<p>Obviously the DSM doesn't see it as such, but the idea of Irvin D. Yalom appears to have some traction <a href="http://www.socialworker.com/feature-articles/real-world-clinical-sw/the-tyranny-of-self-help-of-the-necessity-of-existential-depression/" rel="nofollow noreferrer">at least in magazines</a>:</p>

<blockquote>
  <p>Irving Yalom, in 1981, wrote about near necessity of an existential depression. He basically suggested that a certain level of depression is normal, if not essential. He suggested that this depression is the byproduct of negotiating some key elements of our world and lives. These elements are death, freedom, isolation, and meaninglessness. He argued that the inner conflict that arises in negotiating these forces leaves us depressed and disillusioned.</p>
</blockquote>

<p>Furthermore, there are some sources (also not peer-reviewed) claiming that existential depression is more common in gifted individuals. (Examples: <a href="http://sengifted.org/existential-depression-in-gifted-individual/" rel="nofollow noreferrer">1</a>, <a href="http://drhilarybeech.com/project/existential-depression/" rel="nofollow noreferrer">2</a>).</p>

<p>Are there more rigorous studies of the concept? I'm guessing that a first/necessary step would be to able to reliably distinguish it for other (proposed) subtypes.</p>

<hr>

<p>Kerr's <em>Encyclopedia of Giftedness, Creativity, and Talent</em> mentions some diagnostic instruments (p. 340):</p>

<blockquote>
  <p>A number of measures have been developed to assess aspects of existential depression. The Life Purpose Questionnaire and Purpose of Existence Scale specifically address the presence or lack of existential meaning in an individual's life. These measures are positively correlated with several forms of psychopathology, including depression. The Existential Anxiety Questionnaire is based on the work of the philosopher Paul Tillich and asses one's apprehension of meaninglessness and death. This measure was created to assess existential anxiety, but it can also be applied to existential depression. The Quality of Existence Scale has been used as a measure of existential depression, and the widely used Quality of Life Scale has a particular existential subscale. Finally, the Existential Depression Scale is a general measure of potential existential etiological factors in the development and maintenance of depression.</p>
</blockquote>

<p>Alas it says nothing of the validity/reliability of these and also lacks inline citations, so it'll be a while before I can figure out what published studies (if any) have been using these.</p>

<p>The end of the "existential depression" entry (itself authored by Thomas C. Motl) in that encyclopedia has this statement regarding treatment</p>

<blockquote>
  <p>Treatment for existential depression includes traditional "talking" therapies [...] Pharmacological interventions are less effective because the root cause of existential depression is nonbiological. Those treated with drug therapies have higher relapse rated and a greater chance of recurrence.</p>
</blockquote>

<p>No indication there of what evidence that is based on though.</p>

<hr>

<p>While looking into this, I found two studies with noteworthy (IMHO) results, which don't quite answer my question though.</p>

<ul>
<li>One <a href="https://www.ncbi.nlm.nih.gov/pubmed/28369920" rel="nofollow noreferrer">Dutch study</a> found a significant score difference on an Existential Concerns Questionnaire between nonclinical and clinical (diagnosed with depression and/or anxiety) subjects.</li>
<li>A <a href="https://digitalcommons.ciis.edu/ijts-transpersonalstudies/vol31/iss1/5/" rel="nofollow noreferrer">US study</a> using The Scale for Existential Thinking
only on non-clinical subjects found that subjects of Indian origin scored higher, suggesting a possible cultural influence. Other variables like age, gender, income, or level of education did not have a significant impact on the score.</li>
</ul>

CC BY-SA 3.0
2017-11-18T07:39:29.793Z
Is there any criteria for what should be labeled a "subtype"?  Depression can be caused by a million things, but we don't label each a particular subtype.  Under this logic, we could have existential depression, social depression, romantic depression, and so on.  Part of what NIMH is trying to do is avoid this typologizing and understand more basic processes that lead to dysfunctional behavior.  Depression can be characterized computationally (as in predictive coding) in a way that explains its heterogeneity without the need to invoke subtypes.
mrt
CC BY-SA 3.0
2017-11-18T14:03:21.617Z
@mrt: it's not quite as simple as that. Take the case of ADHD; the DSM does recognize 3 subtypes there.
got trolled too much this week
CC BY-SA 3.0
2017-11-18T14:15:48.123Z
And even in the case of depression, as you can see from the last quote in my question, [some hope](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608844/) that more refined [sub-]categories (even if overlapping) can lead to better treatment. If you don't care at all about "typologizing", why is even bipolar II recognized? For most sufferers, [hypomania isn't much of a problem, and actually it's beneficial for some](https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_episodes).
got trolled too much this week
CC BY-SA 3.0
2017-11-18T17:47:57.977Z
Ah okay, so it's for treatment purposes. That's fair.  I guess my point was that typologizing can often be unproductive for science (as Darwin might point out) in that it encourages essentialism.  We can develop finer and finer-grained typologies, but this approach will ultimately fall short in explaining heterogeneity within and across disorders.
mrt
<intelligence><depression>
Evidence for existential depression as a distinct subtype?
got trolled too much this week
# Evidence for existential depression as a distinct subtype?

(Asked by: username_0 on 2017-11-16)

Obviously the DSM doesn't see it as such, but the idea of Irvin D. Yalom appears to have some traction [at least in magazines](http://www.socialworker.com/feature-articles/real-world-clinical-sw/the-tyranny-of-self-help-of-the-necessity-of-existential-depression/):

> Irving Yalom, in 1981, wrote about near necessity of an existential depression. He basically suggested that a certain level of depression is normal, if not essential. He suggested that this depression is the byproduct of negotiating some key elements of our world and lives. These elements are death, freedom, isolation, and meaninglessness. He argued that the inner conflict that arises in negotiating these forces leaves us depressed and disillusioned.

Furthermore, there are some sources (also not peer-reviewed) claiming that existential depression is more common in gifted individuals. (Examples: [1](http://sengifted.org/existential-depression-in-gifted-individual/), [2](http://drhilarybeech.com/project/existential-depression/)).

Are there more rigorous studies of the concept? I'm guessing that a first/necessary step would be to able to reliably distinguish it for other (proposed) subtypes.

---

Kerr's *Encyclopedia of Giftedness, Creativity, and Talent* mentions some diagnostic instruments (p. 340):

> A number of measures have been developed to assess aspects of existential depression. The Life Purpose Questionnaire and Purpose of Existence Scale specifically address the presence or lack of existential meaning in an individual's life. These measures are positively correlated with several forms of psychopathology, including depression. The Existential Anxiety Questionnaire is based on the work of the philosopher Paul Tillich and asses one's apprehension of meaninglessness and death. This measure was created to assess existential anxiety, but it can also be applied to existential depression. The Quality of Existence Scale has been used as a measure of existential depression, and the widely used Quality of Life Scale has a particular existential subscale. Finally, the Existential Depression Scale is a general measure of potential existential etiological factors in the development and maintenance of depression.

Alas it says nothing of the validity/reliability of these and also lacks inline citations, so it'll be a while before I can figure out what published studies (if any) have been using these.

The end of the "existential depression" entry (itself authored by Thomas C. Motl) in that encyclopedia has this statement regarding treatment

> Treatment for existential depression includes traditional "talking" therapies [...] Pharmacological interventions are less effective because the root cause of existential depression is nonbiological. Those treated with drug therapies have higher relapse rated and a greater chance of recurrence.

No indication there of what evidence that is based on though.

---

While looking into this, I found two studies with noteworthy (IMHO) results, which don't quite answer my question though.

* One [Dutch study](https://www.ncbi.nlm.nih.gov/pubmed/28369920) found a significant score difference on an Existential Concerns Questionnaire between nonclinical and clinical (diagnosed with depression and/or anxiety) subjects.
* A [US study](https://digitalcommons.ciis.edu/ijts-transpersonalstudies/vol31/iss1/5/) using The Scale for Existential Thinking
  only on non-clinical subjects found that subjects of Indian origin scored higher, suggesting a possible cultural influence. Other variables like age, gender, income, or level of education did not have a significant impact on the score.

**Tags:** intelligence, depression

> **Comments:**
> **username_1**: Is there any criteria for what should be labeled a "subtype"?  Depression can be caused by a million things, but we don't label each a particular subtype.  Under this logic, we could have existential depression, social depression, romantic depression, and so on.  Part of what NIMH is trying to do is avoid this typologizing and understand more basic processes that lead to dysfunctional behavior.  Depression can be characterized computationally (as in predictive coding) in a way that explains its heterogeneity without the need to invoke subtypes.  
> **username_0**: @username_1: it's not quite as simple as that. Take the case of ADHD; the DSM does recognize 3 subtypes there.  
> **username_0**: And even in the case of depression, as you can see from the last quote in my question, [some hope](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608844/) that more refined [sub-]categories (even if overlapping) can lead to better treatment. If you don't care at all about "typologizing", why is even bipolar II recognized? For most sufferers, [hypomania isn't much of a problem, and actually it's beneficial for some](https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_episodes).  
> **username_1**: Ah okay, so it's for treatment purposes. That's fair.  I guess my point was that typologizing can often be unproductive for science (as Darwin might point out) in that it encourages essentialism.  We can develop finer and finer-grained typologies, but this approach will ultimately fall short in explaining heterogeneity within and across disorders.  

---

## 0 answers

