Recently, a fellow HSP blogger raised the question of whether knowing one is an HSP might make depression a little easier to handle. In other words, could knowing you are an HSP help you to take a step back and become conscious of your own reactions and needs, instead of automatically acting them out?
The Thinking Cure
But are depressed people capable of that? If the problem is that your brain doesn’t work correctly, can you think your way out of that… with your brain?
That’s the question I’ve always had about cognitive therapy, despite the high ratings it garners in research. As I understand it, cognitive therapy teaches you to take a step back and become conscious of your thoughts and feelings, instead of automatically acting them out, much like the depressed HSP described above. That could be helpful to a mildly depressed person with enough detachment to observe thoughts and feelings, if in no other way than to help them recognize that treatment is needed. As anyone with a depressed family member or partner can tell you, that’s no small thing.
However, during more intense depression, you feel so bad all the time that it’s impossible to conceive of feeling any other way. Your brain churns out worst-case-scenarios for every actual and potential action and interaction in your life, non-stop. There’s no quiet island above the roiling seas from which to pause and check out the big picture. You’re too busy paddling desperately with all your energy just to keep your head above the waterline.
Life in the Vortex
I was clinically depressed in varying degrees for about 40 years. My depression was partly SAD (Seasonal Affective Disorder) and partly a not-so-optimal childhood, aggravated by periodic situational stresses. I knew I had SAD, and that it was a form of depression, but I didn’t understand what depression was, so I had no inkling of how – and how much – it was affecting me. I think a whole lot of depressed people are in the same boat. It’s just criminal that we don’t ditch the stigmatization and get the word out to prevent that. A $300 light box changed my life, after decades of mostly preventable anguish. How many other people are suffering needlessly? It’s inexcusable.
Most depression diagnostic criteria share a fatal flaw: they compare the depressed state to a presumed pre-depressed state. This is utterly useless for people who are chronically or severely depressed, who either won’t be able to recall a happier state, or may never have experienced one.
That was me. I didn’t have a clue how bad I felt, since I had nothing better to compare it to. Yet on some level I sensed something was wrong. I found many reasons to explain to myself why I seemed less functional than other people, but none of them was quite satisfactory.
I see now that this was protective denial. If I had been conscious of how bad things really were, with no prospect for improvement, I couldn’t have continued to live. But I think I must have an exceptionally strong survival instinct. My brain found a way, and hid the magnitude of my pain from me until I finally stumbled upon the explanation that not made only sense, but offered hope.
My fellow blogger had a very different experience of depression, as a one-time episode during a period of extreme stress. In other words, situational depression. I had always been a bit skeptical about situational depression, since the depression I experienced could find the cloud in any situation, no matter how shiny the silver lining. Then again, the next day, the very same situation might seem fine – that’s the emotional landlessness that is depression.
However, I believe her description of her experience, and it’s gotten me thinking. She is an HSP extrovert. Could being an introvert actually make depression worse, not because of whether or how introverts socialize, but because they process things more deeply? Is it possible that introverts are more prone to chronic depression, while extroverts are more likely to have one or more discrete episodes? I would love to see some research on that (and I don’t mean “Big 5” research in which people with “low extroversion” are assumed to have “high neuroticism” because extroverted sociability is – literally! – the definition of happiness).
What Emotions Are For
Here’s my theory of depression: so-called “negative” emotions exist for a reason. Fear makes you run, anger makes you fight back, sadness makes you slow down and turn inwards. When the brain is working as it should, “negative” feelings are stages of a process, impelling you to take action, reconsider your perspective, or take time to heal. Once that stage is completed, the emotion transforms or fades.
Depression blasts that process to smithereens. “Negative” emotions are generated randomly, producing equally random behaviors. The emotional switch is stuck on high, or fluctuates wildly, playing havoc with all sense of reality and identity.
Depression and the Highly Sensitive Person
I’ve seen a lot of obviously (to me, and doesn’t 40 years make me an expert?) depressed people posting on various HSP forums. Elaine Aron tells us that we are more prone to depression than the general population IF we experienced childhood neglect or abuse (but also more prone to thrive with reasonably good parenting).
Intriguingly, in at least one case, being an HSP makes a major difference in the effectiveness of depression management. According to Michael Pluess and Jay Belsky’s 2012 paper, Vantage Sensitivity: Individual Differences in Response to Positive Experiences (pg.6/906), a depression prevention protocol administered to 166 high-risk British schoolgirls was effective only for the girls who scored in the top 3rd of the HSP scale.*
When I first heard about this research, it blew my mind. We can’t know without additional research whether this particular program would have a similar effect for boys and adults who are HSPs, as the study subjects were all 11-year-old girls. We also can’t assume that being an HSP is a crucial factor for other depression prevention protocols just because it was for this one. But what if it is? Potentially, all previous research into depression management that doesn’t differentiate between HSP and non-HSP subjects needs to be done over again.
Depression and Going Deep
Getting back to our original question, I’m inclined to think that deeper brain engagement would make anything beyond mild depression worse. Since depression is by definition (in my experience, anyway) a state of mental and emotional processes gone haywire, deeper engagement with that state is the last thing a depressed person needs. However, I’m still a little hazy on whether my brain engages more deeply because I’m an HSP, or an introvert, or both, and whether there’s a difference in the kind of engagement experienced by introverts vs. HSPs.
The more I think about this, the more questions I have. If there’s a difference of quality, as well as quantity, of engagement between introversion and high sensitivity, what does that mean for people who are one or the other, but not both? Does the double engagement make depression harder for HSP introverts than for non-HSP introverts? Or does HSP insight help? Are HSP extroverts more self-aware than extroverts who aren’t HSPs, or are they more burdened by the impact of depression on the interactions that energize them?
Obviously, it is essential to differentiate between introverts and extroverts in future depression-related research, as well as between HSPs and non-HSPs (hopefully in a more introvert-positive way than by describing introverts as “low extroverts”).
This Post is Historical
I should probably wrap things up by reminding myself and my readers that 20% of 7 billion is a lot of people. There are many other factors besides being HSP/not that influence personalities. That goes double and a half for the 50% of 7 billion that are introverts.
Still, the lack of visibility these particular distinctions have had in all forms of research, not just psychology, is a huge, elephant-in-the-room-sized flaw. It’s exciting to think how much there could yet be to discover in education, communication, sociology, and particularly in political science, where new insights and approaches are desperately needed.
When I became fully conscious of my depression in the late 1990s, I was grateful not to be grappling with it 50 or 100 years earlier, when I might have been shunted away into a nightmare institution for life, or subjected to horrendous treatments like high intensity electric shock or (shudder) lobotomy. Instead, I was able to check out the research, identify and purchase helpful products and supplements, and form an online peer support group with an international membership.
I am equally grateful to become conscious of being an HSP/introvert at this particular point in history. Thanks to the popularity of Susan Cain’s book (I don’t mean to give her all the credit – others had been talking about HSPs and introverts for years, but it’s obvious that Quiet was the perfectly-timed spark), there is a LOT of conversation going on about this now.
Let’s keep talking.
* Unfortunately, we can’t learn more about exactly what the girls were taught, as the study hasn’t been published yet. Here are authors/titles for the two articles about it that are under review.
Pluess, M., & Boniwell, I. (2012). High sensitive personality moderates responsivity to positive effects of a school-based resilience-promoting intervention.
Pluess, M., Boniwell, I., Hefferon, K., & Tunariu, A. (2012). Evaluation of a school-based resilience-promoting intervention in a high-risk population in England: A controlled mixed methods trial.
UPDATE: The report on this study has now been published, and you can download the full article by clicking on the link below.
Sensory-Processing Sensitivity predicts treatment response to a school-based depression prevention program: Evidence of Vantage Sensitivity