Adolescent Depression1

Sixty years ago, Freud (1905) described detachment from parental authority as the most significant—and the most painful—psychic achievement of adolescence. This detachment involves a most difficult struggle; it is indeed of crucial significance in determining whether he will fall within the range of what we consider normal or whether he will be maladjusted. In this essay I shall be focusing on the dynamics of this struggle which appears with dramatic clarity in cases of depressive illness.

The depressed adolescent repeatedly complains of a confused sense of identity; he is apathetic at certain times; over-active at others; at all times, however, he fears criticism. He fears a further loss of his already highly diminished self-esteem and is convinced that he is an unloved and unlovable "nobody". The sense of isolation produced by these feelings becomes increasingly more tormenting; the patient is unable to relinquish his dependent relationship with his parents; he is incapable of relinquishing the past; he is unable to go forward into a "future". He is unable to form new object relationships. The many problems centering on ego identity interfere with further development of the ego towards maturity.

His troubled ego attempts to control the strong instinctual forces and channelize them into a more mature direction, but fails; his inability to function serves as a "realistic" if not desirable means of maintaining his ties to the family.

He cannot adjust to new reality demands; he cannot comply with the superego demands. His superego elements show inconsistent strivings, which are also responsible for his faulty identification, his distorted and confused self-image. His ego and superego are in continual conflict, resulting in feelings of guilt.

Clinical investigations focus attention on the functions of superego manifestations concerning conscience, ethical and moral standards, and problems concerning ego-ideal defects originating in infantile pathologica