Authors: Andrew Solomon
By the time of the Inquisition, in the thirteenth century, some depressives were fined or imprisoned for their sin. In this period, Thomas Aquinas, whose theory of body and soul placed the soul hierarchically above the body, could conclude that the soul was not subject to bodily illness. Since the soul was, however, below the divine, it was subject to intervention by God or Satan. Within this context, an illness had to be of the body
or
the soul, and melancholia was assigned to the soul. The medieval Church defined nine deadly sins (they were subsequently compacted to seven). Among these was
acedia
(translated as “sloth” in the thirteenth century). The word seems to have been used almost as broadly as the word
depression
is in modern times, and it described symptoms familiar to anyone who has seen or felt depression—symptoms that had not previously been counted as vice. Chaucer’s Parson describes it as a thing that “deprives the sinner of the quest for all goodness.
Acedia
is man’s enemy because it is hostile to industry of any kind, and it is also a great enemy to the livelihood of the body, for it makes no provision for temporal necessities and even wastes, spoils, ruins, all earthly goods by
negligence. It makes living men [be] like those who already suffer the pains of Hell. It makes a man peevish and encumbered.” The passage goes on and on, becoming more disagreeable and judgmental with each phrase.
Acedia
is a compound sin whose elements the Parson enumerates. “It is so tender and delicate, as Solomon says, that it will suffer no hardship or penance. The shirking makes man fear even to begin to perform any good work. Despair, loss of hope in the mercy of God, springs from unreasonable remorse and sometimes from excessive fear, which makes the sinner imagine that he has sinned so much that it will do him no good to repent. If it persists to a man’s last moment, it is numbered among the sins against the Holy Ghost. Then comes the sluggish sleepiness that makes a man dull and indolent of body and soul. Last comes the sin of World Weariness, called sadness, which produces the death of soul and body alike. Because of it, a man becomes annoyed with his own life. So the life of man is often ended before, by way of nature, his time has really come.”
Monks were particularly likely to develop
acedia,
which among them manifested itself in exhaustion, listlessness, sadness or dejection, restlessness, aversion to the cell and the ascetic life, and yearning for family and former life.
Acedia
was distinguished from the sadness
(tristia)
that leads a man back to God and to repentance. Medieval sources are not clear about the role volition plays in this. Was it a sin to let oneself develop
acedia
? Or was
acedia
a punishment meted out to those who had committed some other sin? Its most passionate opponents equate it with original sin; the eloquent nun Hildegard von Bingen wrote, “At the moment when Adam disobeyed the divine law, at that exact instant, melancholy coagulated in his blood.”
Order was somewhat precarious in the Middle Ages, and disorder of the mind was therefore particularly frightening to the medieval sensibility. Once reason was impaired, the whole of the human mechanism would fall apart; and then the social order would disintegrate. Folly was a sin; mental disease was a far more serious one. Reason is necessary to allow a man to choose virtue. Without it, he has not enough self-control for such a choice. The psyche, as understood by classical thinkers, could not be detached from the body; the soul, as understood by medieval Christians, was barely coincident with the body.
It is from this tradition that the stigma still attached to depression today has grown. The soul, being a divine gift, should be perfect; we should strive to sustain its perfection; and its imperfections are the primary source of shame in modern society. Dishonesty, cruelty, greed, egotism, and lapses of judgment are all shortcomings of the soul, and so we automatically attempt to suppress them. So
long as depression is grouped with these “afflictions of the soul,” it seems to us to be abhorrent. There are many stories of how the association cast depression in the worst possible light. The fifteenth-century painter Hugo van der Goes, for example, entered a monastery in the 1480s, but continued, by virtue of great talent, to have regular interaction with the outer world. Returning one night from a journey, Hugo is recorded as having been “struck by a strange disorder of his imagination. He cried out incessantly that he was doomed and condemned to eternal damnation. He would even have injured himself, phantasmagorias clouding his diseased mind.” According to his fellow brothers, who attempted treatment with music therapy, “his condition did not improve; he continued to talk unreasonably, and to consider himself a child of perdition.” The monks considered whether Hugo had artistic frenzy or was possessed by an evil spirit, and decided that he had both complaints, perhaps exacerbated by consumption of red wine. Hugo was terrified of the work he had agreed to do and could not imagine that he could finish his commissions. With time, and with great rituals of religious repentance, he eventually recovered his equanimity for some time; but he had a subsequent relapse and died in a bad state.
If the Middle Ages moralized depression, the Renaissance glamorized it. Reaching back to classical philosophers (more than to classical doctors), Renaissance thinkers posited that depression indicated profundity. Humanist philosophy presented an increasingly strong challenge to Christian doctrine (though, in other cases, it strengthened Christian beliefs and tenets). The irrational pain that in the Middle Ages had been described as a sin and curse was now an illness (increasingly called melancholia) and the defining quality of a personality (increasingly called melancholy). Among all Renaissance writers who discussed depression—and they were legion—Marsilio Ficino was its greatest philosopher in the Renaissance. He believed that melancholy, present in every man, is the manifestation of our yearning for the great and the eternal. He wrote of those for whom melancholia is a default state: “It is astonishing that whenever we are at leisure, we fall into grief like exiles, though we do not know, or certainly do not think of, the cause of our grief . . . in the midst of the plays of pleasure we sigh at times, and when the plays are over, we depart even more sorrowful.” The melancholy here described is what is revealed beneath the busyness of daily life, a constant quality of the soul. Ficino reverts to the Aristotelian idea of divinely mad sadness and goes on to say that the philosopher, the deep thinker, or the artist will of necessity be more in touch with his melancholy than the common man, that the very profundity of his experience of melancholy will reflect his success in raising his mind above the distractions
of ordinary life. For Ficino, the tortured mind is the more worthy, as it is catapulted up toward the melancholy inadequacy of its knowledge of God. This becomes a holy credo as he explains the nature of divine melancholy: “As long as we are representatives of God on earth, we are continually troubled by nostalgia for the celestial fatherland.” The state of knowledge is dissatisfaction, and the consequence of dissatisfaction is melancholy. Melancholy divorces soul from world and so propels the soul toward purity. The mind “increases in perfection the more it goes away from the body, and so the mind will be most perfect at the time when it flies away entirely.” Ficino’s description of the divinity of melancholy acknowledges that the state is very near death.
Ficino subsequently proposed that artistic creation relied on a muse who descended during temporary insanity: melancholia was a prerequisite to inspiration. Nonetheless, Ficino recognized that depression was a terrible complaint and recommended treatments for it, including exercises, alterations of diet, and music. Ficino himself was a depressive, who, when feeling low, could not conjure all these attractive arguments in favor of depression; when his friends came to see him, they often had to make his own arguments to him. Ficino’s philosophy, like much post-Renaissance thought on the subject of melancholy, is autobiography—and so he speaks of steering the course between nonmelancholic phlegm on the one hand and desperate melancholic illness on the other, titling the sixth chapter of his first book “How Black Bile Makes People Intelligent.”
The Renaissance attempted to reconcile its understandings of classical thought with certain accepted “knowledge” that came from the Middle Ages. In bringing together the classical idea of the temperaments with the medieval fascination with horoscopes, Ficino described Saturn as the weighty, isolated, ambivalent planet that reigned over melancholy. Saturn is “himself the author of mysterious contemplation,” according to the alchemist and cabalist Agrippa, “not given to public dealing, the highest of the planets, who first recalls the soul from outer offices to its core, then has it ascend from lower matters, leading it to the highest, and granting it the sciences.” These views are borne out in the writings of Giorgio Vasari on the great artists of this time.
The English Renaissance held more closely to medieval views about melancholy than did the Italian, but the southern influence began to creep up in the late fifteenth century. So, for example, the English continued to believe that melancholy came from “the intercourse or meddling of euill angels,” but accepted that those afflicted with such intervention were not responsible for it. For the English Renaissance thinker, the sense of sin experienced by the melancholic is a dangerous
misfortune rather than a sign of the absence of God’s love and is not to be confused with the true sense of sin experienced by the true sinner. Of course it was not always easy to distinguish between the delusional and the real. One student of “melancholick Constitution, distracted with grief,” claimed that he had actually felt an “evil Spirit enter by his fundament with wind, and so did creep up his body until it possessed the head.” Though he was ultimately cured of the devil’s presence, others were not so lucky. George Gifford wondered, “What manner of persons are fittest for the devill to make his instruments in witchcraft and sorceries” and found for his answer that the devil seeks “ungodly persons which are blind, full of infidelity, and overwhelmed and drowned in dark ignorance. If there be above all these a melancholike constitution of body, his impressions print the deeper in the minde.”
The northern idea of a relationship between witches and melancholy gives the southern idea of a relationship between genius and melancholy a good run for its money. The Dutch court doctor Jan Wier (whose
De praestigiis daemonum
was listed by Freud as one of the ten greatest books of all time) was a great defender of witches as the victims of their own melancholia; his assertion that these unfortunate ladies were sick in the head saved a number of them from execution. He argued his position by showing that the victims of witches were usually delusional, focusing on the large number of men in northern Europe who accused witches of stealing their penises. Wier insisted other men could usually spot the stolen organs physically present right where they had always resided and proposed that men were seldom abandoned by their “needles.” If the men who were the “victims” of witches suffered from delusions, then surely the ones who supposed that they were witches were only the more delusional. This model was taken up by the Englishman Reginald Scot, who in his 1584 book on witchcraft proposed that witches were all merely depressed and foolish old women, prodded by evil as though it were a mosquito, who ineptly took on themselves blame for the problems they saw around them. In their “drousie minds the divell hath goten a fine seat; so as, what mischeefe, mischance, calamitie, or slaughter is brought to passe, they are easilie persuaded the same is doone by themselves.” This view, that what had been held to be religious truth was all merely delusion and connected to melancholic mental illness, had strong opponents who continued to champion the medieval position; though Scot’s book was broadly read in Elizabethan England, King James commanded that all copies of it be burned—as though the books themselves were witches.
Illness gradually overtook possession. In a French case of this period, physicians perceived in a witch “some rumbling under her short ribs on the left side, proper to those that are subject to the Spleene,” and this led
to the 1583 synod command that priests “inquire diligently into the life of the possessed” before an exorcism, “for oftentimes those that are Melancholike, Lunatike, and Bewitched by Magicall Artes . . . have more neede of Phisitians Remedie, than of the Exorcists Ministrie.” Renaissance rationalism triumphed over medieval superstition.
The French were the first to treat effectively symptoms that could reflect either primary disease or affliction of imagination. Montaigne, something of a melancholic himself, was a great believer in philosophy as physic, and he created an antimelancholic theater of illusion. He tells, for example, of a woman who was in terror because she believed she had swallowed a needle; so he made her throw up and put a needle in her vomit, and she was cured.
Andreas Du Laurens’s
Discourse of Melancholike Diseases
was published in English in 1599. Du Laurens stated that melancholy was “a cold and drie distemperature of the brain” that could proceed “not of the disposition of the bodie,” but of patients’ “manner of living, and of such studies as they bee most addicted unto.” Du Laurens divided up the mind into three parts: reason, imagination, and memory. Concluding that melancholia was an illness of imagination, he left to the melancholic an intact reason, which meant that in the eyes of the Church the melancholic was not deprived of his humanity (his “immortal rational soul”) and was therefore not cursed by God. He took on board the idea that melancholy can come in degrees, separating “melancholike constitutions which keep within the bounds and limits of health” from the ones that did not keep within those bounds. Like most other writers on the subject, his book is full of anecdotal descriptions of individuals, including “one Sienois a Gentleman, who had resolved with himselfe not to pisse, but to dye rather, and that because he imagined that when he first pissed, all his towne would be drowned.” The man was apparently paralyzed with a depressive anxiety and a sense of his own destructiveness and was causing trauma to his bladder; eventually, his physicians built a fire next door, persuaded the man that the town was burning down and that only by his relieving himself could he save it, and so brought him through this particular anxiety.