Depression is one of the most prevalent medical disorders. Attempts to sub-classify the disorder into reactive and non-reactive or endogenous proved to be unreliable. It can occur at any age and can be expressed with primary symptoms that do not involve obvious mood change. This is the reason why it is one of most commonly missed diagnoses. The psychodynamic understanding of depressive mood states is essentially influenced by the works of Freud and Abraham, and by the Kleinian object relations theory. Subsequently Beck and Seligman's cognitive behavioural approach was developed. Some clinical examples will, in this paper, illustrate the manifestations of depressive (unipolar) expressions of depressive disturbances of different intensity, including risk of suicide, from the viewpoints of age, developmental characteristics, personality structure, and cultural factors. Neurophysiological research is underscored as the next most important element in understanding depressive mood and its medical and psychotherapeutic treatments. The author suggests that empathic attunement and the sharp clinician's eye, assessment of prevailing defence mechanisms, and understanding, transference, counter-transference and the therapeutic alliance will yield the best possible results in the treatment of depressive patients.
Keywords: depression, unipolar, psychodynamic psychotherapy