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.
KeywordsPsychotic Depression Behavioral Output Antianxiety Drug Lower Quadrant Abdominal Pain Locus Coeruleus Lesion
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