• Daniel X. Freedman


In writing this introduction, I feel relieved of the task—not seriously assigned to me, thankfully—of summarizing what depression really is. As with any major disorder with multiple determinants, it is convenient to “lump” phenomena into a simple, comprehensible psychological or psychobiological grouping. Thus, we can see a nonnegotiable symptom complex in which the dynamics of loss, hopelessness, ambivalence, and introverted anger play their role, based on historically determined vulnerabilities in the regulation of self-esteem, “adgression,” and object relations. We can view the lack of coping, the redundancy of thought processes, the attentional fixation—the general lack of behavioral output with its vegetative and psychological concomitants—as an organismic conservation-withdrawal response. We can see these responses as triggered through stress, as the individual has been “prepared” for it through developmental vicissitudes or biological vulnerabilities, and sustained perhaps by a different weighting of somatic and psychological factors. The fixation of depressive behavior, its intransigence—this aspect represents a possibly different constellation of issues and psychobiological consequences from issues of vulnerability and resistance to recurrence.


Psychotic Depression Behavioral Output Antianxiety Drug Lower Quadrant Abdominal Pain Locus Coeruleus Lesion 
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  1. 1.
    Bayer W von: Zur Psychopathologie der endogenen Psychosen. Nervenarzt 24: 316, 1953.Google Scholar
  2. 2.
    Tsuang M, Dempsey M, Rauscher F: A study of “atypical schizophrenia.” Arch. Gen. Psychiatry 33: 1157 1160, 1976.Google Scholar
  3. 3.
    Procci WR: Schizo-affective psychosis: Fact or fiction? Arch. Gen. Psychiatry 33: 1167 1178, 1976.Google Scholar
  4. 4.
    Kraepelin E: Clinical Psychiatry. ( Translated from Seventh German Edition by Diefendorf AR.) New York, Macmillan, 1923.Google Scholar
  5. 5.
    Kasanin J: The acute schizoaffective psychoses. Am. J. Psychiatry 13: 97–126, 1933.Google Scholar
  6. 6.
    Cobb S: Borderline of Psychiatry. Cambridge, Harvard University Press, 1943.Google Scholar
  7. 7.
    Himmelhoch JM, Mulla D, Neil JF, Detre TP, Kupfer DJ: Incidence and significance of mixed affective states in a bipolar population. Arch. Gen. Psychiatry 33: 1062–1066, 1976.PubMedCrossRefGoogle Scholar
  8. 8.
    Avery D, Winokur G: Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. Arch. Gen. Psychiatry 33:1029–1037, 1976.Google Scholar
  9. 9.
    Mandell AJ, Markham C, Fowler W: Parkinson’s syndrome, depression and imipramine. Calif. Med. 95: 12–14.Google Scholar
  10. 10.
    Halaris A, Freedman DX: Psychotropic drugs and dopamine uptake inhibition. In: Freedman DX (ed) Biology of the Major Psychosis: A Comparative Analysis, Research Publications Vol. 54, pp. 247–258. New York, Raven Press, 1975.Google Scholar
  11. 11.
    Shagass, CS, Naiman J, Mihalik J: An objective test which differentiates between neurotic and psychotic depression. Arch. Neurol. Psychiatry 75: 461, 1956.Google Scholar
  12. 12.
    Perez-Reyes M: Differences in sedative susceptibility between types of depression: Clinical and neurophysiological significance. Arch. Gen. Psychiatry 19: 64–71, 1968.PubMedCrossRefGoogle Scholar
  13. 13.
    Jones BE, Harper ST, Halaris AE: Effects of locus coeruleus lesions upon cerebral monoamine content, sleep-wakefulness states and the response to amphetamine in the cat. Brain Res. 124: 473–496, 1977.PubMedCrossRefGoogle Scholar
  14. 14.
    Shopsin B, Friedman E, Gershon S: Parachlorophenylalanine reversal of tranylcypromine in depressed patients. Arch. Gen. Psychiatry 33: 811–819, 1976.PubMedCrossRefGoogle Scholar
  15. 15.
    Shopsin B, Friedman E, Gershon S: Parachlorophenylalanine reversal of tranylcypromine in depressed patients. Arch. Gen. Psychiatry 33: 811–819, 1976.CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Daniel X. Freedman
    • 1
  1. 1.Department of PsychiatryUniversity of ChicagoChicagoUSA

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