel responsible for his distress and, an even greater fear, that they would then castigate themselves for being ignorant of his condition.
In my experience, high achievers who suffer from clinical depression often evidence this type of social isolation, and self-punishing thoughts like these tend to be a common thread.
Any good therapy for depression must help patients contend with this masking behavior, and with the dynamics of their lives that may have inspired them to hide this pain. Often by understanding what lies behind the masking, patients can also begin to make sense of the depression itself, uncovering its roots in an overdeveloped sense of obligation to others.
Want to learn more? Contact my Philadelphia psychotherapy practice today.
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