Melancholy and Depression

  • Tullio GiraldiEmail author


This chapter traces the history of depression back to Greek Hippocratic medicine. An unbalance of the humours constituting the human body, with a prevalence of black bile , was associated with the low mood condition thus called “melancholia”. This view also led to the development of treatments such as emetics and cathartics , and of widespread bloodletting . Radical evolutions occurred with the foundation of modern psychiatry and the classification of mental diseases by Emil Kraepelin , and with psychoanalysis and the concepts of neurosis and psychodynamic depressive adaptation to life events provided by Sigmund Freud . Depression dramatically changed with the changes in the organisation of society and medicine; its manifestations, causes and prevalence fundamentally depend on the nature of the diagnostic criteria, whose evolution are analysed in detail in this chapter.


  1. Belofsky, N. (2013). Strange medicine. A shocking history of real medical practices through the ages. London: Perigee Book.Google Scholar
  2. Bynum, W., & Bynum, H. (2011). Great discoveries in medicine. London: Thames and Hudson.Google Scholar
  3. Cabras, P. L., Lippi, D., & Lovari, F. (2005). Due millenni di melancholia. Bologna: CLUEB.Google Scholar
  4. Carhart-Harris, R. L., Mayberg, H. S., Malizia, A. L. et al. (2008). Mourning and melancholia revisited: Correspondences between principles of Freudian metapsychology and empirical findings in neuropsychiatry. Annals of General Psychiatry, 7(9). doi: 10.1186/1744-859X-7-9.
  5. Craddock, N., & Owen, M. J. (2010). The Kraepelinian dichotomy—going, going … but still not gone. British Journal of Psychiatry, 196(2), 92–95.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Decker, H. S. (2004). The psychiatric works of Emil Kraepelin: A many-faceted story of modern medicine. Journal of the History of the Neurosciences: Basic and Clinical Perspectives, 13(3), 248–276.CrossRefGoogle Scholar
  7. Engstrom, E. J. (1991). Emil Kraepelin: Psychiatry and public affairs in Wilhelmine Germany. History of psychiatry, 2(6), 111–132.CrossRefPubMedGoogle Scholar
  8. Flynn, G. E. (1968). The development of the psychoanalytic concept of depression. Journal of Psychiatric Nursing and Mental Health Services, 6(3), 138–149.PubMedGoogle Scholar
  9. Frances, A. (2013a). The new crisis of confidence in psychiatric diagnosis. Annals of Internal Medicine, 159(3), 221–222.PubMedGoogle Scholar
  10. Frances, A. (2013b). Saving normal: An insider’s revolt against out-of control psychiatric diagnosis, DSM-5, Big Pharma, and the medicalization of ordinary life. New York: HarperCollins.Google Scholar
  11. Greenstone, G. (2010). The history of bloodletting. BC Medical Journal, 52(1), 12–14.Google Scholar
  12. Grube, G. (1954). Greek medicine and the Greek genius. Phoenix, 8(4), 123–135.CrossRefGoogle Scholar
  13. Kraam, A. (2002). Essay review: The legacy of Kraepelin. History of Psychiatry, 13(52), 475–480.CrossRefPubMedGoogle Scholar
  14. Lawlor, C. (2012). From melancholia to prozac: A history of depression. Oxford: Oxford University Press.Google Scholar
  15. Mattern, S. (2011). Galen and his patients. Lancet, 378(9790), 478–479.CrossRefPubMedGoogle Scholar
  16. Nesse, G. C., & Williams, R. M. (1996). Why we get sick: The new science of darwinian medicine. New York: Vintage Books.Google Scholar
  17. Neuburger, M. (1944). An historical survey of the concept of nature from a medical viewpoint. Isis, 35(1), 16–28.CrossRefGoogle Scholar
  18. Paykel, E. S. (2008). Basic concepts of depression. Dialogues in Clinical Neurosciences, 10(3), 279–289.Google Scholar
  19. Robertson, B. M. (1979a). The psychoanalytic theory of depression. Part I-The major contributors. Canadian Psychiatric Association Journal, 24(4), 341–352.CrossRefPubMedGoogle Scholar
  20. Robertson, B. M. (1979b). The psychoanalytic theory of depression. Part II-The major themes. Canadian Journal of Psychiatry, 24(6), 557–574.CrossRefPubMedGoogle Scholar
  21. Shorter, E. (1993). From paralysis to fatigue: A history of psychosomatic illness in the modern era. New York: The Free Press.Google Scholar
  22. Shorter, E. (1994). From the mind into the body: The cultural origins of psychosomatic disorders. New York: The Free Press.Google Scholar
  23. Shorter, E. (2013). How everyone became depressed: The rise and fall of the nervous breakdown. Oxford: Oxford University Press.Google Scholar
  24. Smith, C. M. (2005). Origins and uses of primum non nocere—Above all, do not harm! Journal of Clinical Pharmacology, 45(4), 371–377.CrossRefPubMedGoogle Scholar
  25. Spiegel, R. (1976). Reflections on depression and melancholy: From myth to psychoanalysis. Journal of the American Academy of Psychoanalysis, 4(3), 279–300.PubMedGoogle Scholar
  26. Vadakan, V. (2004). The asphyxiating and exsanguinating death of President George Washington. The Permanente Journal, 8(2), 76–79.Google Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  1. 1.University of TriesteTriesteItaly

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