The Disorder of Depression and Elation—A Clinical Study of the Changes from One State to the Other1

There is a large literature relating to depressive states and elation and to some extent it has been critically reviewed. It is fair to say, however, that little systematic or consecutive study of the problems involved has been made, notwithstanding the fact that they have been approached from a great many directions. One consecutive sequence of investigations can be observed in the work of Abraham (1), Freud (5), Helene Deutsch (2) and Bertram Lewin (9). Perhaps the best critical examination of these studies is in Lewin's recent valuable work, The Psychoanalysis of Elation(10).

The foundation of our present psychoanalytic understanding of these commonplace disorders is the classic papers by Freud and Abraham. The two most promising trends in the recent study of the disorders are in the work of Helene Deutsch and of Bertram Lewin. Deutsch is concerned chiefly with ego phenomena which these disorders show in the later phases of development, whereas Lewin concentrates on the "psychological matrix of the defenses, their antecedant anlage in the early stages of the psyche" (10, p. 10). The two authors complement each other and have widened the basis of our understanding.

Clinical reports of these states usually concentrate on one phase or the other, on depression or on elation. Very few analysts have studied the relation between the states or the transition from one to the other. Some investigation of this relation and transition