Depression pp 149-171 | Cite as

Psychoanalytic Contribution to a Theory of Depression

  • Phillip L. Isenberg
  • Alan F. Schatzberg


Recent advances in biological research of depression may lead practitioners to adopt a stance that some depressions are biologically caused, whereas others are psychologically determined. Some may go so far as to argue that the classic endogenous or autonomous depression is due solely to biochemical or biological causes, whereas the neurotic depressive disorder is due entirely to psychological factors. Such an assumption would be simplistic, since neurotic disorders have physiologic symptoms (e.g., sleep disturbance, tachycardia, etc.) and patients may experience endogenous depressions after a specific loss, disappointment, or psychological injury. Recently, Akiskal and McKinney1 have attempted to synthesize various psychodynamic, neurochemical, and neurophysiological theories in an effort to understand depressive disorders. Although we advocate incorporating a psychoanalytic viewpoint to such an approach, we feel this is difficult, since a unified, comprehensive, and precise psychoanalytic theory of depression has not fully emerged. Rather, there has been a tendency within psychoanalysis for discrete theoretical approaches to be applied to a host of diagnostic categories (including schizophrenia, neuroses, borderline states, and several types of depression), thus obscuring crucial diagnostic differentiation. Also, although many psychoanalytic theories exist, few have attempted to differentiate among the many subtypes of depressive disorders.


Depressive Disorder Depressive Episode Object Representation Depressive Illness Cognitive Distortion 
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Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Phillip L. Isenberg
    • 1
    • 2
  • Alan F. Schatzberg
    • 1
    • 2
  1. 1.Department of PsychiatryHarvard Medical SchoolBostonUSA
  2. 2.McLean HospitalBelmontUSA

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