THE MANAGEMENT OF DEPRESSION – ANALYTIC, ANTIDEPRESSANTS OR BOTH?

Abstract

Patients with depression cover the spectrum, in terms of severity of psychopathology, between those receptive to analytic psychotherapy and those that require treatment with medication. In this paper, the author demonstrates how an analytic framework of understanding has a place in the latter group, and can aid general psychiatrists in relation to their depressed patients. It will be demonstrated, with clinical illustrations, how analytic thinking can help to make sense of many of the symptoms of depression, including early-morning wakening, diurnal mood variation, agoraphobia and hypochondriasis. It is also important to help the supportive relative with their countertransference experiences, when their partner is undergoing a depressive episode. Finally, the notion of a pathological ego-destructive superego taking over the driving-seat in depression is explored. The need to unseat it and replace it with a more mature superego provides an overall framework of approach to the treatment of depression.

Notes

¹International Classification of Diseases.