Depression as an Evolutionarily Conserved Mechanism to Terminate Separation Distress: Only Part of the Biopsychosocial Story?

The article by Douglas Watt and Jaak Panksepp provides a much-needed opportunity to attempt to bridge the gap between psychological and biological processes in depression research. In addition, their article provides the opportunity to address critically Diagnostic and Statistical Manual of Mental Disorders (DSM-IV: APA, 1994) assumptions that may hinder rather than facilitate current research concerning depression (Blatt & Luyten, in press-a; Luyten & Blatt, 2007; Luyten, Blatt, Van Houdenhove, & Corveleyn, 2006). Moreover, the article illustrates the relevance of a number of areas that are highly interesting for psychoanalysis—such as animal models and contemporary stress research—but until now have been relatively neglected by the psychoanalytic community.

In this commentary, we respond primarily from a clinical perspective to the important and extensive contribution by Watt & Panksepp on their biological perspective of depression as an evolutionarily conserved mechanism that terminates separation distress. In particular, Watt & Panksepp consider depression as an evolutionarily adaptive mechanism that terminates the protest phase of distress—a process of resignation that becomes removed from adaptive control. While we agree about the importance of early trauma, especially the impact of early separation and loss, on the development of depression and psychopathology more generally, we argue that extensive research indicates that issues of separation and loss account for only a relatively limited subset of patients in the development of depression. Thus, we stress the need to integrate the extensive investigation of neurobiological dimensions in psychopathology, especially based on animal models and contemporary research on stress, with understanding achieved through systematic investigation with humans of normal and disrupted psychological development. In this context, we also note that although it is important to attempt to bridge the gap between biological and psy