Are Depressed People Afraid of Happiness?

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Jordan and colleagues, in a paper published in the March issue of Journal of Clinical Psychology, suggest that depressive symptoms are associated with two phenomena: Negative affect interference and fear of happiness. Before discussing the study, let me explain the meaning of negative affect interference and fear of happiness.

Negative Affect Interference in Depression, Anxiety, and Trauma

Research on posttraumatic stress disorder (PTSD) suggests many individuals who have experienced trauma often react to pleasurable stimuli and positive events with negative affect (e.g., anxiety, guilt, shame). This is called negative affect interference.

These intrusive negative emotions can discourage traumatized individuals from engaging in pleasurable activities in the future. Not engaging in enjoyable activities reduces the likelihood of experiencing joy and happiness, and increases the likelihood of depression.

Patients with anxiety and particularly depression may show similar tendencies. Why? According to the reward devaluation theory, anxious and depressed patients actively avoid and devalue positivity and rewarding activities because of past associations between enjoyable activities and negative emotions, like guilt, shame, frustration, and disappointment.

Depression and Fear of Happiness

A related phenomenon is called fear of happiness. (You can find the Fear of Happiness Scale here.)

Happiness and joy are not always experienced as pleasurable. Sometimes they are experienced as frightening. Such fears of happiness (and other positive emotions) might have a number of potential causes, including:

• the belief that one does not deserve to be happy
• fear of loss (i.e. loss of happy feelings or causes of happy feelings, such as money or friends)
• happiness often being experienced as less intense and thus more aversive than the more familiar feelings of unhappiness
• associations between happiness and distressing events that occurred at the same time or soon after experiencing feelings of happiness

Furthermore, some individuals with depression “inhibit any form of gratification because of strongly held taboos... instilled by their families and culture” (p. 1362).

To give an example, Gilbert et al. recount the case of a patient whose mother had agoraphobia, and who recalled “often getting excited about going out to the beach or to watch a film only for her mother to break down at the last moment in a panic attack, triggering arguments with her father.” As a result, the patient learned “it was better not to look forward to things.”

Affect Interference, Fear of Happiness, and Depression: The Study

Let us now turn to the study by Jordan and collaborators.

The sample consisted of 476 U.S. residents (79 percent White). The data were collected at three points (Time 2, 3, and 4) during nine months:

• Time 2: 375 (266 females; average age of 40 years; range of 18 to 76 years)
• Time 3: 292 (209 females; average age of 41 years; range of 18 to 75 years)
• Time 4: 220 (153 females; average age of 43 years; range of 20 to 77 years)

Participants completed three measures, as described below.

1. The Fear of Happiness Scale (FHS): Measures anxieties related to present or future happiness.

Sample items: “Good feelings never last,” “If you feel good you let your guard down,” and “I worry that if I feel good something bad could happen.”

2. Hedonic Deficit and Interference Scale (HDIS): Assesses whether anhedonia (inability to experience happiness) is accompanied by negative emotions.

Sample items: “Would you say that you can’t... experience feelings of interest, enthusiasm, and excitement, even when you try, and even when good things in your life happen?” and “When positive events happen in your life: do you feel ‘numb,’ like you can’t feel emotions and feelings?”

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3. Quick Inventory of Depressive Symptomatology, Self‐Report (QIDS‐SR): Assesses depression; the items concern sleep, appetite, weight gain or loss, sad mood, concentration problems, loss of interest, psychomotor changes, self-criticism, and fatigue.

What the Study Found

The results showed negative affect interference and fear of happiness were related, though they were not the same. In addition, they were independently linked with depression, positive emotions, and inability to experience positive affect.

Specifically, greater negative affect interference and fear of happiness predicted increased depressive symptoms.

The data further showed negative affect interference and fear of happiness characterized two pathways to depression:

1. Negative affect interference: Sometimes people are unable to experience good feelings after positive events because of the experience of powerful negative emotions.
2. Fear of happiness: Sometimes people actively avoid good feelings because they view positivity as dangerous.

These pathways differ from previous conceptualizations of depression, which had suggested depression is caused by a sensitivity to negative emotions or a lack of positive emotions—whether due to biological abnormalities, biased cognitions, rumination, or other factors.

Instead, the present results suggest that (at least some) depressed people suppress or actively dampen their reactions to positive emotions due to negative affect interference or fears of happiness.

The avoidance of feeling happy (or sources of happiness) may have initially appeared protective to traumatized or depressed patients, perhaps given past associations between happiness and distressing or traumatic experiences. Nevertheless, avoiding happiness could lead one to feel hopeless and to experience less pleasure and joy in life. And this often contributes to the development, maintenance, or worsening of depression.

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Takeaway

If future research replicates the present findings—that negative affect interference and fear of happiness predict depressive symptoms—then common therapies offered to depressed patients need to be modified.

For instance, cognitive behavioral therapy, which emphasizes challenging negative thoughts and beliefs, does not necessarily address depressed patients’ experience of distress in response to positive stimuli or biases related to the avoidance of positivity. Nor does it teach depressed patients how to savor positive experiences.

Luckily, some newer interventions, like Positive Affect Treatment and Augmented Depression Therapy, are attempting to address some of these concerns.

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