Symposium on 'Depressive Illness'—Ii. Depressive States1

The study of depressive states leads the psycho-analyst to the centre of the fundamental drama that troubles the heart of man, for man is possessed by two apparently equal and contradictory powers, pulling him in opposite directions. Yet sometimes these forces may be intimately blended and linked together, and even, occasionally, replace each other. Thus man is moved by an imperious need to love, to create and construct, and by an opposing and equally tyrannical desire to hate and to destroy.

It may happen that these forces are turned in favour of, or against, the individual himself: the man who hates may unconsciously adopt self-destructive behaviour; if, accepting himself, he becomes open to a more positive attitude, he will select a more beneficent type of behaviour. Love, as we know, often turns into its opposite, hatred; and we also known that when this hatred can find no outlet in the external world it is capable of more or less overwhelming man's inner world. It is this 'more or less' which defines the various depressive states, from the 'little' neurotic depression to the delirious states of melancholia.

For this reason we shall not attempt any further distinction between the various depressive states that have already been more or less satisfactorily classified, both clinically and by tradition. But to eliminate any ambiguity of terminology about our central theme, we shall call the patient in a state of depression depressed, and the patient exposed or liable to states of depression, depressive: and we define depression as a pathological state of conscious psychic suffering and guilt, accompanied by a marked reduction in the sense of personal values, and a diminution of mental, psycho-motor, and even organic activity, unrelated to actual deficiency.

We should point out at once that this descriptive definition makes it impossible to accept, without reservations, terms such as 'depressive position' and 'anaclitic depression' as