What Is Anaclitic Depression?

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We have all heard about depression, but have you ever heard about anaclitic depression? 

Overview

Over the past years, depression has been extensively studied. It has been proposed that normal personality development occurs through two dimensions: the formation and maintenance of relationships and the development of a positive, and stable sense of self. The interaction between psychological, biological, and environmental factors can disrupt the balance between these two dimensions resulting in the neglect of one and overemphasis on the other. The term anaclitic depression has been used to describe individuals with a need gratification towards others and struggles with dependency. 

Anaclitic depression is a type of depression that is characterized by feelings of loneliness and emptiness and fear of abandonment. It results from the absence or loss of an important attachment figure (e.g., primary caregiver).1 It was first described by Rene Spitz in 1945 who observed a developmental and emotional deterioration in infants who were separated from their mothers for a long time.2

Spitz’s work was expanded by psychologist Sydney Blatt who introduced two subtypes of depression: anaclitic and introjective depression. Anaclitic depression denotes extreme interpersonal feelings such as weakness, loneliness, abandonment fears, helplessness, and intense neediness. These feelings can lead to maladaptive hypersensitivity when individuals feel rejected by others. 

On the other hand, introjective depression is characterized by a self-evaluation and self-criticism tendency and involves concerns about achievements. Individuals with introjective depression use a compulsive striving for unrealistic achievements to manage their chronic guilt, low self-esteem, and self-blame.3 In this article, we will focus on anaclitic depression exploring its causes, symptoms, and treatment plan. 

Causes of anaclitic depression

Research has shed light on the underlying causes of anaclitic depression identifying genetic, environmental, and social factors that predispose individuals in developing this condition. Generally, anaclitic depression refers to intense anxiety when you do not feel emotionally cared for. Although genetic causes are not clear, individuals may have a genetic predisposition to developing depression. For instance, family studies have shown quite a large contribution of genetic factors in depressive disorders.45 However, more research is needed to find candidate genes that may play a role in anaclitic depression. 

Additionally, environmental factors have been identified as significant risk factors for anaclitic depression. For instance, early life stress, loss of an attachment figure, and trauma are all environmental factors. Studies have demonstrated that early life stress and trauma such as neglect, parental separation, and abuse predispose children to depression later in life.6 Furthermore, losing an important attachment figure can profoundly impact the psychological and emotional well-being of an individual during childhood. Infants who are separated from their primary caregiver for a prolonged period are at risk of developing anaclitic depression.2

Other causes of anaclitic depression include social factors which involve social support and cultural factors. Individuals with a strong social support network have a decreased risk of experiencing depression after a stressful event (e.g., the loss of a loved one) than individuals who do not.78 Moreover, another cause of anaclitic depression is social isolation. This involves a lack of contact with family and friends or a long-distance romantic relationship.9

Who does anaclitic depression affect?

Anaclitic depression can affect all ages but is most commonly observed in infants and young children who are separated from their primary caregiver(typically their mother) for a long period . Several factors can trigger this separation such as parental divorce, death, or illness.2 However, anaclitic depression can also be observed in older children and adolescents that have lost a significant attachment figure because of death, or significant changes in their social environment. Children who have experienced these kinds of losses are at higher risk of developing depression.10 

Anaclitic depression is less commonly observed in adults but it can occur because of a breakdown of a relationship or the death of a partner.11 Finally, individuals who have other mental health conditions such as depression or anxiety, maybe more vulnerable to developing anaclitic depression in response to the loss of someone.12

Symptoms of anaclitic depression

As discussed before, anaclitic depression can be seen in all ages and the symptoms may vary from age to age.9,13

Adults

  • Lack of interest (in most activities)
  • Sleep disturbances 
  • Changes in appetite (increase or decrease)
  • Persistent sadness 
  • Fatigue
  • Fear of abandonment
  • Intense desire to feel loved 
  • Anxiety
  • Loneliness 

Babies

  • Crying (more than usual)
  • Lethargy
  • Withdrawal (from social interactions and the environment)
  • Sleep disturbances (difficulty falling asleep)
  • Poor feeding (poor gain weight/growth)

Risk factors for anaclitic depression

While the exact causes of anaclitic depression are not fully understood, certain risk factors increases  the risk of developing this condition. One of the most crucial risk factors is early life experiences related to bonding and attachment. Prolonged separation during infancy can increase the risk of anaclitic depression later in life.14 Moreover, individuals with chronic stress are also more likely to develop depression. Chronic stress may impact the formation and maintenance of social connections and contribute to depression.15 

Other medical conditions such as diabetes, heart disease, or cancer are other factors known to increase depression risk. Medical conditions may impair social functioning resulting in social isolation and turn into anaclitic depression.16 It is important to identify these risk factors to improve outcomes of anaclitic depression and seek appropriate treatment. 

Treatment for anaclitic depression

There are multiple treatment options and plans for individuals who suffer from anaclitic depression. For infants, symptoms reduce if the baby is reconnected with the caregiver. If this is not possible, usually, anaclitic depression treatment involves psychotherapy which means a talk session with a healthcare professional to explore and address the causes and triggers of your emotions. The goal of psychotherapy is to aid you in developing coping strategies.9,13 Your healthcare professional may also prescribe medications such as antidepressants.17

When to seek medical attention?

It is important to seek medical attention if you are experiencing any symptoms of anaclitic depression. If your symptoms are persistent and interfere with your daily life. If you are experiencing suicidal thoughts, you should contact your healthcare professional.17

Summary

Anaclitic depression is a severe mental health condition that can affect all ages. It is primarily caused by the loss of a significant attachment figure although it has various risk factors both genetic and environmental. Symptoms are mostly the same in all ages and involve weight loss, crying, sleep disturbances, and fatigue. It is crucial to seek medical help if you are experiencing persistent symptoms or you worry about your safety. Treatment options include therapy and medication which can greatly improve your quality of life.

References

  1. Rost F, Luyten P, Fonagy P. The anaclitic-itrojective depression assessment: development and preliminary validity of an observer-rated measure. Clinical Psychology & Psychotherapy; 2017. 25: 195-209.
  2. Spitz RA. Hospitalism: An inquiry into the genetics of psychiatric conditions in early childhood. The Psychoanalytic Study of the Child; 1945. 1: 1, 53-74.
  3. Reis S, Grenyer FS. Pathways to anaclitic and intojective depression. Psychology and Psychotherapy: Theory, Research and Practice; 2002. 75: 445-459. 
  4. Murgatroyd C, Patchev AV, Wu Y, Micale V, Bockmuhl Y, Fischer D, Holsboer F, Wotjak CT, Almeida OFX, Spengler D. Dynamic DNA methylation programs persistent adverse effects of early-life stress. Nat Neurosci; 2009. 12(12): 1559-1566.
  5. Shadrina M, Bondarenko EA, Slominsky PA. Genetics factors in major depression disease. Front Psychiatry; 2018. 9: 334.
  6. McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and first onset of psychiatric disorders in a national sample of adolescents. Arch Gen Psychiatry; 2012. 69(11): 1151-1160. 
  7. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont); 2007. 4(5): 35-40. 
  8. Karakas NM, Dagli FS. The importance of attachment in infant and influencing factors. Turk Pediatri Ars; 2019. 54(2): 76-81.
  9. PsychCentral. 2023. What is anaclitic depression? https://psychcentral.com/depression/anaclitic-depression
  10. Hammen C. Interpersonal stress and depression in women. Journal of Affective Disorders; 2003. 74: 49-57. 
  11. Rodhe P, Lewinsohn PM, Klein DN, Seeley JR. Association of parental depression with psychiatric course from adolescence to young adulthood among formely depressed individuals. J Abnorm Psychol; 2006. 114(3): 409-420.
  12. Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K, Raphael B, Marwit SJ, Wortman C, Neimeyer RA, Bonanno GA, Block SD, Kissane D, Boelen P, Maercker A, Litz BT, Johnson JG, First MB, Maciejewski PK. Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med; 2009. 6(8):e1000121.
  13. Medical News Today. 2023. What to know about anaclitic depression. https://www.medicalnewstoday.com/articles/anaclitic-depression-causes-symptoms-and-more
  14. Bowlby J. Attachment and loss. The American Journal of Psychiatry; 1969. 97: 1158-1174. 
  15. Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, Turner RB. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci USA; 2012. 109(16): 5995-5999.
  16. Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci; 2011. 13(1): 7-23.
  17. Mayo Clinic. 2023. Depression (major depressive disorder). https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

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Athina Servi

Research Assistant at Imperial College London, Department of Brain Sciences

My name is Athina Servi, and I am a young professional with a strong academic background
and a passion for neuroscience and mental health. I graduated from the University College
London with a degree in Biomedical Sciences BSc and then I pursued a Translational
Neuroscience MSc at Imperial College London where I currently work as a Research
Assistant. My academic and professional journey so far has provided me with extensive
experience in various healthcare settings. I believe in making medical information accessible
to everyone, not just those with a medical background. Through my writing, I want to help
people better understand their health, make informed decisions about their care, and
ultimately, live healthier, happier lives. I hope you enjoy my article!

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