/tmp/lncof.jpg Depression - Psychoanalyst London

Depression

We have all lost something we loved some time, a loved one, a dream, an ideal, freedom or we have moved cities, countries, families… In all these situations there is a risk of “producing” melancholia.

Freud tried to explain that depression, an extremely painful mental disorder , in which contact with reality is almost completely lost, is produced in a similar way as another status, not pathological, which is the mourning.

Mourning is the reaction caused by the real lost of a loved object: death, separation… My father died, my boyfriend left me, I lost that job…: I am no longer interested in exterior reality. I am only interested in things of reality which remind me to my father, my boyfriend or that job. Mourning is so painful because the ego is fighting to get detached from the loved object. I have to decide if I follow the loved object and join the death or if I choose life and stay alive. According to Freud this status which looks like a disorder, it is not because it is temporary. In a individual who is mourning in the end, reality wins over: “ that loved object does no longer exist, you have to look for another one”. Against this demand, there is an opposition: it is very difficult for the human being to abandon what he one loved even when he has found a substitution for it. This normal affect of mourning is very interesting because it doesn’t imply a loss of the Ego. It means: “ My father died, I was sad, wasn’t interested in the exterior world, but I didn’t stop being intelligent, pretty, tall nor arrogant”. My self love did not decrease.

On the contrary, with depression, I cant love, there is a loss of the Ego: I can not work. In mourning, it is not that I cannot work, but that I do not want to, I am not interested in working because I have lost my interest in the exterior reality.

In Depression, there is self – reproach. There is a decrease of self love.

Mourning could be a mental disorder if it became permanent. The only case in which the loss of a loved object could lead to depression, is when the object choice is narcissist: the melancholic individual loves himself in the object.

All in all:

  • Mourning concerns a real loss.
  • Depression concerns the loss of an unconscious object. The melancholic doesn’t know what he has lost, even when “he knows it” he doesn’t know what it meant for him.
  • Sadness is just the feeling that comes after (understanding) the sentence: “one day, I will die”. It is not a passion of the soul according to Philosophy, it is not the opposed affection of happiness.

Depression is similar to psychosis in the sense that melancholic individuals can attack themselves to the point that sometimes they manage to kill themselves. Freud asked himself: How is it possible that the ego kills the ego? Then he realised that that was not what was happening: A depressed person is not someone sad, it is a silent killer. Because he/she wasn’t able to “replace” what he/she lost (an idea, a person he/she loved…), he/she identified with it in order not to loose it (the person/idea they lost, became part of themselves, consuming their own ego —> that is very unhealthy). That is why depressed people kill themselves, they don’t want to kill themselves. They want to kill the person who abandoned them (who, by identification, became part of their own ego).

How did Freud discover this complex mechanism? Because he realised that the toughest pieces of self reproach had, in fact, nothing to do with the individual: “I am useless, I never achieved anything – and the individual is in fact very skilled-.” Why is that? Because they are in fact not self- reproach but pieces of reproach addressed to the loved one who abandoned them (or died).

Could then maybe… depression be related to Cancer? In the sense that “I kill/disintegrate a part of myself … not my ego but the part of my ego which is lost in the identification with the lost object?”

It has been proved that everybody with Cancer was depressed prior to having Cancer. If that was the case… we could fight cancer by treating depression.

There is something else characteristic of depression: impoverishment. Although being bankrupt is not exclusive of melancholia, you can be bankrupt without being depressed.

Psychoanalytical treatment of the depression demands – more than ever- than no one mess up with the patient’s life. Interfering with the patient`s life could be catastrophic: he could kill himself or… someone else. There is an “altruist depression”, one day I am sad thinking I have no future and I put a bomb so that everyone is dead and they don’t suffer for not having a future. That would be “altruist suicide”. Treating a depressed patient is like in medicine, treating someone with radiation, it cant be any doctor, it cant be any psychoanalyst, it has to be an specialist, someone who knows his job very well, because the game of passions takes place as in a normal individual. It is not psychosis but it is crazier than psychosis. It is more likely that a depressed individual kills himself than a psychotic one.

There is no need to fall in depression to realise that I identify myself with what I loose: example: Girl coming from a foreign country: Why she cant substitute? what prevents her for replacing the streets of her country for the streets in the new country and enjoy the new place? Her ego is invaded , it is not free to walk on the new streets because it is full with the previous ones. Without being depression, it is the same mechanism.

Nowadays, depression is trendy, fashionable because it is a bit selfish, individualist… even convenient. Example: Ay… I am depressed because COVID19 lockdown… , why is it trendy? Because when you are depressed you are no longer interested in reality, I am no longer interested in people, nor things… I stay playing with my ego to self reproach. So, instead of doing something useful, learning online, thinking of new ways of doing things… I stay depressed lying on my bed.

One of the measurements of mental health is the ability to “replace”. Even in those cases in which we are deeply convinced (feelings are always missleading) that someone is unique, we need to be capable to “replace”. For people is difficult to “replace”, we tend to think we then dont love so much. That is just a mistaken idea (that is how we have built morality – we build everything: religion, beauty, relationships – everything in the human being is a construction). Not being able to “replace” ideals, loved ones… leads to anger and hence depression, pain and poverty.

The object of the drive is contingent, what matters is “to love” not what we love. In occidental culture, the object is magnified, however what matters is the drive. The issue with the depressed people is that they turn something contingent into necessary “ It has to be this one and not any other”. On top of that, if the choice is narcisisst, when they lose their loved object it is like if they loose a part of themselves.

“Loved objects” have to be replaced, that is the psychic apparatus: that is normality. If someone asks: what does “normal” mean to Psychoanalysis: to replace everything we lose. The sooner, the better.