The concept of Depression revised according to Freud and Lacan: a comparison with the modern psychiatric paradigm.

Abstract

This article compares two perspectives on depression: the modern psychiatric paradigm, which conceives of depression as an episodic nosographic entity with neurobiological underpinnings, sometimes accompanied by psychotic symptoms; and the Lacanian psychoanalytic framework, which understands depression as an affect secondary to a specific psychic structure and to the subject's relation to the Real. In Freud's work, depression may be endogenous (melancholia) or related to grief, whereas in Lacan's theory it may arise within any psychic structure (neurotic, perverse, or psychotic) and reflects a subjective renunciation of knowledge, carrying a fundamental ethical dimension. The paper discusses the clinical implications of Lacanian perspective: it is crucial to assess the possible presence of an underlying psychotic structure beyond the depressive affect, in order to prevent potential harm for the patients.