Loss and Depression in Young Adults

An enduring question in the psychodynamic study of depression is the relationship of a precipitant to a clinical episode. It remains unclear how the experience of an external event becomes transformed into feelings of dysphoria, hopelessness, and low self esteem. Historically, the connection between life events and depression has been described differently at different times by various theories. We are all familiar with the classic explanation of the predisposition to depression as residing in the childhood formation of a pathognomonic introject representing the absorption into the ego of a lost love object (Freud, 1917). Later losses reactivated the experience of this early loss and the episode of depression was a manifestation of anger directed against the initial love object which had become part of one's self. The importance of these self recriminations also featured largely in later views that explained depression as a helpless ego being punished by a strict superego and the depressive manifestations representing the ego's attempt to win forgiveness for having forced a love object to abandon it (Rado, 1927).

These early contributions, together with Abraham's (1924) careful delineation of regressive fixation points, all centered on object loss precipitating depression by reviving an earlier experience of dysphoric abandonment crystalized by Abraham by the term “primal parathymia.” The difficulties with these formulations are well known. Depression did not always follow object loss, self recriminations were not always clinically present, and equally absent were those symptoms signifying a regression to oral or anal modes of libidinal organization. From a theoretical framework, those structures implicated in the