Theoretical perspectives on depression

The understanding of depression has gone through different theoretical paradigms over time. One of the first approaches was psychoanalytic, which conceptualized depression from intrapsychic conflict, loss of a loved one, and unconscious guilt. Figures such as Freud, Melanie Klein, and Karen Horney explored how early experiences of loss or detachment could lead to a predisposition to depression.

Subsequently, the behavioral model emerged, influenced by research such as that of Konrad Lorenz, who observed how certain animals and humans experienced learned helplessness when faced with the impossibility of changing their environment.

This approach suggested that depressive symptoms could arise from a lack of positive reinforcement in the environment and a perception of personal ineffectiveness. At the end of the 20th century, the cognitive model gained traction, particularly with contributions from the University of Pennsylvania and Aaron Beck.

From this perspective, individuals with depression tend to have negative thought patterns, constant rumination, and a distorted view of themselves, the world, and the future. This theoretical basis gave rise to one of the most effective therapies currently available: cognitive behavioral therapy (CBT).

Advances in genetics, biology, and systemic theories

Since the 1990s, the study of depression has incorporated a more biological and genetic approach. Today we know that there is a significant hereditary component: children of parents with depression are more likely to develop the disorder.

At the neurobiological level, the role of neurotransmitters such as serotonin and dopamine has also been identified, as well as alterations in the hypothalamic-pituitary-adrenal axis. On the other hand, systemic theories have been consolidated, which place depression in the family and social context.

This approach maintains that the environment, interpersonal relationships, and family dynamics can favor or protect against the onset of depressive disorder.

In this sense, the emotional environment, communication within the family, the level of violence or social support, and socioeconomic conditions become key factors in the mental health of children and adolescents.

Integration of models for a comprehensive view

Currently, mental health professionals recognize that no single model fully explains depression. Progress has been made toward a theoretical integration that recognizes that biological, psychological, and social factors interact with each other.

This biopsychosocial view allows for a more realistic and compassionate approach to the complexity of depressive disorder in children and adolescents.

In clinical practice, this translates into combined interventions that may include psychotherapy (supported by the theories mentioned above), systemic family intervention, and, when necessary, pharmacological treatment. This combination is tailored to the individual needs of the child, their family, and their context, promoting comprehensive and effective care.