Melancholia defined: Surviving clinical depression

by Scott Malcolm Patterson

Despite its name, humorism is no barrel of laughs.

It was a system of medicine formulated by the Ancient Greeks, an admittedly simplistic framework. The most prominent component in today’s world is the four temperaments, four different personality types that a person might possess: sanguine, choleric, phlegmatic and melancholic. All exist in the modern lexis, but clearly melancholic is the most famous. Hippocrates attributed it to a surplus of black bile in the body.

One has to wonder just how it was that such a feeling or mood could be so prominent that it defined a person’s character. It also reveals that melancholia – a likely manifestation of clinical depression – has been around for as long as we have written about the human condition. Yet, somehow, it continues to be widely misunderstood.

Mental health has long lagged behind the other medical sciences, and this has causally bled into our culture. We are long past the medieval days when despair was considered a sin, but are still far from a time when it is universally recognised. The notion that one can still dismiss it becomes absurd when the figures are taken into account.

A 2009 NHS study found that 4-9% percent of people in England will suffer depression at some point in their life. That’s at least two million human beings. A 2016 YouGov survey found that a quarter of students in the UK suffer from a form of mental illness, and 77% of those students will experience depression. 6.7% of Americans (more than fifteen million) are diagnosed every year, while it is estimated that one in six Australians (more than three and a half million) will be similarly affected. Stats can be numbing, so it might better serve to imagine a crowd of twenty two million.

It is very easy to dismiss depression as mere sadness, partly due to the manner in which hyperbole has resulted in semantic shift, so that the word often lacks literal meaning. Perhaps it is also easier to underestimate the genuine toll of a disease that cannot be seen. There is profound comfort in discovering that the terrible monster under the bed is fictional. Yet this is to ignore the outcomes of a condition that continuously finds new ways to demonstrate its power, using the bearer of the black dog as a terrible puppet.

Depression may work relative to class and economic standing, with those ‘less-off’ more vulnerable, but it is by no means universally reflective of environment or circumstance. It can happen to anyone. In 2009, professional footballer Robert Enke committed suicide. He had struggled with depression for six years, and the resultant paranoia convinced him that his adopted daughter would be taken from his wife if the state learned of his condition. A highly successful international goalkeeper due to play for Germany at the 2010 World Cup stepped in front of a train in the certain belief that it would save his wife and child from heartbreak. I challenge anybody who considers this cowardly to summon an argument defending their view, and then further to keep a straight face as they deliver it.

This is perhaps the true nature of the beast, and why ‘melancholic’ was considered a personality type. Its behaviour is organic, enjoying its own life cycle. Often it begins with a disequilibrium in the sufferer’s perception of reality, the uncanny sensation that what surrounds them isn’t real. This will be followed by the intensification of present emotions. A disappointing grade will drive you to the conviction that you’re a failure. That feeling will dominate your life, an inescapable thought that follows your every step. The reassurances from friends and family would mean more if you hadn’t begun to believe that you are burdening them with your existence.

Every expression that isn’t a smile, and every joke that doesn’t get a laugh, confirms this. You cannot hide, because life itself is conspiring against you through the many faces of one agent, a hydra-esque demon. You forget that the world is the same as it always was, that it is your mind that has turned against you. It has been clouded by an involuntary darkness that imbalances the chemical reactions in your brain. It is akin to a mental cancer, the cellular composition turning on itself.

Five years ago, I was diagnosed with clinical depression. It lingered for a period of between a year and eighteen months. If this sounds uncertain, it’s because the memory is almost abstract,  recalled through a fog like that caused by adrenaline. I took anti-depressants and I attended counselling, but this was at best a slight respite from what was the worst thing that has ever happened to me. Routine and distraction were crutches for a gangrenous leg.

The people around me struggled just as I did, some refusing to acknowledge what awful battle raged in my head, others remaining fearfully distant. My closest friend didn’t understand and cut me adrift, even as her friendship became the most important thing in my life. She wasn’t inhumane, she merely mistook what was happening to me as something sinister. When she was gone, the depression became my best friend. I surrendered to it, believed its harsh whispers, took comfort in its presence. It was my God.

Trying to describe this period has forever been a haunting target, one I can never quite seem to reach, and has driven me to many an analogy. Simply imagine your broken heart at a break up or a traumatic moment, then imagine feeling it every single day, at every point, until it normalised. Imagine it was so all-pervading that it was your identity. Imagine the despair was in control. Imagine missing it when it was gone. Melancholic, a personality type.

However, there is something to be said for the blight. By surviving, I have three things that can never be taken from me. The first is a true understanding of a common and reprehensibly misunderstood affliction, and in some small way the means to help others. The second is the inspiration it gave me to write a book, to make meaning of the ordeal and ultimately own it. The third is the realisation that I now face a world that I can best, that I can defy and pursue. No matter how hard things may get, they will never be as bad as they once were. It made me stronger. This, in fact, was a line I used for my book. “You’re strong. Show the world how strong you are.”

To any among you who fear it, or are already in its grip, I would ask this: were the Ancient Greeks actually right to define a person by their melancholy, even if only to identify their strength in surviving it? Poetic license, perhaps, but getting to a point. Nobody wants to be defined by their suffering or victimhood, but there is virtue in being defined by your victory. It is a victory you can achieve. You are not alone, it is not your fault, and you are strong.

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