When I was seventeen, I carried these and other fragments up the stairs of an old Victorian home in Cincinnati. As I sat in the waiting room of a psychiatry practice, I knew I was lonely, unhappy, even desperate. I did not know I was depressed. But that was the word that waited for me, a diagnosis that physicians since Hippocrates have been trying to elucidate and one that I would inherit.
The Hippocratic writers believed that gloom, abnegation, and misanthropy could be traced to excesses of black bile. Unlike the other three bodily humors (blood, phlegm, and yellow bile), black bile was never actually observed. Today, we know no such substance ever existed. Still, the Greek words--for black ( melan ) and bile ( khole )--dominated the language of inner states for more than two millennia.
In 1905, the influential American psychiatrist Adolf Meyer proposed that "melancholy" and "melancholia" be retired from the clinical vocabulary. He believed that the terms were used too broadly. They described "many dissimilar conditions" and also "implied a knowledge of something that we did not possess"--that is, the causal role of black bile. Meyer preferred the word depression. Other physicians followed him, as did medical texts and the lay culture.
In the hands of modern writers, "melancholy" has recently experienced a renaissance. In Darkness Visible, William Styron charges that Meyer "had a tin ear for the finer rhythms of English and therefore was unaware of the semantic damage he had inflicted by offering 'depression' as a descriptive noun for such a dreadful and raging disease." The word depression, Styron continues, has "slithered innocuously through the language like a slug, preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control."
It strikes me as telling that writers--for whom words are tools and imprecision deathly--knowingly use a term that is literally untrue; and that they use "depression," "melancholy," and other imperfect words interchangeably. These are two of many indications that the experience they describe has no true name. Styron, for instance, readily concedes the paradox that his memoir of melancholia is but a hazy shadow of something "indescribable." Most accounts of depression will have this sort of disclaimer. Others disclaim implicitly through dependence on metaphor and allusion.