Depressive psychoses and manias are considered endogenous disorders that can be relatively successfully treated with psychotropic medications. However, it cannot be overlooked that severe experiences of separation, losses, humiliations, or disappointments often trigger such manifestations of illness. Additionally, pre-existing inner psychological conflicts, specific defense mechanisms, and character structures, as well as psychogenic factors, shape the symptomatology. Starvos Mentzos elucidates the circular causality of these factors in his integrative psychosomatic model.