From Melancholia to Prozac: A History of Depression, Clark Lawlor, Oxford University Press, Pp 265 (HB), $ 20.49
GUILT is often linked to depression, as Dr Samuel Johnson himself recognised. Despite being bestowed the glamour of literary fame, he, the ‘Great Cham’ of English literature and towering giant of the Enlightenment, suffered from crushing despair and ‘misery’ characteristic of the condition. Compared to physical pain, the mental turmoil that he endured was far worse. His physical ailments at the end of his life, gout and asthma among them, prevented him from disentangling his physical symptoms from the psychological malady. Johnson’s life was long and his depression came and went with varying degrees of severity and with different forces driving it.
The author of this book is of the view that ‘duty’ breeds guilt and guilt, melancholy – all the more insidious and difficult to ignore than immoral images conjured by the imagination. He says that it became clear later that Johnson’s depression was fuelled by religious guilt, initially in the form of regret that he had talked against religion in his earlier years and then because he applied impossible standards of behaviour on himself when older. In an essay titled ‘Idler’, Johnson rejected both pagan philosophies of the Epicureans and the Stoics and instead, pointed to Christianity as the only permanent solution to loss and sorrow. It must be remembered, however, that he had a terror of death – increasing with age –and found it difficult to believe that any rational person would not be afraid of their final judgement.
In classical writings, depression was not called depression but the term ‘melancholia’ commonly indicated a long, running mental illness with core symptoms of causeless sadness and fear that derived from an excess of black bile – the melancholy humour – one of the four humours supposed to constitute the body. Ancient Greeks considered causeless fear and sorrow as the foundation for melancholy, sometimes accompanied by hallucinations, though in modern medicine this is not taken to be true.
The author makes an unusual observation to say, “If literature was slow to realise the potential for intellectual and creative depth in the character of the melancholic, it made up for it later, not least due to the powerful intervention of Aristotle or – more likely – one of his followers who linked melancholy with genius.”
The author is of the view that anti-depressants carry a placebo effect and in essence do not work, but social psychiatry is said to work as it is considered an acknowledgement of the social pressures on people rather than individual chemical pathologies to fit in the modern agenda. His conclusion is that depression requires more extended talking cures, though with drugs.
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