Depression als Handlungsstörung

We develop a philosophical interpretation of altered experience in conditions of severe unipolar depression. Drawing on phenomenological analysis, on published depression memoires and on a recent questionnaire study with patients in Britain, we hold that depression is a profound impairment of agency. Its experiential core consists in a paralyzing loss of drive and energy, a suspension of initiative, an inability to adopt a stance and act in accordance with it. Moreover, we show that experiences such as a loss of self and world, altered interpersonal relatedness, modified corporeal experience as well as marked changes in the experience of time go along with the loss of agency. In order to assess their broader philosophical significance, we relate our analyses to an almost forgotten philosophical discussion: that of the term Selbstgefühl in 19th century German philosophy and early psychiatry. We also briefly discuss recent debates about the alleged historical and cultural specificity of depression