What is Melancholia?

Originally defined by Greek doctors around 300 BCE, melancholia is a psychological disorder marked by loss of appetite and a depressed mood. Modern psychologists generally believe that it's another term for what is now know as depressive disorder. In ancient Greek medicine, doctors believed that every disease was caused by an imbalance in one of four main bodily fluids, or humours. An excess of black bile was said to be the cause of a depressed disposition. The name was taken from the Greek root words melas, meaning "black," and kholé, meaning "bile."

As defined in the Hippocratic writings, melancholia produced certain symptoms that are very similar to those associated with depressive disorder today. Persistent sleeplessness, lack of appetite, and despondency were all considered to be signs of this condition. In addition, Greek doctors noted that patients suffering from melancholia exhibited aggressive behavior, sometimes leading to suicide.

It is interesting to note that early studies of melancholia resulted in conclusions that strongly correlate with what we know now about depression. For example, the ancient Greeks reported that it seemed to worsen or become more prevalent during the autumn months, evidence which may link the condition with seasonal affective disorder (SAD). In addition, a condition known as mania, characterized by a severely elevated mood, was later believed to be connected to melancholia. This suggests that some patients involved in these early studies may have been suffering from bipolar disorder.

Ancient studies on melancholia also seem to differentiate between situational and chemical depression. Although Hippocrates attributed melancholia to a chemical excess of black bile, he also noted that the symptoms could be produced by lingering grief and fear, suggesting that situational problems could also cause depression. By the medieval era, physicians were studying the connection between family history and melancholia.

While the word still refers to a bleakness of disposition, it is no longer used as a medical diagnosis. Today, physicians define clinical depression as a persistent state of melancholia or despair. In order to result in a diagnosis of depressive disorder, this condition must progress to the point of disrupting an individual's daily life.