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ARTICLE HISTORY Received 29 August 2023; Accepted 19 September 2023
The present essay (Watt, 2023) provides a comprehensive, updated review of the research evidence within neurobiological determinants of depression and psychosocial correlates of depression, in support of the theory that depression might reflect an evolutionarily conserved shutdown mechanism, aimed at terminating protracted separation distress (Watt & Panksepp, 2009). Starting from Bowlby’s (1980) description of the separation distress reaction as implying a first phase of protracted and unsuccessful “separation protest,” followed by a second phase of depressive shutdown, the “despair phase,” Watt reviews the clinical syndrome of depression in humans, and convincingly describes the distress reaction, its concomitant anxiety and sadness, as distinct from the depressive emptiness and un-motivational withdrawal typical of the symptomatology of major depression. His and Panksepp’s theory implies that the separation-distress phase reflects the desperate search for the lost attachment object, followed, when unsuccessful, by a “shutdown” process geared to protect the organism from exhaustion by the complete loss of all connections with the nourishing and protective function of the psychological and social environment. This normal protective mechanism is psychologically hypertrophied under conditions of excessive traumatic situations of abandonment, rejection, or abuse, and becomes a pathological neurobiological and psychological structure. Clinically, the differences between chronic dysthymic reactions or characterological based depressive symptoms, and the typical syndrome of major depression reflect these different degrees of severity of depressive illness. They correspond to the differences of the pathological functions involved.
In reviewing the research literature on the neurobiological systems involved in depression, including the neuroendocrine HPA axis, the cholinergic and the monoamine systems, multi