Despite the fact that it has long been recognised that narcissism can contribute to depression, we have become accustomed to referring to depression mostly in terms of a neurotic disturbance. The author highlights the difference between the narcissistic elements in depression, which is based on guilt, and the graver narcissistic depression, which is governed by shame. He attempts to define the elements that constitute ‘narcissistic depression’ where primal psychic mechanisms rule, and stresses the importance of recognising this form of depression if it is to be dealt with appropriately. The author focuses on adolescence, during which, he believes, this type of narcissistic depression is predominant. In the presentation of two cases of psychoanalytic psychotherapy of adolescents, he seeks to analyse this psychopathology, looking particularly at how it affects therapeutic techniques.