depression

When we think of depression, what often comes to mind are the familiar symptoms—low mood, fatigue, loss of interest, changes in sleep or appetite, and feelings of hopelessness. While these symptoms are very real and distressing, they only tell part of the story.

From a psychodynamic perspective, depression isn't just about feeling bad—it's about why we feel bad, and what those feelings might be trying to tell us.

Common Underlying Defensive Structures in Depression

✦ Introjection and Self-Attacking

One of the most common defensive patterns underlying depression is introjection—a process whereby aggression originally directed outward (e.g., toward a frustrating or disappointing other) is turned inward toward the self. The depressive person unconsciously preserves the external attachment by locating the “badness” inside themselves rather than risking the loss of the other by expressing anger outwardly.

• Example: A child whose parent is emotionally unavailable may conclude unconsciously, “I am unlovable” rather than, “My parent is failing me.”

• This preserves a sense of connection to the caregiver at the cost of self-worth.

• Over time, this turns into self-critical internal narratives that become central to depressive experience.

✦ Reaction Formation

This defense involves expressing the opposite of one’s unacceptable impulse. A person who feels deep unconscious resentment may overcompensate by being excessively compliant or self-sacrificing, which may give rise to resentful depression when the false self becomes burdensome.

✦ Repression and Denial of Aggression

Many depressive individuals struggle with repressed anger, particularly toward primary attachment figures. Since anger feels dangerous (i.e., it threatens love or safety), it gets disavowed. But the energy of the aggression does not disappear—it gets turned against the self or manifests as somatic complaints, guilt, or a persistent sense of unworthiness.

✦ Idealisation and Devaluation (of Self)

Someone who struggles with maintaining a consistent sense of self is like to reflect a shift between experiencing an idealised self- or other-representations. When someone with perfectionistic defenses fails to live up to internal ideals, harsh self-devaluation ensues, resulting in shame, worthlessness, and depressive collapse.

✦ Identification with the Lost Object

Melancholic depression may involve unconscious identification with a lost or disappointing loved one. The ego treats itself as the bad object, internalising its traits in a punitive way. Hence, self-attack may unconsciously be a disguised attack on someone else.

Attachment Dynamics and Object Relations

Depression may reflect a failure in early caregiving, particularly around emotional attunement, mirroring, or safety in expressing needs. The internal world of the depressed person often includes:

• An internalized punitive or rejecting object (e.g., a critical parent).

• A weak or absent good object (e.g., an emotionally attuned parent to facilitate co-regulation), making self-soothing difficult.

• A fragile sense of self-worth that is dependent on external validation or approval.

Therapeutic Implications

• Depression from this lens is not merely a mood disorder, but an expression of relational trauma, internal conflict, and defensive compromises that once served a survival function.

• Therapy aims to make defenses conscious, allow space for previously warded-off affects (especially anger), and help the client develop more integrated internal object relations.

• Central to this is the therapeutic relationship, where the client’s unconscious expectations are both reenacted and revised through the therapist’s consistent, attuned presence.