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Both new developments in the concept and treatment of depression and sociocultural changes in the role of women prompt a study of the emotional disorders in women whose mothers have been depressed. During the past 10 years, there have been impressive advances in our understanding of the biology of depression and its pharmacological treatment. There is strong evidence for a genetic etiology in some depressions.1 Most proponents of analytic psychotherapy, for example, Arieti and Kernberg, are not against using medication when physiological symptoms of depression are present. On the other hand, many psychopharmacologists give short shrift to psychological theories. The medical students that I teach have been given an almost totally biological orientation.
As our scientific techniques become more refined and our nomenclature more specific, we must not lose sight of the basic principles of psychodynamics and the interactions between illness and environment. I have chosen to discuss depressive illness in mothers and its effect on their daughters, as this seems to me an ideal area in which to study the interactions among genetic/biological, psychological, and sociocultural variables.
Depressions predominate in women over men by nearly a 3:1 ratio. In Myrna Weissman's excellent review,2 she states that this prevalence has been validated in different cultures, at different economic levels, and throughout the life span, and she concludes that the prevalence is real rather than artifactual. She discusses sociocultural explanations for this difference, including socialization into the position of learned helplessness and barriers to economic achievement for women, and cites evidence such as the fact that marriage seems to protect men while it puts women at increased risk.
When discussing sociocultural factors in women's depressions, it is important to be aware of the relationship between the sociocultural and the psychological. Esther Menaker, a New York psychologist and psychoana