Medicine for melancholy

Katherine Sharpe here has a deep and rich look at the history of depression as a concept. The idea that melancholy and sadness are in and of themselves a kind of illness, and that they should be treated as such, is fairly new. And as with many things, my own instinct is to follow the money. There is a big profit to be made from psychopharmaceuticals, but to really maximize it, you need a big base of customers. Sort of like how the plastic surgery industry can't simply satisfy itself with burn victims and people born without skin. Sharpe sees more at work, though.

That’s why depression is not a disease like diabetes. Diabetes isn’t a metaphor. It was discovered, not invented. Its cause and nature are known. Depression exists—all those disparate societies acknowledged and named it. But it is among the most conceptually malleable of illnesses. Its borders are fuzzy: at the extreme, depression is eminently disease-like, a true madness, but its mildest forms are fleeting and banal, comprising thoughts and feelings that we’ve all had a taste of. Most of all, perhaps because it affects consciousness, depression cries out for interpretation. Throughout history, each culture has given depression a meaning, or meanings. Each has told a story about it, and the story reflects much about that culture’s values, fears, and aspirations. Chemical imbalance is our chosen story, and it speaks volumes about the way we would like to approach the world.

Breaking thoughts and feelings down into matters of chemistry makes them more manageable, more controllable. What's lost in poetry is, the hope goes, gained in certainty. But that control is quite likely illusory.