From Melancholia to Prozac: A history of depression

From Melancholia to Prozac: A history of depression - Clark Lawlor The preface to this books starts with discussion of the depression of on of the most famously melancholy writers of his time, Samuel Johnson. This is an interesting look into the mind of someone who suffers from quite deep manic depression helping to contextualise the later narrative and understanding of the condition.

“They are drawn to deserts and solitary places where they confine themselves and consume themselves with discontent and hatred they beare to mankind” -Samuel Johnson's melancholy

Lawler then goes back to the Classical period and discusses the views of the Ancients – for sure melancholia has existed as long as history. The 'heroic' and 'aggressive madness' are discussed. The need to combat the imbalance in the 'black bile' though activity and good diet, seems to be the answer here.

Through the medieval period, more idleness, and of course, demonic activity are blamed as the causes – the pressure of the religious beliefs, though in truth are also a contributing factor.

With renaissance and enlightenment and new theories arise about bad blood and bad nerves appear. The causes and the cures seem to have not changed that much, exercise, good diet, and maybe a bit of blood letting.

The 'genius' of the melancholic is admired during these periods – but of course only for the better classes – in Victorian times, the severely depressed working class, would just be locked up in asylums, no genius there of course.

Towards the end of the 19th century, towards the middle of the 20th , Kraepelin proposed theories of the biological kind in a fairly straightforward scale from melancholia simplex to melancholia gravis were suggested, competing with the Freudian view that is was all about the mothers breasts.

Freudian views won at that time - looking for self loathing in some unknown past loss through psychoanalysis, with, in worst cases, use of electrical therapies (ECT) or lobotomies (quite popular at one point).

Later these were to be replaced with more 'scientific' Kraepelinian-esque ideas in the 80s with a set of guides (DSM III) describing depression by it's symptoms – guides that seemed to be a little too loose, encompassing normal 'sadness' with that which is abnormal (without reason).

The resultant boom of 'big pharma' and the commercialisation of 'magic bullet' cures ensued in the 90s – it is after all cheaper to get your GP to write a prescription for a wonder drug than to work out the problems you have with a psychoanalyst.

The final chapter discusses where we are now, Cognitive Behavioural Therapy – Talking to some one about it and them helping you correct where your thinking is wrong (thinking Positive), Mindfullness-Based Cogitative Therapy (meditation – living for the moment), the falling out of favour of solely drug based solutions - described as 'little better than placebo' only with side-effects (this hasn't filtered down to my GP yet), societal pressures, learned helplessness, more biology, and renaming back to melancholia – in short, we are not really any further to understanding what causes depression or indeed what depression is, than the Ancient Greeks were.

A fascinating book, it certainly helps me with my own English Malady to know where the ideas come from for therapy at to know it is all, still, a bit hit and miss.