Depression – disease known for ages
A lot is being talked nowadays about a peculiar epidemic of depression, particularly in highly developed countries. Such unfavourable features of big city life as overpopulation, excessive noise, haste, ubiquitous consumerism and superficial relationships with others all contribute to the widespread sense of loneliness, emptiness or depersonalisation – states leading to depression very frequently (Pużyński, 2005).
Depression is a source of suffering for millions of people around the world. In some, it results in only a transient disappearance of the willingness to live, showing by cyclical states of apathy and discouragement; in others, it wreaks havoc in life, often leading to permanent disability and even to the most tragic effect of that terrible disease – suicide.
As Erich Fromm (1970) stated, the “age of anxiety,” which reigned during the Cold War, has been followed by the “age of melancholy.” Epidemiologic studies carried out worldwide are showing that ca. 17% of the general population suffers from depression during their lifetime. 12-25% of patients reporting to their general practitioner suffer from depression, out of which a half meets the criteria for moderate or severe version of this disease. However, it would be an oversimplification to state that people did not suffer from depression in the past. History shows that regardless of the time and the cultural environment, man experienced this state in a similar way – it was an inability to active participation in social life.
In antiquity, clear accounts on the state of melancholy can be found in works of Plutarch, Aretaeus, Gailen and Hippocrates. These accounts do not significantly diverge from what is observed in patients with depression in this day and age. Here, it is worth quoting the abovementioned Plutarch (after Pużyński, 1988): “. . . man in depression exaggerates the smallest evil under the influence of anxiety. They look at themselves as an individual hated and persecuted by gods. Everything that is the worst is ahead of them. They cannot use their mind in wakefulness and sleep does not free them from terror. The mind is dull and fears are constantly there. They have nowhere to run from their anxiety. They cannot fight evil as it would be like fighting gods. They move a doctor and kind friends away and tells them: leave me alone, let me, a cursed heathen hated by gods, suffer my punishment . . .” Apart from creating accurate descriptions of depressive states, in their deliberations they reached convergent conclusions as to the sources of the disease. They were generally agreed that this is a condition of humoral background. And so e.g. Hippocrates associated depression with the excess of “black bile” and Galen – with disordered function of the brain. As a result, many contemporary psychiatrists regard them as precursors of today’s psychiatry.
As we can see, pathological sadness, or depression, accompanied people from time immemorial. It hid under many labels and the ways it was understood were diverse as well. First of all, however, the approach of the society towards people struck by this serious disease changed – the odium of sin or possession was taken off their backs and their huge suffering was acknowledged.
In contemporary times, one of the most prominent books written on depression is, according to many, is Andrew Solomon’s book entitled “The Noonday Demon: An Anatomy of Depression.” Let us quote a suitable fragment from his autobiographical book (2004, pp. 14-15): “Depression can be mild or severe. Mild depression deepens gradually, it is sometimes irreversible and destroys people like rust destroys iron. This is great sadness, disproportionate to a trivial cause; pain that drives other feelings away and stifles them. Such depression lodges in eyelids and the muscles supporting the spine. It does violence to the heart and the lungs, makes the contractions of muscles working without our awareness are more intense than usually. Such a depression, similarly to chronic physical pain, is difficult to bear not because the suffering is at times unbearable but because of the moments of relief, when the individual keeps the awareness of what they went through and knows what awaits them in the future . . . Major depression is an entire series of breakdowns. If we imagined a soul as a building of iron, one might say that mild depression covers it with rust and destroys it gradually and major depression is an abrupt collapse of the entire structure.”
Fromm, E. (1970). Ucieczka od wolności [Escape from freedom]. Warsaw: Polish Scientific Publishers PWN.
Pużyński, S. (1988). Depresje [Depressions]. Warsaw: Publisher: Wydawnictwo Lekarskie PZWL.
Pużynski, S. (2005). Depresje i zaburzenia afektywne [Depressions and affective disorders]. Warsaw: Publisher: Wydawnictwo Lekarskie PZWL.
Solomon, A. (2004). Anatomia depresji. Demon w środku dnia [The noonday demon: an anatomy of depression]. Poznań: ZYSK i S-ka Publishing House.