Melancholy

Melancholia was described as a distinct disease with particular mental and physical symptoms in the 5th and 4th centuries BC. Hippocrates, in his Aphorisms, characterized all "fears and despondencies, if they last a long time" as being symptomatic of melancholia.[4] Other symptoms mentioned by Hippocrates include: poor appetite, abulia, sleeplessness, irritability, agitation.[5] The Hippocratic clinical description of melancholia shows significant overlaps with contemporary nosography of depressive syndromes (6 symptoms out of the 9 included in DSM [24] diagnostic criteria for a Major Depressive).[25] In ancient Rome, Galen added "fixed delusions" to the set of symptoms listed by Hippocrates. Galen also believed that melancholia caused cancer.[6] Aretaeus of Cappadocia, in turn, believed that melancholia involved both a state of anguish, and a delusion.[7] In the 10th century Persian physician Al-Akhawayni Bokhari described melancholia as a chronic illness caused by the impact of black bile on the brain.[26] He described melancholia's initial clinical manifestations as "suffering from an unexplained fear, inability to answer questions or providing false answers, self-laughing and self-crying and speaking meaninglessly, yet with no fever."[27]
In Middle-Ages Europe, the humoral, somatic paradigm for understanding sustained sadness lost primacy in front of the prevailing religious perspective.[8][9] Sadness came to be a vice (λύπη in the Greek vice list by Evagrius Ponticus,[28] tristitia vel acidia in the 7 vice list by Pope Gregory I).[29] When a patient could not be cured of the disease it was thought that the melancholia was a result of demonic possession.[10][30]
In his study of French and Burgundian courtly culture, Johan Huizinga[31] noted that "at the close of the Middle Ages, a sombre melancholy weighs on people's souls." In chronicles, poems, sermons, even in legal documents, an immense sadness, a note of despair and a fashionable sense of suffering and deliquescence at the approaching end of times, suffuses court poets and chroniclers alike: Huizinga quotes instances in the ballads of Eustache Deschamps, "monotonous and gloomy variations of the same dismal theme", and in Georges Chastellain's prologue to his Burgundian chronicle,[32] and in the late 15th-century poetry of Jean Meschinot. Ideas of reflection and the workings of imagination are blended in the term merencolie, embodying for contemporaries "a tendency", observes Huizinga, "to identify all serious occupation of the mind with sadness".[33]