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This paper differentiates between “classical” psychoanalysis, psychoanalytic work, and the psychotherapeutic aspect each uses in work with depressed patients. A few aspects of two clinical cases are presented as illustrations. This paper discusses the tool for evaluating depression that is unique to psychoanalysis. It then refers briefly to the evolution of Freud’s thought in a few essential articles that constitute the core of psychoanalytic work in depressions. Then, the paper reviews the new theoretical sources by post-Freudian authors, which are the main references used in this paper. It defines the transformation of psychic functioning that occurs through the patient-analyst relationship, which is always unique. Both experience this relation through representations which must necessarily be linked affectively for change to occur. This needs considerable time and the relation can never be transposed from one patient to another, from one analyst to another, and from one patient-analyst encounter to another. Lastly, this paper underlines some of the current cultural obstacles to this form of work with depression.