Depression

Hiding the Self, Depression, and the Need for Connection

New research explores the role of shutting out others.

Posted Sep 24, 2020

by Grant H. Brenner

Understanding the personality traits that contribute to depression is not only important for identifying vulnerabilities, but also to improve individual treatment outcomes. As highlighted by clinical researchers Kealy and Rice (2020) in their recent paper in the European Journal of Psychiatry, dispositional connectedness and self-concealment may be key factors.

Connection and concealment

Dispositional connectedness is “a tendency to value and prioritize interpersonal relationships.” People with high dispositional connectedness see other people as friendlier, are receptive to forming attachments, with greater emotional openness, expressions of affection and warmth, and communal feelings. 

Dispositional connectedness is associated with the personality trait of agreeableness (2006). While a strong orientation toward bonding is a prosocial characteristic that has value in personal and professional relationships and can protect against depression by increasing support, when relational needs are strong and unmet, it heightens distress.

Self-concealment, by contrast, is “the tendency to avoid revealing aspects of the self that are perceived to be negative.” It goes against connection, often, it seems, in a misguided attempt to preserve relationships. In depressive states, we tend to feel worse about ourselves, compounding feelings of shame and self-blame. Confronted with distorted fears of what others will think of us—especially for people who grew up with childhood maltreatment from primary caregivers—hiding ourselves from others may seem like the only viable choice.

Studying self-concealment in those seeking help

Hypothesizing that self-concealment would worsen depression for people with high dispositional connectedness, study authors Kealy and Rice surveyed 116 depressed patients in treatment in a public mental health clinic. Patients had been admitted with clinically significant psychiatric issues, accompanied by impairment in personal and/or occupational function.

The participants completed questionnaire measures of connectedness, self-concealment, and overall depression severity. Over 80 percent of the group were above the threshold for clinical depression, with over 40 percent in the severe range. Half reported experiencing suicidal thoughts within the prior two weeks.

Statistical analysis revealed that "higher connectedness was linked with stronger self-concealment tendencies, which in turn linked with depressive symptom severity." The more that depressed participants hid aspects of themselves, the more it may have gotten in the way of reaching out to others, a necessary step for recovery. Self-concealment is likely to worsen depression by interfering with actual social connection, as well as by reducing perceived social support, a key driver of resilience.

Practical implications

Those with depression may harbor fears that they are a burden to others. Such distortions stem from “anticipatory interpersonal guilt” and lead to further withdrawal and depression in a vicious cycle. People with a poor self-image may also have been raised to believe that their normal needs were a problem for primary caregivers, strengthening the tendency to maladaptively withdraw out of a desire to preserve connection and protect others. 

Paradoxically, when people reject help, it may place more of a strain on loved ones than when we reach out in an adaptive connection. High dispositional connectedness can work both ways, either protecting against or worsening depression. Pretending we don’t need others when we do, and trying to pretend things are better than they really are, adds fuel to the fire. Recognizing self-concealment, and modifying unhelpful self-concealment and underlying feelings of guilt and of burdening others, may play a role in recovery, especially for those with strong attachment needs.

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