Melancholy has very little poetic and evocative. It is a formless void, a yearning for yesterday that tarnishes the present. Few states plunge us into such a state of immobility, fatigue and psychological exhaustion to the point of delineating a very particular form of depression which in many cases can be quite severe.
Victor Hugo used to say that melancholy is the happiness of being sad. Stendhal was of the view that people who engage in writing, painting or poetry are prone to melancholy. As we see, this emotional state has always been related to the natural impulse that connects the human being to creativity. To the more virtuous and profound side of our being that exploits sadness to its advantage.
Without melancholy, the ink runs out, the romantics used to think. However, what the artists of that era forgot is that the Greeks coined this term to diagnose what we know today as depression. It was Hippocrates who suggested that melancholy was an excess of black bile, which contributed to making the person feel demoralized, frightened, sad, etc.
Later, Sigmund Freud began to delve into this idea to give it a real clinical basis. Melancholy, therefore, is not mere sadness, at least not that stimulating state capable of bringing out our muses. It is like the cinematic metaphor presented to us by Lars Von Trier in his famous film. A planet called depression that, at any moment, can collide with us destroying everything.
When melancholy knocks on our door
We can all experience sadness at any given time. Perceiving that emptiness into which melancholy creeps in, into which memories of yesterday are introduced that make us see the present with an aura of pain. Usually these states are punctual and limited in time. Not only that, psychologists also remind us that although sadness often has a halo effect (it covers everything), it leaves room for other feelings, thoughts and motivations.
However, when melancholy settles in our lives, it doesn’t even leave a corner free. The person stops feeling pleasure, curiosity, interest. Rey, Savard and Post (1980) define the melancholy state as “affective inaccessibility”. The person has a clear inability to experience any kind of feeling, including sadness. In reality there is a complete alteration of emotion.
On the other hand, one aspect that is no less important must be remembered. In the new edition of the DSM-V (
What are the symptoms of melancholy?
The main characteristic of the melancholy person is the inability to feel affection. There is no joy, no interest, much less the typical emotionality associated with sadness which can be translated into tears or an expression of discomfort. Melancholy is stillness, emptiness and a perennial desire for something that the subject is unable to define.
Psychomotor retardation, difficulty thinking, perennial physical and mental exhaustion are also highlighted. Another frequent feature is the inability to explain one’s emotional state, to connect with one’s inner reality and to be able to communicate in words what is happening, what it feels like.
Finally, a factor that usually differentiates melancholic depression from other forms of depression is the inability to think. In other depressive disorders the subject experiences a large number of nervous, obsessive and exhausting thoughts, among which there is no shortage of suicidal ideas. In melancholy this does not happen.
In the words of the psychologist Giovanni Stanghellini, “if major depression is a shipwreck with a spectator, melancholy resembles a shipwreck without a spectator”. In other words, while the depressed person usually tries to make sense of his depression, the melancholy person is confined to himself and does not see or feel anything.
Therapeutic approach to treat melancholy
The treatment that the melancholy person will receive will depend on the diagnosis received. As we know, there is no single type of depression, so when melancholy appears as a descriptive category, several things can happen. The first is that we are in the presence of a person with major depression, bipolar melancholy depression, Cotard syndrome or a delusional or non-delusional melancholy.
It will all depend on the evaluation of the professionals and on the particular case of the individual patient. In most cases, and since many times the root of this clinical condition is biological, the person responds very well to drug treatment. Similarly, cognitive-behavioral therapy presents itself as a strategy with good results.
Finally, in more severe cases such as deep depressions, other psychiatric treatments and closer and constant monitoring will be required. In any case, it is a psychological condition that affects about 2% of the population and that in general responds very well to the therapeutic approaches we have today.