Abstract
Melancholia has accounted for severe human suffering throughout history. Numerous individuals have poignantly described the various symptoms and feelings that accompany severe depressions. However, it was not until the beginning of the 20th century that both psychological and constitutional theories were developed. Abraham postulated intense oral fixation in depressed individuals and differentiated grief from morbid depression.1 Moreover, he viewed depression as aggression turned toward the self. Freud embraced these ideas but elaborated the concept of object loss.2 He contended that the real or fantasied loss of an ambivalently loved person precipitates an ego regression with introjection and intense anger toward the lost object. This process results in self-deprecating, guilty feelings. Many authorities have argued that depression is not simply the result of aggression turned inward. Overt expressions of hostility do not relieve depressive symptoms. Weissman et al. emphasize that depression and aggression are separate affects that frequently coexist in depressed individuals.3
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Gelenberg, A.J., Schoonover, S.C. (1991). Depression. In: Gelenberg, A.J., Bassuk, E.L., Schoonover, S.C. (eds) The Practitioner’s Guide to Psychoactive Drugs. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1137-0_2
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