Psychology of Depression- Psychodynamic Theories

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What is the Psychodynamic Theory’s Approach to Depression?

Psychodynamic theory explains the origins and treatment of depression by positing that unresolved conflicts and unconscious processes from early childhood experiences contribute to depressive symptoms. Psychodynamic therapy aims to explore these underlying conflicts, defenses, and patterns of relating to others, fostering insight and emotional processing to alleviate depressive symptoms.[1]

In psychodynamic psychotherapy for depression, therapists provide a supportive and empathetic environment where people can explore their emotions, thoughts, and relationships. Through the therapeutic process, patients gain insight into the unconscious factors contributing to their depression and develop healthier ways of coping and relating to themselves and others.[1] >>

Psychological theories provide evidence-based explanations for why people think, behave, and feel the way they do. Personality factors, history, early experiences; and interpersonal relationships are seen as important factors in causing depression. Unlike biology, psychology is not truly a unified field. There are still many disagreements within the field as to what subject matter is important to focus on, and what methods are best to use for studying the subject matter. Consequently, different schools of thought within psychology have developed their own theories as to why someone becomes depressed. Learn more about your depression with a comprehensive online depression test.

Psychodynamic Theories


Psychodynamic theory was the dominant school of thought within psychiatry and much of clinical psychology during the first part of the 20th century, at least with regard to ideas about how psychotherapy should be conducted. Early psychodynamic approaches focused on the interrelationship of the mind (or psyche) and mental, emotional, or motivational forces within the mind that interact to shape a personality. The famous Dr. Sigmund Freud, who is credited with inventing psychodynamic theory and psychoanalysis, influentially suggested that the unconscious mind is divided into multiple parts, including the irrational and impulsive Id (a representation of primal animal desires), the judgmental Super-ego (a representation of the rules and norms of society inside the mind), and the rational Ego (which serves as an attempt to bridge the other two parts).

Understanding Psychodynamic Theory

Psychodynamic theory is a psychological perspective that explores how unconscious thoughts, emotions, and conflicts influence behavior and mental processes. It emphasizes the role of early childhood experiences, internal drives, and interpersonal relationships in shaping personality and psychological functioning.[2]

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The core principles of psychodynamic theory include:

  • Unconscious processes: Psychodynamic theory suggests that many mental processes occur outside of conscious awareness and can influence behavior and emotions.
  • Dynamic interplay: It posits that human behavior is driven by inner conflicts, desires, and defenses, which interact with external experiences and relationships.
  • Early childhood experiences: Psychodynamic theory highlights the significance of early relationships and experiences in shaping personality development and psychological functioning.
  • Defense mechanisms: It proposes that individuals use defense mechanisms to protect themselves from anxiety and distress by unconsciously distorting reality or denying threatening thoughts and emotions.

Unconscious processes play a significant role in shaping emotions and behavior, particularly in depression. According to psychodynamic theory, unresolved conflicts, repressed emotions, and negative early experiences can manifest in depressive symptoms. The unconscious mind may harbor painful emotions, such as guilt, shame, or anger, which contribute to feelings of sadness, hopelessness, and low self-esteem. Exploring and addressing these unconscious processes in therapy can help individuals gain insight into the root causes of their depression and develop healthier coping mechanisms and interpersonal relationships.[2]

According to Freud, the conscious and unconscious parts of the mind can come into conflict with one another, producing a phenomenon called repression (a state where you are unaware of having certain troubling motives, wishes, or desires but they influence you negatively just the same). In general, psychodynamic theories suggest that a person must successfully resolve early developmental conflicts (e.g., gaining trust, affection, successful interpersonal relationships, mastering body functions, etc.). to overcome repression and achieve mental health. Mental illness, on the other hand, is a failure to resolve these conflicts.

Key Psychodynamic Mechanisms in Depression

Defense Mechanisms and Depression

Defense mechanisms are psychological strategies that individuals unconsciously use to protect themselves from anxiety, distress, and internal conflicts. In the context of depression, defense mechanisms, such as repression, denial, and displacement, may play a significant role in coping with painful emotions and unresolved conflicts. 

For example, individuals with depression may use repression to push distressing thoughts and feelings into their unconscious mind, temporarily alleviating emotional discomfort but contributing to the persistence of depressive symptoms.[3] 

While defense mechanisms serve as adaptive strategies for managing emotional distress, overreliance on maladaptive defense mechanisms may exacerbate depressive symptoms and impede psychological growth and recovery.

The Id, Ego, and Superego

The id, ego, and superego are three components of Freud's structural model of personality, representing different aspects of the human psyche.

In depression, the interplay of these psychological constructs can manifest in various ways. The id, driven by primal instincts and desires, may generate impulses and cravings that contribute to depressive symptoms, such as excessive guilt or pleasure-seeking behaviors.

The ego, responsible for mediating between the demands of the id, the constraints of reality, and the moral standards of the superego, may struggle to balance conflicting demands, leading to feelings of helplessness and inadequacy.

The superego, internalizing societal norms and moral standards, may exacerbate feelings of worthlessness and self-criticism in individuals with depression. 

Understanding the dynamic interplay of these psychological forces can provide insight into the underlying mechanisms of depression and inform therapeutic interventions aimed at promoting psychological well-being and resilience.

Depression Through the Lens of Psychodynamic Theory

Internal Conflicts

Internal conflicts refer to psychological struggles between opposing desires, needs, or beliefs within an individual's mind.[4]

In depressive disorders, internal conflicts often involve unresolved emotional experiences, conflicting self-perceptions, and negative beliefs about oneself and the world. 

For example, individuals may experience conflicts between the desire for autonomy and the fear of abandonment, leading to feelings of loneliness and worthlessness.[4]  

Internal conflicts contribute to depressive symptoms by generating feelings of guilt, shame, and self-doubt, which can exacerbate negative emotions and impair adaptive coping strategies.

Childhood Experiences and Development

Childhood experiences and developmental stages play a significant role in the development and expression of depression.[5]

Adverse childhood experiences, such as trauma, neglect, or dysfunctional family dynamics, can increase the risk of developing depression later in life by disrupting healthy emotional development and interpersonal relationships.[5]

Moreover, developmental stages, such as adolescence, represent critical periods of psychological growth and identity formation, during which individuals may experience heightened vulnerability to depressive symptoms due to hormonal changes, peer relationships, and academic stressors.[5]

Early intervention and supportive interventions that address childhood experiences and developmental needs are crucial for preventing and mitigating the impact of depression across the lifespan.

Other Psychodynamic Explanations for Depressive Symptoms

Multiple explanations fall under the psychodynamic "umbrella" that explain why a person develops depressive symptoms. Psychoanalysts historically believed that depression was caused by anger converted into self-hatred ("anger turned inward"). A typical scenario regarding how this transformation was thought to play out may be helpful in further explaining this theory. Neurotic parents who are inconsistent (both overindulgent and demanding), lacking in warmth, inconsiderate, angry, or driven by their own selfish needs create an unpredictable, hostile world for a child. As a result, the child feels alone, confused, helpless, and ultimately, angry. However, the child also knows that the powerful parents are his or her only means of survival. So, out of fear, love, and guilt, the child represses anger toward the parents and turns it inwards so that it becomes anger directed towards him or herself. A "despised" self-concept starts to form, and the child finds it comfortable to think thoughts along the lines of "I am an unlovable and bad person." At the same time, the child also strives to present a perfect, idealized (and therefore acceptable) facade to the parents as a means of compensating for perceived weaknesses that make him or her "unacceptable". Caught between the belief that he or she is unacceptable, and the imperative to act perfectly to obtain parental love, the child becomes "neurotic" or prone to experiencing exaggerated anxiety and/or depression feelings. The child also feels a perpetual sense that he or she is not good enough, no matter how hard he or she tries.

This neurotic need to please (and perpetual failure to do so) can easily spread beyond the situation in which it first appears, such that the child might start to feel a neurotic need to be loved by everyone, including all peers, all family members, co-workers, etc. The goal of traditional psychodynamic psychotherapy might be to help the child (now an adult in therapy) to gain insight into the mistaken foundations of his or her belief in his or her badness and inadequacy so that the need to punish himself/herself and to be perfect decreases.

Psychodynamic theory has evolved a fair amount over its long history, and many variations of the original theory are available today. One popular branch of modern psychodynamic theory, known as object relations theory, is concerned with how people understand and mentally represent their relationships with others. The "objects" in object relations theory are representations of people (how other people are experienced, represented, and remembered by the person doing the objectification). According to object relations theory, people's moods and emotions (and many other aspects of their personalities) can only be properly understood against the backdrop of the relationships those people have experienced. It is a foundational assumption of object relations theory that early relationships tend to set the tone for later relationships.

According to object relations theory, depression is caused by problems people have in developing representations of healthy relationships. Depression is a consequence of an ongoing struggle that depressed people endure in order to try and maintain emotional contact with desired objects. There are two basic ways that this process can play out: the anaclitic pattern, and the introjective pattern. Even though these terms are not currently used in the DSM, some therapists may still use them to label different types of depression.

Anaclitic depression involves a person who feels dependent upon relationships with others and who essentially grieves over the threatened or actual loss of those relationships. Anaclitic depression is caused by the disruption of a caregiving relationship with a primary object and is characterized by feelings of helplessness and weakness. A person with anaclitic depression experiences intense fears of abandonment and desperately struggles to maintain direct physical contact with the need-gratifying object.

Introjective depression occurs when a person feels that they have failed to meet their own standards or the standards of important others and that therefore they are failures. Introjective depression arises from a harsh, unrelenting, highly critical superego that creates feelings of worthlessness, guilt, and a sense of failure. A person with introjective depression experiences intense fears of losing approval, recognition, and love from a desired object.

Historically, psychodynamic theories were extensively criticized for their lack of empiricism (e.g., their disinterest in subjecting their theories to scientific testing). However, this resistance to putting psychodynamic concepts on a scientific footing has started to change recently. Another modern derivative of psychodynamic theory, Coyne's interpersonal theory of depression has been studied extensively and forms the basis of a very effective treatment option known as Interpersonal Therapy or IPT. 

According to interpersonal theory a depressed person's negative interpersonal behaviors cause other people to reject them. In an escalating cycle, depressed people, who desperately want reassurance from others, start to make an increasing number of requests for reassurance, and the other people (to whom those requests are made) start to negatively evaluate, avoid, and reject the depressed people (or become depressed themselves).. Depressed people's symptoms then start to worsen as a result of other people's rejection and avoidance of them. IPT has been designed to help depressed people break out of this negative spiral. We'll have more to say about IPT in the treatment sections of this document.

Additional Resources

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  1. Leichsenring, F., & Luyten, P. (2019). Psychodynamic psychotherapy for depression: A systematic review of the empirical evidence. Psychotherapy and Psychosomatics, 88(5), 274-282.
  2. Gabbard, G. O. (2014). Psychodynamic psychiatry in clinical practice (5th ed.). American Psychiatric Publishing.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. Blatt, S. J. (2008). Polarities of experience: Relatedness and self-definition in personality development, psychopathology, and the therapeutic process. American Psychological Association.
  5. Rudolph, K. D. (2009). The interpersonal context of adolescent depression. In Nolen-Hoeksema, S. & Hilt, L. M. (Eds.), Handbook of Depression in Adolescents. Routledge.

Additional Resources

As advocates of mental health and wellness, we take great pride in educating our readers on the various online therapy providers available. MentalHelp has partnered with several thought leaders in the mental health and wellness space, so we can help you make informed decisions on your wellness journey. MentalHelp may receive marketing compensation from these companies should you choose to use their services.

MentalHelp may receive marketing compensation from the above-listed companies should you choose to use their services.