Depression and Psychoanalysis
A psychoanalytic view of depression.
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Portuguese version here
According to an epidemiological study of depression in Brazil made available by the Ministry of Health, around 15% of people suffer from this condition at some point in their lives. The WHO (World Health Organization) states that around 10% of people who seek primary care are affected by depression.
We often confuse depression with mourning or sadness, the latter are something common for our species and are part of our development, they are linked to the disappointments we have throughout life or the process of losing an object and moving towards a new one. Depression can be understood as a lowering of our will to live, loss of interest in life, and can be divided into mild, moderate or severe, in the latter the decrease is so severe that there is a great risk of suicide.
Some of the warning signs of depression observed are extreme intolerance to losses and frustrations, subordination to other people’s judgment, exaggerated demands on oneself, low self-esteem, feeling unloved and a constant feeling of unattainable desire.
For contemporary neurology, one of the main factors for this to occur is low levels of serotonin, but for psychoanalysis, this is just the effect of a larger problem.
For Freud, both mourning and melancholia arise from a traumatic event, a loss. This loss does not necessarily have to be a death, it can be a change of city, the end of a friendship or even the end of a cycle in life. Mourning is not usually pathological, it is a moment in which the loss is reworked and gains new meaning, it is the necessary moment for the individual to stop associating libido with a certain object. It is the victory of reality over our Ego, accepting it we can continue to live. Mourning occurs because our psychic energy is directed towards a certain object, and when that object is lost, that energy returns to the Ego. Social withdrawal occurs because the individual is focused on letting go of the lost object to reinvest this energy in new objects.
According to Freud, there are three preconditions for melancholia, the loss of the object, ambivalence and regression of the libido to the Ego. Both the loss of the object and ambivalence are also present in the self-recriminations that occur in mourning, but in relation to the libido which returns to the Ego, it connects to a new object after the process, whereas in melancholia this does not happen.
With the melancholic, identification with the object occurs. It is as if in a certain way the object was part of the individual, he does not accept the loss, he focuses on what was lost even without knowing what was lost, sometimes even being aware of the lost object, but not exactly what was lost with that object.
Considering the idea of ambivalence conceived by Freud, unconsciously we love and hate the same object, when loss occurs in the melancholic, the hatred previously directed at the object returns to the Ego, which is then divided into two parts, one that attacks, sadistic and another that is attacked. Pleasurable self-martyrdom as it is called by Freud occurs in the melancholic when he takes revenge on the object through self-punishment instead of confronting the object itself. Therefore, the melancholic person does not mind exaggerated self-criticism, insulting himself, self-incrimination, as the attacks actually unconsciously refer to other people. According to Freud (1917), “In mourning it is the world that becomes poor and empty; in melancholy it is the Self” (Freud, Mourning and melancholy, 1917)
Some authors such as Julia Kristeva differentiate melancholy from depression. According to the author, depression is more associated with a loss of energy and vitality, while melancholy involves a deeper loss of the meaning of life.
Both can also be explained by Lacanian thought. The origin of depression is related to the object of the subject’s desire, with depression being a manifestation related to the search for the fulfillment of this desire.
According to Lacan , the subject is constituted through the process of alienation, thus, being introduced into culture, into language, this alienation causes the subject to identify with an imaginary ideal, seeking to fit into a pre-established image, and can thus lead to a feeling of frustration, inadequacy, when not achieving the ideal image. In this sense, “(…) Man’s desire finds its meaning in the desire of the other, not so much because the other holds the keys to the desired object, but because its first object (of man’s desire) is to be recognized by the other.” (LACAN)
For Lacanian theory, we can say that depression arises from the subject’s relationship with lack. When the confrontation with the lack occurs, separation occurs. The subject will always be separated from his object of desire by the symbolic, by language, when he cannot deal with this lack, depression arises.
Anaclitic or essential Depression is perhaps the most common type of depression in our era. To better understand we must be aware of the concept proposed by Freud of the anaclitic choice of the object, which is based on the choice of the object using as a model the relationship with his parents, the desire to receive treatment similar to that he received from his mother and/or your father.
In a generic way, we can explain the roots of essential depression, for psychoanalysis, during the phases of psychosexual development. In childhood, our libido is directed to the zone corresponding to that stage, this libido continues its path until it reaches the latency stage, where a certain “dormancy” occurs and, in this process, part of it is desexualized, opening the way for interests in other activities. external, social. Later, the part of the libido that remained sexual returns, directing the individual to search for a sexual partner.
Some individuals in the stage prior to latency were unable to resolve their Oedipus complex effectively, despite overcoming this stage they tend to maintain in their unconscious an imprisonment in this “perfect” pre-Oedipal relationship where their desires, wants and needs were all supplied by the country. The individual with these characteristics seeks in different ways to find again the pleasure that was allowed in this relationship and, during this path, his unconscious objective ends up being a kind of “fuel” for his development, however, this search for a concept of happiness, impossible achievement ends up frustrating him and often, despite his professional achievements, in relationships or other positive points in his life, he never finds what he is looking for, and it is when he realizes the impossibility of his search that depression is born, that feeling that leads to a lowering of the will to exist, to live.
With the research of psychiatrist Bowlby , in which three stages were discovered that occurred when babies were removed from their mothers, we can better understand what happens in depression.
The first is the protest where the child cries looking for his lost mother. The second is hopelessness in which the baby is in pain and no longer believes he can find his mother. The last stage is withdrawal, when emotional detachment and indifference occur, this phase would correspond to adult depression.
Another type of depression, proposed by psychoanalyst Jorge Forbes , is depression resulting from the breakdown of our identity .
We are currently experiencing a change in the form of our social organization and the organization of our identity. According to Forbes, we are moving from a world that was previously vertically oriented to a horizontally oriented world. He differentiates them as Earth one (old) which was hierarchical, progressive, disciplined and modalized for the world and Earth two (new) which is variable, creative is diverse, fluid. The generation of older adults had their identity established in the old, vertical world and was forced to adapt to the new, horizontal world. These people end up feeling out of tune, they feel lost, without understanding what to choose and how to do it.
We can better understand by following an example close to that given by Forbes, in which the individual finds himself walking along a busy street with a friend when he sees another friend coming towards them, he prepares to greet him and, as he passes by, greets, but is ignored. The friend next to him then says, “What did you do to make him treat you like that?” At that moment, the subject begins to think about what he could have done wrong. With this example we see the following situation, the loss of identity when being ignored and this identity being recovered when the individual blames himself, insults himself, thinking about what was wrong with him. As we know, when identity is recovered through self-insult, depression results from the blaming itself.
We can better understand by following an example close to that given by Forbes, in which the individual finds himself walking along a busy street with a friend when he sees another friend coming towards them, he prepares to greet him and, as he passes by, greets, but is ignored. The friend next to him then says, “What did you do to make him treat you like that?” At that moment, the subject begins to think about what he could have done wrong. With this example we see the following situation, the loss of identity when being ignored and this identity being recovered when the individual blames himself, insults himself, thinking about what was wrong with him. As we know, when identity is recovered through self-insult, from the blaming itself, results in depression.
An important consideration, which also serves as a warning to reduce damage to future generations, is depression caused by pathogenic identifications that are identification with the depressed object. In this type of depression, the child ends up following the same path as that of the adult who is preparing them for life and will hardly be able to escape the pessimism and loss of will, the lack of interest in living in the world that the adult is presenting to them. .
It is worth remembering the concept of good enough parenting, derived from the English psychoanalyst Donald Woods Winnicott’s concept of good enough mothers. Good enough parents must prepare their children by offering them all the foundation that allows them to experience frustrations both in their relationship with them and with the world, without losing interest in life. According to the author; “the good-enough environmental provision” which makes it possible for the offspring to “cope with the immense shock of loss of omnipotence”
This good enough relationship and a facilitating environment can be demonstrated with the situation of a baby playing alone, but with his mother nearby, doing his chores ready to help him when needed, thus letting him develop his own space. Both an insufficient relationship that leads the child to helpless development early, and one that does not allow him the necessary space to develop individuality, will probably give rise to future psychopathologies.
This good enough relationship and a facilitating environment can be demonstrated with the situation of a baby playing alone, but with his mother nearby, doing his chores ready to help him when needed, thus letting him develop his own space. Both an insufficient relationship that leads the child to helpless development early, and one that does not allow him the necessary space to develop individuality, will probably give rise to future psychopathologies.
It is important to emphasize that these are not the only origins of the different types of depression. Given the complexities surrounding the topic, it must be debated in a multidisciplinary way, always taking into account the cultural and social implications.
Psychoanalysis seeks a better relationship between the subject and the lack. The acceptance that we will always be subjects of desire and will always be dealing with lack, moving from missing subjects to desiring subjects, leaving alienation, leaving the position of object of desire and starting to satisfy our own desire.
Bibliographic references:
FREUD, Sigmund. Luto e Melancolia. In: Edição Standard Brasileira das Obras Completas de Sigmund Freud. Editora Imago, 1996, v. XIV.
FREUD, Sigmund. Três Ensaios Sobre a Sexualidade. In: Edição Standard Brasileira das Obras Completas de Sigmund Freud. Editora Imago, 1996, v. VII.
KRISTEVA, Julia. “Melancolia e Depressão: do Luto à Clínica
LACAN, Jacques. Escritos. Editora Zahar, 1998.
LACAN, Jacques. O Seminário. Livro 10: A angústia. Editora Zahar, 2005.
LACAN, Jacques. O Seminário. Livro 11: Os quatro conceitos fundamentais da psicanálise. Editora Zahar, 1985.
LAPLANCHE, Jean. Vocabulário da Psicanálise. Martins Fontes, 2012.
MINISTÉRIO DA SAÚDE. Depressão. Disponível em: <www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/d/depressao> Acesso em: nov. 2023.
ZIMERMAN, David E. Fundamentos Psicanalíticos: Teoria, Técnica e Clínica. Editora Artmed, 2017.
WINNICOT, D. W. O Ambiente e os Processos de Maturação. Editora WMF Martins Fontes, 2019.
DUNKER, Christian. Como a psicanálise enxerga a depressão? [Online]. Disponível em: < www.youtube.com/watch?v=UV5JpG3O64g >. Acesso em: nov. 2023.
FORBES, Jorge. Depressão | Jorge Forbes [Online]. Disponível em: <www.youtube.com/watch?v=io-PLcgw9rg >. Acesso em: nov. 2023.
