Meetings of the New York Psychoanalytic Society

June 9, 1959. THE PSYCHIC FUNCTION OF DEPRESSION: A STUDY IN ENERGETICS. Mortimer Ostow, M.D.

Depression is an affective reaction to the loss of an object, or to a diminution in self-esteem. As in all psychic events (fantasies, symptoms, dreams, etc.), affects have a cause, a meaning, and an effect. According to the author, the functions of depression are: 1, to impel the individual to retrieve the lost object; 2, to communicate the affective state to others through phylogenetically determined automatic expressions, postures, movements, and other visible physical changes to gain comfort and support; 3, to decrease the psychic energy content of the ego, thereby diminishing the impact of the loss, preventing desperate and often destructive actions and the development of anxiety. It is suggested that the clinical variants of the syndrome, depression, can be understood and the possibilities predicted on the basis of the combination of gravity of object loss, the intensity of sadness and longing, the degree of ego enervation, and the strength of various reactive tendencies.

To clarify the issue of ego energy loss, the two complementary conditions of excessive enervation or inadequate enervation of the ego are considered. In the former, where the energy loss is more profound and protracted, one observes melancholia; in the latter, there occurs anxiety, desperate acting out, or both. In schizophrenia, the build-up of libido occurring in the id flows into and fills the ego. The author suggests the possibility that if anxiety had set in earlier during the course of the build-up of libido, and had caused an abandonment of the libidinal position—to be followed by depression and withdrawal of ego energy—the schizophrenic position of complete and cataclysmic withdrawal might never have been reached. Thus, the characteristic solution of the schizophrenic lies in his attempt to rebuild the world, and himself as object in it, but with the essential requirement that the reb