What is Melancholia?

Sally Foster

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."

Seasonal affective disorder is a form of depression brought on by a change in seasons.
Seasonal affective disorder is a form of depression brought on by a change in seasons.

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.

In some cases, grief therapy and depression management are part of a broader treatment plan.
In some cases, grief therapy and depression management are part of a broader treatment plan.

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.

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Melancholia can be produced by lingering grief.
Melancholia can be produced by lingering grief.

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.

Sleeplessness can be caused by melancholia.
Sleeplessness can be caused by melancholia.

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Discussion Comments


The Greeks might have been right (partially). Since one of your articles about the brain mentions a substance called simply "black matter" by neuroscientists, too much of which in the brain region where it is normally found has been linked with clinical depression. This condition could be the origin of the term "melancholia," unless they thought that the bile from the spleen somehow seeped up into the brain.


@lestert- In the same vein, I think it’s amazing that the ancient Greeks were performing these kinds of studies. Reading this, it becomes obvious depression has always been a very human experience and problem. In the current day, it seems as though depression is a much more common experience than it was historically. But reading this makes me wonder if maybe it was just not as widely discussed. Also, I’m sure the resources and knowledge about mental illness were not as widely available in ancient times, so maybe people just didn’t recognize depression as a disorder.

Perhaps there would be more acceptance of mental illness and more services to those who suffer from mental illness today if we knew that even ancient peoples studied and suffered from it.


I think it’s incredibly interesting that the ancient Greeks were attempting to study the root causes of melancholia in the same way that modern psychologists do. It’s fascinating to me that ancient Greek scholars and scientists believed that there was a biological source of melancholia, much like we do today -- in the same way that they believed that melancholia was at least partially caused by an imbalance in the four bodily fluids, we now believe that depression is caused by a chemical imbalance in the brain. While we have obviously progressed in many ways scientifically, it is significant how much of our modern day understandings of illness and many other human experiences come from ancient Greek and Roman scholarship.

Also, while the terms we use to describe this illness may have changed, the term melancholia is still used to describe certain aspects of depression. In his essays on Mourning and Melancholia, Freud discusses melancholia as one of two common responses to a loss.

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