Depressive realism

Depressive realism. This theory puts forward the notion that depressed individuals actually have more realistic perceptions of their own image, importance, and abilities than the average person. While it’s still generally accepted that depressed people can be negatively biased in their interpretation of events and information, depressive realism suggests that they are often merely responding rationally to realities that the average person cheerfully denies.

Those with paranoid disorders can sometimes possess a certain unusual insight as well. It has often been asserted that within every delusional system, there exists a core of truth—and in their pursuit of imagined conspiracies against them, these individuals often show an exceptionally keen eye for the real thing. People who interact with them may be taken aback as they find themselves accused of harboring some negative opinion of the person which, secretly, they actually do hold. Complicating the issue, of course, is the fact that if the supposed aversion didn’t exist before, it likely does after such an unpleasant encounter.

As one might imagine, these issues present some problems when it comes to treatment. How does one convince a depressed person that “everything is all right” when her life really does suck? These problems put therapists in the curious position of teaching patients to develop irrational patterns of thinking—patterns that help them view the world as a rosier place than it really is. Counterintuitive as it sounds, it’s justified because what defines a mental disorder is not unreasonable or illogical thought, but abnormal behaviour that causes significant distress and impairs normal functioning in society. Treatment is about restoring a person to that level of normal functioning and satisfaction, even if it means building cognitions that aren’t precisely “rational” or “realistic.”

It’s a disconcerting concept. It’s certainly easier to think of the mentally disordered as lunatics running about with bizarre, inexplicable beliefs than to imagine them coping with a piece of reality that a “normal” person can’t handle. The notion that we routinely hide from the truth about ourselves and our world is not an appealing one, though it may help to explain the human tendency to ostracize the abnormal. Perhaps the reason we are so eager to reject any departure from this fiction we call “normality” is because we have grown dependent on our comfortable delusions; without them, there is nothing to insulate us from the harsh cold of reality.

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