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Tijdschrift voor Psychiatrie 62 (2020) 1, 47 - 53

Essay

Existential hope: a phenomenological key to understanding depression?

T. Baert, Z. Van Duppen, D. De Wachter

background Researchers that try to identify the relationship between hope and mental health often lack a conceptual understanding of ‘hope’. Nonetheless, experiences of despair that are central in depression seem to surpass our everyday understanding of hope and hopelessness. How can this despair be understood and recognized? objective To describe depression through a phenomenological understanding of hope and to explore how this insight relates to our current definition of depression as a mood disorder, as well as to clinical practice.
results Existential hope arises spontaneously in our experience of the world and through the relationship with significant others. A significant part of the experience of depression amounts to the loss of existential hope. Depressive despair features a radically shifted experiential structure, which seems to be absent in demoralisation; this advocates the view of depression as a ‘disorder of attunement’. A therapeutic relationship can recover the loss by cultivating a new sense of possibilities.
conclusion The idea of existential hope provides a new conceptual framework to understand the experience of depression as well as the possibility for its recovery.

keywords depression, despair, existential hope, hopelessness, phenomenology