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From Melancholia to Prozac: A History of Depression

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A fascinating cultural exploration of the history of depression and melancholy
Demontrates the changing nature of the condition - it was viewed at various periods as fashionable and a malady of the elite, as closely linked with insanity, and now as a purely biochemical condition
Engages with contemporary debates relating to diagnosis and treatment, such as the use of drugs or behavioural therapies

Depression is an experience known to millions. But arguments rage on aspects of its definition and its impact on societies present and past: do drugs work, or are they merely placebos? Is the depression we have today merely a construct of the pharmaceutical industry? Is depression under- or over-diagnosed? Should we be paying for expensive 'talking cure' treatments like psychoanalysis or Cognitive Behavioural Therapy?

Here, Clark Lawlor argues that understanding the history of depression is important to understanding its present conflicted status and definition. While it is true that our modern understanding of the word 'depression' was formed in the late nineteenth and early twentieth centuries, the condition was originally known as melancholia, and characterised by core symptoms of chronic causeless sadness and fear. Beginning in the Classical period, and moving on to the present, Lawlor shows both continuities and discontinuities in the understanding of what we now call depression, and in the way it has been represented in literature and art. Different cultures defined and constructed melancholy and depression in ways sometimes so different as to be almost unrecognisable.

Even the present is still a dynamic history, in the sense that the 'new' form of depression, defined in the 1980s and treated by drugs like Prozac, is under attack by many theories that reject the biomedical model and demand a more humanistic idea of depression - one that perhaps returns us to a form of melancholy.

288 pages, Hardcover

First published February 1, 2012

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Clark Lawlor

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Displaying 1 - 9 of 9 reviews
Profile Image for S.P..
Author 2 books7 followers
August 28, 2012
The preface to this books starts with discussion of the depression of on of the most famously melancholy writers of his time, Samuel Johnson. This is an interesting look into the mind of someone who suffers from quite deep manic depression helping to contextualise the later narrative and understanding of the condition.

“They are drawn to deserts and solitary places where they confine themselves and consume themselves with discontent and hatred they beare to mankind” -Samuel Johnson's melancholy


Lawler then goes back to the Classical period and discusses the views of the Ancients – for sure melancholia has existed as long as history. The 'heroic' and 'aggressive madness' are discussed. The need to combat the imbalance in the 'black bile' though activity and good diet, seems to be the answer here.

Through the medieval period, more idleness, and of course, demonic activity are blamed as the causes – the pressure of the religious beliefs, though in truth are also a contributing factor.

With renaissance and enlightenment and new theories arise about bad blood and bad nerves appear. The causes and the cures seem to have not changed that much, exercise, good diet, and maybe a bit of blood letting.

The 'genius' of the melancholic is admired during these periods – but of course only for the better classes – in Victorian times, the severely depressed working class, would just be locked up in asylums, no genius there of course.

Towards the end of the 19th century, towards the middle of the 20th , Kraepelin proposed theories of the biological kind in a fairly straightforward scale from melancholia simplex to melancholia gravis were suggested, competing with the Freudian view that is was all about the mothers breasts.

Freudian views won at that time - looking for self loathing in some unknown past loss through psychoanalysis, with, in worst cases, use of electrical therapies (ECT) or lobotomies (quite popular at one point).

Later these were to be replaced with more 'scientific' Kraepelinian-esque ideas in the 80s with a set of guides (DSM III) describing depression by it's symptoms – guides that seemed to be a little too loose, encompassing normal 'sadness' with that which is abnormal (without reason).

The resultant boom of 'big pharma' and the commercialisation of 'magic bullet' cures ensued in the 90s – it is after all cheaper to get your GP to write a prescription for a wonder drug than to work out the problems you have with a psychoanalyst.

The final chapter discusses where we are now, Cognitive Behavioural Therapy – Talking to some one about it and them helping you correct where your thinking is wrong (thinking Positive), Mindfullness-Based Cogitative Therapy (meditation – living for the moment), the falling out of favour of solely drug based solutions - described as 'little better than placebo' only with side-effects (this hasn't filtered down to my GP yet), societal pressures, learned helplessness, more biology, and renaming back to melancholia – in short, we are not really any further to understanding what causes depression or indeed what depression is, than the Ancient Greeks were.

A fascinating book, it certainly helps me with my own English Malady to know where the ideas come from for therapy at to know it is all, still, a bit hit and miss.
Profile Image for dejah_thoris.
1,351 reviews23 followers
April 8, 2022
Hard to read more than one chapter in a sitting, but if you've ever felt like depression is more a part of your personality than something to be treated, Lawlor's discussion of melancholy will resonate with you. I especially enjoyed reading about the prolific Samuel Johnson. His advice: if you are idle, be not solitary; if you are solitary, be not idle. (Sometimes it is good to think, but if you've got anxiety it's easy to get lost in bad possibilities.) Klerman's concept of psychological Calvinism also serves as an interesting argument against medication, which is being well turned on its head in recent mental health campaigns.
Profile Image for Cal Davie.
237 reviews15 followers
January 26, 2023
Interesting, but fairly brief. Was quite dry at points, but offers an adequate overview of the topic. He has helpfully put an extensive list for further reading. This makes it a decent resource for students.
Profile Image for Ariadna73.
1,726 reviews121 followers
February 28, 2013
A book that confirms my suspicions: Melancholia has always been the same. The problem is that there are way more people in the world now than then; so it is more visible. Besides; it has always bee fashionable to have an illness of the emotions. That is kind of cool and low educated people fall for it (no matter how many college titles they have). Of course; there is a note of caution that must be taken: there is a real illness and is very serious; but it affects an extremely low part of the population. A very high percentage of those who say they are depressed are only trying to be cool; and seeking for attention. The real illnes does exist; but is very rare.
Profile Image for Marie Hew.
154 reviews1 follower
November 3, 2012


Interesting volume that speeds through the history of the various incarnations of depression and its treatments. A controversial condition that seems to be ever evolving definition which ends up affecting how patients are treated. First chapter starts off with humor and energy...ironic considering the topic.
1 review
November 16, 2019
one of the best books written on the history of melancholia which is a flexible term that its concept has changed through time.
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