 Ahmadim and so on and so forth, we start with depression. Depression is classified, or has been classified for a very long time now, as a mood disorder. However, I beg to differ. I don't think it's a mood disorder. I think depression is a cognitive distortion. A cognitive distortion is a way of perceiving reality wrongly. Cognitive distortion as the name implies distort reality, impair reality testing. In the case of depression, the mechanism involved in falsifying reality is catastrophizing. The person, the depressed person, the person with depression develops helplessness and hopelessness. And the hopelessness derives from a scenario of everything is going to be bad, everything is doomed, everything is gloom, nothing is ever going to be as it used to be or nothing is ever going to be good. This is known as catastrophizing. And it's a mental pathology. Catastrophizing is a pathological mechanism. And we deal with catastrophizing in cognitive behavior therapy. But depression is a cognitive distortion. It's a filter. It's a glass darkly. It's a filter through which we misperceive reality, extrapolating the negative elements in our existence, add infinitum to extremes, add extremis, and minimizing the positive elements to the point of vanishing, actually overlooking the positive elements. So depression is all the hallmarks of cognitive distortion. Mind you, cognitive distortions are sometimes positive adaptations. For example, when the baby says goodbye to mommy, when the baby separates from mother and starts to explore the world, the infant develops grandiosity to separate from mother and then to venture out into the unknown, into this huge globe with these giants known as adults at the age of two or 18 months, you need to be seriously deranged. You need to be grandiose. So infants around the age of 18 months develop grandiosity. This grandiosity, which is a cognitive distortion, the baby believes in itself to be omnipotent or powerful. The baby says, I can take on the world. I'm a hero. I'm the greatest of all. I'm godlike. Of course, the baby doesn't use these words unless the baby is very gifted the way I have been. So the baby develops grandiosity. Grandiosity is a cognitive distortion, but in this particular case, this infantile cognitive distortion is a positive adaptation because it allows the child to separate from mommy and to take on the world to explore it and gradually to develop object relations and become an adult, individuate, create an individual personality. So cognitive distortions are not always bad. If you're an inmate in Auschwitz, depression is a positive adaptation. It is still a cognitive distortion because being depressed in Auschwitz is the same as saying the Nazis will never be defeated. Auschwitz is forever, which of course we know to have been counterfactual. The Nazis have been defeated. Auschwitz has been liberated, had been liberated, but depression within the context of being an inmate in Auschwitz is a cognitive distortion. And yet it's a positive adaptation. It allows you to survive because having hope in Auschwitz would have been a seriously bad move. Hope in Auschwitz would have led to reckless behavior, constant frustration, and ultimately aggression, which would have been would have resulted in execution. So depression kept the inmate within narrow behavioral confines and limits. Depression, this cognitive distortion in Auschwitz caused the inmate to channel the inmate's behavior in a way that would not endanger the inmate's life. So depression is not a mood disorder. It's a cognitive distortion. Sometimes it has its merits. We tend to give currently in current Now I would like to invite our next speaker, Professor Sam Backney, and he is from Southern Federal University, Russia, and would like to invite with his presentation titled Depression and Aspective Pathologies of the Self. So Professor, kindly start your presentation. Thank you. Thank you for having me. My name is Sam Backney. I'm a professor of psychology in Southern Federal University in Ostov-on-Don, in the Russian Federation. And I am a professor of finance and a professor of psychology in the outreach program of CIAPS Center for International Advanced and Professional Studies. My apologies for inflicting all this on you, but it's according to my contract. I have to say it in every presentation. Today, actually, I would like to discuss a topic that is a bit different from the one published. And that is the topic of rethinking depression, trying to reconceive of depression as actually a positive thing and questioning whether it is a wise idea to try to quell depression, intervene with depression, suppress depression, eliminate depression. Is it a good idea? Everything in nature and everything in psychology has a reason. Depression is there for a reason. It had a reason through an evolutionary process, and it fulfills critical functions. When we administer antidepressants, when we deal with depression through talk therapy, for example cognitive behavioral therapy, are we not interfering with natural processes which should be allowed to run their course? This is the topic of my presentation. And I would like to open with a quote by Ardors Huxley in his famous Tom Brave New World Revisited. He says, the real hopeless victims of mental illness are to be found among those who appear to be most normal. Many of them are normal because they are so well adjusted to our mode of existence. Because their human voice has been silenced so early in their lives that they do not even struggle or suffer or develop symptoms, as the neurotic does. They are normal not in what may be called the absolute sense of the word. They are normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness. These millions of abnormally normal people living without fuss in a society to which if they were fully human beings, they ought not to be adjusted. These are very profound words. The concept of depression relies on two meta concepts, on two pillars, conceptual pillars of psychology, modern psychology at least. The first pillar is the individual and the second pillar is dysfunction. We can distill all the science or pseudoscience of psychology into these two concepts, the individual, the individual's style, the individual's personality, but always the individual in divisible, like an atom, and the concept of dysfunction. But you see, individual and dysfunction are not real entities. They are not objective entities. These are counterfactual ideals and they are based on a statistical normal. We survey big populations, we study cohorts, groups of people, and we say, okay, this is normal. This is statistically most prevalent and most common, so it is normal. Anything outside to the left or to the right in this Gaussian distribution, anything, the tails, the tails of the distribution are actually dysfunctions. And who are the points? Which, which are the points in this Gaussian distribution? The individuals. There's no such thing as an individual. It's a fake counterfactual concept. In the 1960s, there was a school of psychology in the British Isles. It was called the British Object Relations School. And one of the major contributions of that school of thinking was that the self, the individual, as we call it today, is the outcome of intersections and interactions with other people. If we were to prevent a baby from interacting with other people, if we were to isolate an infant and prevent the infant from reacting to reality, that infant would have not developed a self. Jung called this process constellation. The infant would not have a constellated self. The self is like a Venn diagram. It's like the intersection of multiple circles. It's the outcome of having interactions with other people and with reality. So in reality, there is a spectrum. The approach to mental illnesses should be dimensional. The ICD-11, the latest edition of the International Classification of Diseases, has had, had adopted this approach. The Diagnostic and Statistical Manual, edition five, is trying to adopt this approach in its alternate models. So we are transitioning now from a discrete differential atomized form of psychology to a holistic relational form of psychology where the human being is embedded in social networks and is defined by these networks. So depression is an individual, is supposed to be an individual trait or property or an individual process, process within the individual and it's supposed to be a dysfunction. But if there is no such thing as individual and if a dysfunction is merely a statistical norm, then maybe the whole concept of depression is wrong. Maybe it's not a dysfunction. There's no question that depression has biological underpinnings or at least correlates. We know that depression is somehow correlated with a microbiome in the intestines, the gut flora and these biases, imbalances in the gut flora. We know that serotonin is produced mostly in the intestines, in small part in the brain, but 90% of serotonin is produced in the guts. We know that depression is somehow associated with an imbalance in the reabsorption of neurotransmitters, the processing of certain neurotransmitters in the brain. So clearly there are some biological correlates, something afoot biologically and physiologically that somehow yields or is connected to or is correlated with what we call depression. But the medicalization of depression is philosophically erroneous. It's a fallacy. It's a fallacy to say that A causes B. The only thing we can say for sure is that depression is concomitant, occurring with, appears together with certain physiological, biochemical, neurological and hormonal events or processes. How do we know, how can we tell whether depression is a brain event, whether it's a cerebral effect? We administer antidepressants and then antidepressants, when consumed, sometimes, not very often by the way, but sometimes, alleviate depression. So we say, oh well, if since we had administered antidepressants and we had affected the brain and the depression disappeared, we can now reverse engineer the process and we can say, well depression is an artifact of the brain. It's an epiphenomenon. It's an emergent phenomenon in the brain. But of course it's utterly wrong, because whatever is happening in the brain when you're depressed, this could be mere correlation. There is even the possibility that the depression had caused the changes in the brain, not the other way around. And there is a possibility that there's a third overlying, third overarching structure or process which give rise to the changes in the brain and to depression simultaneously. We simply don't know. We are very far from knowing the brain. Neuroscientists like to brag and pretend narcissistically, megalomaniacally, I would say even grandiosly, that they are fully acquainted with the brain. We don't know anything about the brain. These are baby steps. We know nothing. In 100 years we will know that we had known nothing today. And so this is hubris to claim that we can trace depression all the way to the microstructures of the brain, to multi-unit activity in the brain, to hormones, to... I mean that's hubris. It's also probably counterfactual. One thing we do know. Depression is an adaptive, appropriate response. I repeat, depression is a positively adaptive, appropriate response to stressful or dystopian environment. If you were an inmate in the extermination camp Auschwitz and you were not depressed, that's a sign of mental illness. To be an inmate in Auschwitz and to not be depressed shows that something is wrong with you. Because the only adaptive, appropriate response in Auschwitz is to be depressed. Auschwitz was a depressive environment, depression inducing environment. To live in today's world with pandemics, with economic recessions, with disintegration of institutions and society, with disorientation, with dislocation, to live in today's reality and not to be depressed is sick. It is sick to not be depressed when you are faced with the daily news. Our world, our reality is depressing. And the only appropriate, mentally healthy, positively adaptive response to our world, to our existence, to our reality today is depression. If you are mentally healthy, you're going to react to the news cycle with depression. It's a sign of mental health. You are right to be depressed. It's healthy to be depressed. You should be depressed. And if you're not, something is wrong with you. So depression is context dependent, context dependent. And yet we don't treat it as context dependent. Whenever we come across depression, we immediately medicate it. We immediately try to eliminate it. We immediately try to remove it. Why? Why are we doing this? This is wrong. We must analyze the context, the culture, recent events, personal history, future horizon. We must analyze a monopoly of multiple dimensions before we reach a decision to medicate depression away. Depression has many evolutionary adaptive and recuperative functions. Depression is an alarm signal. It tells you that something is wrong. It alerts you to danger. It alerts you to threats. It motivates you to act, to preempt. It's an alarm signal. Depression involves catastrophizing. Catastrophizing is preparing for the worst. Catastrophizing is a pathological process. But if you are embedded in a pathological environment, if you live in a sick society, if the world around you is falling apart, catastrophizing is not pathological. It's adaptive because it allows you to prepare for the worst possible scenario, the worst case scenario. Depression is about mourning and grieving. It's about loss, adapting to loss, adjusting to loss, digesting loss, assimilating loss, accepting loss, the famous five-stage cycle of Kubler-Ross, five stages of grief. So depression is an integral part of mourning and grieving. And mourning and grieving is an integral part, are integral parts of depression. Depression allows you to mourn and grieve sequentially and structurally. Depression helps you to reframe, depress people, reassess and reevaluate their lives, people in their lives, events, decisions they've made, choices, better and good, outcomes. Depression is a processing. It's a process of processing. It's a process of reevaluating and analyzing the entirety of your life. So it allows people to reframe, to gain new insights, a new understanding which ultimately is the very foundation of healing. Depression restores reality testing. When we are not depressed, when we are relatively content and happy, when we inhabit an environment where we have favorable outcomes, where we are self-efficacious, we tend to drift apart from reality. We develop delusions, we develop illusions, we develop fantasies, we develop grandiosity. It happens to all of us, to the best of us, to everywhere, at every time. It is depression that brings us back to reality with a bang. Depression forces our feet back to the ground. Depression drags us from the clouds. Depression confronts us with the things in our lives that are wrong, that should be amended, that should be discarded, that had unfavorable outcomes, choices and decisions we have made which had impacted us and others adversely. All this is part of depression, the process of refraining and the process of restoring reality testing. Depression also provides emotional release. It is through depression that we cry sometimes for no reason. That's emotional release. We need to release emotions in an environment, in a society that frowns on emotions, that mocks emotions, because our Western society is a death count. We worship dead objects, we worship material objects and we sacrifice human beings and we sacrifice human emotions to preserve the economy, the sum total of material goods. We had objectified reality and in turn we had objectified each other. We are objects to each other, sexually, emotionally, in every possible way. We had become objects and so depression legitimizes, allows us to cry, allows us to feel sad, lets us experience that which is not allowed, that which is frowned upon, that which is taboo. Depression is accepting our frailty, our weakness, our neediness, our vulnerabilities. Finally, which is a very healing process, a very good process. Depression also allows us to economize energy. In daily life, when we are not depressed, we overspend energy and we end up being very depleted, very exhausted. Depression slows us down, reduces the rhythm and tempo of life, lets us sit aside and recuperate gradually. Animals do this. When a dog is wounded, the dog withdraws and retreats under a bush until the wound heals. We are wounded daily, multiply and it is depression that provides us with a respite, with a break, within which we can gradually heal and recover. Depression also allows us to rebuild shattered psychological defense mechanisms. Depression usually follows decompensation and technically depression could be thought of as a form of acting in rather than acting out, internalizing conflict and dissonance to the maximum, internalizing aggression, internalizing aggression that was the old view of depression. So it allows us to rebuild functional defense mechanisms so that we again can cope with reality without being constantly injured, constantly wounded, constantly battered, constantly devastated. And finally, depression allows us to reconstitute the self. The self is sometimes subject to torsion and conflict and dissonance and pressures and stress that damage it. The self is not immune to damage and is not immutable in all its parts. Depression allows us to reintegrate the self, to reconstitute the self, to reconstitute the self. I, in other words, regard depression as a very healthy process, a process of healing. We should intervene in depression only when there is suicidal ideation, never before, never otherwise. Where we are, what we are doing today is disastrous and counterproductive. We meditate and we intervene whenever and wherever depression appears. That's bad. That retires growth that prevents healing. We are not healers. We perpetuate depression. We perpetuate victim mentality and victim stance. We don't allow people to develop scar tissue over the wound. We keep probing the wound. We keep preserving, preserving the initial state which preceded the depression, which was not a healthy state. Depression is a healthy reaction to a preceding unhealthy state and by giving antidepressants, we preserve the unhealthy state by removing the defense known as depression. When there is suicidal ideation, of course we should intervene. No question about it. Any hint of suicide should bring us to the fore with all the weapons we have, antidepressants, talk therapy, CPT, you name it, hospitalization if needed, but otherwise we should let nature take its course in restoring equilibrium, homeostasis and ultimately functioning and happiness. Thank you for listening. Anyone having any query kindly asked him? Is that to answer us? Hello. Yes, doctor. I just want to appreciate from Mr. Sam for his excellent presentation and the reality grounded in his speech. Thank you. Very well presented. Thank you. Thank you very much. I think generally in psychology and psychiatry we tend to throw medicines, throw pills at problems because it's very easy, you know? You come with a problem, take a pill, leave me alone. It's learned helplessness, it's embedded laziness. We don't bother to think about the role, the function of mental illnesses or mental dysfunctions. They have a role. The evolution made them happen because they are useful. Thank you. Thank you very much for listening. I have a client I'm afraid I have to run. It's very kind of you and see you next conference. Thank you. Thank you so much professor. Thank you. Tsunami, school shooting, pandemic, war, 100 million refugees. You open any American television network and smiling faces. Good to be with you Judy. Everyone is smiling all the time and it is so fake. It's fake and it's a metaphor of the narcissism of our age because narcissism is a fake feigned facade hiding beneath a catastrophe, hiding depression. And today's topic is the narcissist's three types of depression. Narcissists are almost habitually depressed. They just don't know it and they are not happy go lucky as is often portrayed even in scholarly literature. Today we know that what we used to call overt narcissists is actually a subspecies of psychopathy. It's a kind of psychopath and that the only true variants of narcissism are the compensatory narcissists and the covert narcissists. The compensatory narcissists compensates. He puts forth a brave facade, a false self which is everything the narcissist is not. The false self is omniscient, knows everything, is omnipotent, is all-powerful, perfect and brilliant when the narcissist actually has an inferiority complex. Narcissist is insecure, full of shame. Indeed many scholars describe early childhood shame as the engine of the formation of pathological narcissism and compensatory narcissism is to the fore and then we have covert narcissists. So these are the only true forms of narcissism. All other forms of narcissism, the grandiose in your face Donald Trump type of narcissism, that's actually a subspecies of psychopaths. And so we will deal with it at another time. At the core, there's no core but had there been a core there's depression. Depression coupled with shame to some extent guilt. These are of course repressed emotions. Narcissist has no access to these founds of hurt and pain, primordial hurt and pain. The narcissist exactly like the borderline is terrified of dysregulation, of being overwhelmed, overwhelmed by his emotions. But the narcissist's solution is to suppress and ignore emotions, especially positive emotions. And this is self-betrayal. This is self-denial. The narcissist doesn't love himself. He loathes himself. He hates himself. And he wants to put as much distance between himself and himself, between his false self and the repository of his agony, the true self. The memories of abuse, trauma, parentifying and instrumentalizing, not being allowed to separate, to become an individual, to self-actualize. There's a lot of anger, a lot of frustration, a lot of pent-up rage there. And so the narcissist cannot allow himself to re-experience this. And he betrays himself. He denies himself. He puts himself down. He buries himself. He covers himself. He constricts himself. And this of course creates depression whenever we don't allow ourselves to be ourselves, whenever we don't actualize our potentials, whenever we are inhibited and cannot freely express who we are. The reaction is depression because it's a form of self-directed aggression. Depression. Depression has been long described as a form of self-directed aggression, to not allow yourself to manifest, to not let yourself express yourself autonomously, agentically, self-efficaciously, independently and freely. That's a knife in your own back. You become your own worst enemy. And of course this creates anxiety. And anxiety prolonged becomes depression. The narcissist suffers from three types of depression on a regular basis. A little disambiguation before we proceed. There's a difference between dysphoria, depression and anhedonia. Dysphoria is a general state of malaise and unease, a discomfort and kind of ambient sadness. One of the manifestations of dysphoria is known as dysthemia. It's a dysphoric type of depression. Then there is depression in its most extreme case, most extreme form. Depression is known as clinical depression or more precisely major depression, a major depressive episode for example. But depression has milder forms. It's a whole spectrum. But what depression means is loss of vitality, a loss of elan vital, a loss of libido if you want to use Freudian terms. The inability to engage in life, on life and with life, a rejection of life. Depression is about withdrawing, avoiding, shunning, limiting, constricting, cocooning. Depression is about dying while still alive. That's depression. Now it doesn't mean that all depressed people, all people with even major depression, just lie in bed and wait for the inevitable to happen. That's not true. Actually many depressed people. I would mention Stephen Frey, Winston Churchill and others. Many depressed people are actually hyperactive. They're trying to compensate. They're trying to drown out their depression by being super active. Many women, for example, engage in sexual self-trashing as a form of fighting off depression. Substance abuse, of course, is another activity that is intended to allay, mitigate and ameliorate depression. And then there is anhedonia. Anhedonia is the inability to enjoy doing anything, not finding pleasure in any activity, any person, any place, any plan, simply being unable to experience pleasure. Okay. Back to the topic, the narcissist. The narcissist experiences three types of dysphoria which can easily and often do easily deteriorate, degenerate or escalate if you wish into depression. The first one is what I call the loss-induced dysphoria. Now we all experience losses. Losses are very important in life. Losses drive us forward. Losses are engines of growth, personal development. Losses are good for you. You should seek out situations which are emotionally risky, situations where there's the possible outcome of pain and hurt and loss. Because that's the only way you can evolve. It's part of constant healing. This scar tissue becomes your identity. In the absence of loss, when the child, for example, is totally isolated from reality, from harsh reality, is totally prevented from experiencing rejection and loss, this kind of child never becomes a doubt, never individuates, is never happy and is very likely to develop personality disorders, mood disorders, and other types of anxiety disorders, other types of disorders. So loss is good for you. But the narcissist reacts to loss in a very particular way. Loss-induced dysphoria is the narcissist's depressive reaction to the loss of one or more sources of narcissistic supply. I refer you to my last two videos. One of them deals with how does the narcissist experience deficient narcissistic supply? How does he experience collapse? And the second video I've made is about self-destructive narcissists and psychopaths. And this is the third in the series. So when the narcissist loses sources of narcissistic supply or when his pathological narcissistic space disintegrates, he reacts with loss-induced dysphoria or lost-induced depression. To remind you, pathological narcissistic space is the stalking, the stomping, the hunting grounds, the horns and the dives, the physical, physical locations, the social unit whose members lavish the narcissist with attention in narcissistic supply. It could be a pub, a church, a workplace. So when the narcissist loses his pathological space, he also loses his sources of supply. And very often when he loses too many sources of supply, he had actually lost a pathological narcissistic space. He cannot cope with this. This is the kind of loss that threatens his equilibrium, the precariously balanced thing that passes for his personality. In the absence of narcissistic supply, the narcissist is voided, nullified, evaporates. He doesn't have an existence outside the gaze of others. His mind is a hive mind, a collage, a kaleidoscope. He puts together various inputs in order to come up with a heuristic on-the-fly personality or mind. So the narcissist recreates himself every minute. That's why there's no continuity and many dissociative gaps. And that's why the narcissist needs to confabulate all the time, misperceived as lying by self-styled experts. And so when the narcissist loses his narcissistic supply, he thrashes about. He tries desperately to regain his footing. He tries to somehow find alternatives. And if the failure continues, he begins to develop depression. Depression is a signal to the narcissist. You should become schizoid. You should withdraw. You should avoid because the pain and the hurt are going to lead you to narcissistic modification from which you may not ever emerge or which you may not survive. The second type of depression that the narcissist experiences is what I call deficiency-induced dysphoria. Deficiency-induced dysphoria. Deep. It's a deep and acute depression. So the previous depression, the lost induced dysphoria is kind of ambient. It's kind of in the atmosphere. It's all permeating, all pervasive. It's very, very similar to dystemia and easily confused and misdiagnosed even by clinicians, experienced clinicians. The second type is acute. Deficiency-induced dysphoria is deep. It's acute. It follows losses, abrupt losses of supply sources or pathological narcissistic space, sudden, unexpected, unpredicted denial of narcissistic supply by people, places who either, either to, had been reliable providers. So there's this group of people who provide a narcissist with narcissistic survival. It could be four people or four million people, a political party or a family, church or workplace. So there's this group of people. They provide a narcissist with narcissistic survival and then suddenly on a dime overnight, they stop doing so. They stop doing so because they've come across new information about the narcissist or because the narcissist was a fashion or a fad. What they had to offer was a fashion or a fad and it was passing of course or for any other reason. They found a new idol. Whatever the case may be, the abruptness is what brings on the deficiency induced dysphoria. Having mourned and grieved these losses, the narcissist now mourns and grieves the inevitable outcomes of these losses, the absence or deficiency of narcissistic supply. Paradoxically, the deficiency-induced dysphoria energizes the narcissist, moves the narcissist to find new sources of supply to replenish the dilapidated stock. In other words, the deficiency-induced dysphoria is the trigger, is the initiator of the narcissistic cycle. I encourage you to watch my videos about the narcissistic cycle. He, in a romantic sense, he begins to love home, he groom, he finds an intimate partner for a shared fantasy, finds another workplace, moves to another city. This is all engendered by the deficiency-induced dysphoria, so it's a catalyst for action. In essence, a positive thing. The last type of dysphoria, the last type of depression that the narcissist experiences is the self-worth dysregulation dysphoria. Just to recap, we have the loss-induced dysphoria when gradually sources of supply and the pathological narcissistic space fade away, so it's a prolonged continuous predictable process. Then we have the deficiency-induced dysphoria, which is an acute response to abrupt loss of supply, and then we have the self-worth dysregulation dysphoria. A narcissist reacts with depression, to criticism, to disagreement, to being demeaned and humiliated, especially in public. This could lead to narcissistic modification. And he reacts this way, especially when trusted and long-term sources of supply administer the blow when he perceives it as a knife in the back, as a betrayal. So this depression is a reaction to a sudden drop in self-esteem, self-confidence, and a fluctuation in the sense of self-worth, because some trusted source of supply could be a secondary source, like a spouse or a primary source, like an idol or a boss. A source of supply suddenly turns on the narcissist, criticizes him, disagrees with him, humiliates him privately or in public, demins him, and generally ignores him. The narcissist fears the imminent loss of the source and the damage to his own fragile, vulnerable mental balance. The narcissist also resents his own vulnerability and his extreme dependence on feedback from others. This type of depressive reaction is therefore a mutation of self-directed aggression, kind of a self-punitive depression. You are a zero, you're a dormant, you're dependent, you're not as powerful as you thought you were. It's a crisis of identity, it's an undermining of the grandiosity, cognitive distortion, which is a major defense associated with his fantasies. So when this all crumbles, the narcissist can't regulate his sense of self-worth anymore, because he can do it only from the outside. So when the outside source is a gun, his sense of self-worth fluctuates wildly and then settles at a very low ebb. The narcissist begins to regard himself exactly the opposite, as inferior, as a victim, as a failure, he feels defeated and deflated, and this is very depressing. Narcissism mourns the loss of narcissistic supply. They grieve over vanished sources of supply. They bemoan the injustice and discrimination that they suffer at the hands of their inferiors, especially covert narcissists who are passive-aggressive. Narcissists are often in a bad mood, actually, unhedonic, dysphoric, aggressive, and outright depressed. The narcissist's mood swings are self-destructive and self-defeating. So yes, narcissists suffer from modulability, exactly like border lines. This is acknowledged for the first time in the alternative model of narcissistic personality disorder in the Diagnostic and Statistical Manual, edition 5, 2013, page 767 for all you lazy bums. Okay, Shoshaneem, many scholars consider pathological narcissism to be a form of depressive illness. You remember, those of you who are still watching my videos, an ever-dwindling number, you remember the videos I've made separately and with Richard Granum about the prolonged grief syndrome. The prolonged grief syndrome starts with the narcissist, actually. He, as a child, he grieves his inability to separate and individuate. He mourns his unrealized potential, what he could have become and never will. So this prolonged grief, it then exports to his intimate partner. But if prolonged grief is the foundation of the narcissistic defense and the fantasy defense, if this is the foundation, then pathological narcissism can be easily described as a depressive illness. This is actually the position of the authoritative and prestigious magazine, Psychology Today. The life of a typical narcissist is punctuated with recurrent bouts of dysphoria and depression, ubiquitous sadness, a sense of helplessness and hopelessness, and hedonia, loss of ability to feel pleasure and other clinical forms of depression, psychothermic, dystemic, and so on. Pathological narcissism is comorbid with or duly diagnosed with mood disorders, very frequently. Actually, in some cases, we confuse, we misdiagnose bipolar disorder as narcissistic personality disorder. The picture is obfuscated by the frequent presence of mood disorder, such as bipolar 1, with narcissism. So it's a very, a very murky picture. But I think it's time to accept that narcissism is not about elation, it's not about joy and cheer. These are not happy-go-lucky people. These are heavily wounded, traumatized, grieving, mourning, sad, depressive people. They're trying to compensate for this, but pretending to be happy-go-lucky, joyful, cheerful, I can't be touched, my way or the highway, in your face, I am the best message. It's compensatory, it's infantile, it's hilarious, it's pathetic. The distinction between reactive depression, exogenous depression and endogenous depression. We don't use this distinction anymore. It's obsolete. But I think in the context of narcissism, it is still very useful. The narcissist has two sources of depression, one of them internal and one of them external. Externally, the narcissist reacts with depression to a loss of supply. It's very simple. But there are engines of depression inside the narcissist. His lost childhood, his trauma, his dead mother, his constant failure in relationships with other people, his inability to connect, the denial of love to himself and to others, the lack of intimacy, the insecure attachment, the phobias, the paranoias. This is not easy to live with. Indeed, Kernberg had suggested that narcissism and borderline are two sides of the same coin and both of them are on the verge of psychosis. That's why he called it border, that's why it's called borderline. Narcissists react with depression not only to life crisis, but to fluctuations in narcissistic supply and in a sense of self-worth. They react with depression to a circumstantial inability to express their dominant personality and psychosexual time, cerebral or somatic. The narcissist's personality is chaotic, it's disorganized, it's precariously balanced. Many would argue that he has no personality, that he's discontinuous, that the dissociative gaps are so frequent that actually there's no core identity there. We call it identity disturbance similar to borderline. The narcissist regulates his sense of self-worth by consuming narcissistic supply from other people. He's heavily dependent on external regulation. Any threat to the uninterrupted flow of supply compromises the narcissist's psychological integrity, his variability to function, it's life-threatening. It's not a joke, it's not a fringe benefit, it's food. Indeed, depression can be conceptualized as a reaction to the systemic failure of hitherto trustworthy and efficacious coping strategies, either owing to seismic changes in circumstance, the environment, or because of overwhelming new information. Unable to cope with the turmoil inside himself, the narcissist deadens and kills himself. The narcissist is a numbing process, writ large, but in this suicidal act, the narcissist remains stuck with the corpse of his true self. He mourns and grieves over this dead child, never overcomes this, and he needs other people to console him by acting as a mother figure, or by somehow providing him with the attention and adulation and love that his parents didn't. He needs other people, and when they're all gone because they've had enough, or because they see through him, the narcissist falls apart into the deepest abuse of sadness and melancholy ever imaginable.