The feeling of loss in depression

“Loss in all of its manifestations is the touchstone of depression—in the progress of the disease and, most likely, in its origin.” (Laing, p. 39, 2010)

The idea that loss plays a role in the development of depression was made popular when in 1922 Freud wrote his famous paper, Mourning and Melancholia. This paper remains uniquely relevant because, as Andrew Solomon writes, it “has probably had more effect of contemporary understanding of depression than any other single piece of written material” (p. 324).

Freud was curious about the fact that so much of what can be said about depression can also be said about grief. We would not want to intervene with grief, he said, so what makes depression different? Debate continues today around this subject, with many pointing out that the DSM classification for depression might lead to grief being pathologized.

For Freud, the major difference between grief and depression (mourning and melancholia), was that “in grief, the world becomes poor and empty; in melancholia, it is the ego itself which becomes poor and empty”. That is, the depressed person tends to be highly critical of themselves. What is lost is a basic sense of self-esteem. At the centre of the experience is a split ego, one half threatens and the other half recoils. The self turns against the self. Thus the psychological world breaks down into disorganisation. According to Freud, what puts one at risk of developing depression is “incomplete mourning”. The traumas and losses of childhood, if not held by an attuned and loving adult, and processed in a safe relationship, remain in the mind and body, often outside of awareness.

There is a catharsis in grief. The body and mind takes its natural route toward healing. If this doesn’t properly occur, a burden of not only sorrow, but rage and guilt, can build, and without an appropriate mode of expression, gets inexorably turned inward.

“Depression is the flaw in love”, writes Solomon. Not only does depression emerge out of the things and people that we lose, whether through death or other twists of fate; the loss of love itself contributes significantly to the emergence of depression. Rejection, disapproval, neglect and indifference from those we love undermines self-esteem and agency, leading to the sense of guilt and failure which characterises depression.

Resources

Solomon, A. (2014). The noonday demon: An atlas of depression. Simon and Schuster. Chicago

Laing, R. (2010). The divided self: An existential study in sanity and madness. Penguin UK.

Freud, S. (1917). Mourning and melancholia. The standard edition of the complete psychological works of Sigmund Freud, 14(1914–1916), 237-258.