Mourning the Loss of Unmedicalized Sadness
“’I had understood myself for years as basically vertical, an odd forked stalk of stuff and blood. I felt denser now; I felt more solidly composed, now that I was horizontal. I was impossible to knock down.’”
David Foster Wallace, Infinite Jest
Sadness holds a very strange place in our culture. The Yung Lean/Lana Del Rey/Tumblr-sad aesthetic that briefly strangled popular art in the early 2010’s has mostly died out, and it seems the reactive anti-sadness of new sincerity is here to stay. At the same time that sadness has lost its cultural cache, the cult of psychopathology has continued to grow, with an ever-present celebration of therapy, mental illness, and “trauma” that turns uncomfortable emotions into identity markers or logic puzzles to solve. To be sad has become passe, with the best option for a sad person who does not revel in their suffering being a total medicalization of their situation. The question of what it means to be sad in a serious, non-medical way has all but disappeared.
A tragic effect of all of this has been the erasure of an important condition that stands at odds with the contemporary understanding of sadness: melancholia.
While melancholia is no longer considered a “real” disorder like it once was, there has been something of a resurgence in attempts to write about it. The problem is that they almost universally fail. The author may overmaterialize the situation — the melancholic is made into a pure subject, their sadness born out of the material plight of life under modern capitalism. Or maybe they clinicalize — melancholia becomes dysthymia, or depression, or bipolar II. Or maybe they romanticize it — the melancholic becomes artistic or more intuitive, a hauntological figure whose pain grants them a Martyrs-like proximity to some divine truth. Melancholia doesn’t mean anything, so it becomes a mere codeword for some other, real state of being. The condition itself does not exist, and its symptoms can be managed through its understandable constitutive elements.
Truthfully, melancholia is actually quite simple: it is a compression. The melancholic’s life is consumed not with the self-hatred of the clinically depressed, nor is it focused on the things they yearn for that they lack. They are not reaching towards some meaning that they cannot attain, nor do they feel like meaning has escaped them. The stasis is the meaning. Like the Thomistic sloth, melancholia is “an oppressive sorrow . . . a sluggishness of the mind which neglects to begin [anything].”1 Unlike depression, it is not a negative state — it does not directly align with loss or failure on the individual level. For the depressive, action or inaction takes place to directly harm the sufferer, as the disorder orients them on a downward trajectory. There is a further place to which to sink, and the depressive is always moving towards it. The bottom for each person may differ, but the idea of a bottom is universal. They know that they can fail more, and in a way, they crave this — it means that something is happening.
This world of the depressive is larger and more mysterious than that inhabited by the melancholic. Unlike the anhedonia of major depression, melancholia is an avolitive, abulic, almost acedic condition. The melancholic is not the drying riverbed, cracking as it empties — they are the L.A. flood channel, visibly similar but structurally much different, with distinct but unpleasant purpose.
The melancholic does not hurt out of yearning or lack — they simply do not want. They do not yearn. They cannot will. They do not experience the retrenchment we expect to see with a sad person. They simply assume that things won’t change — and they seemingly do not care. They will admit as much. Their pain is deep, but it is a pain they never expect to subside. They may claim to see futures of hurt or failure, but really, they are simply repeating their current moment ad infinitum. A future, even one of failure, is unknown — the melancholic is certain of their trajectory, and in a perversely Randian way, they know that the world will bend to make it happen. For Howard Roark, life bent down to lift him to his proper station — for Esther Greenwood, it bent to hold her tightly in her place. The only relief comes when the world lays one flat — when they lose their verticality. And it is with this reality that contemporary culture is unable to grapple.
As Benjamin Fong noted in a recent discussion about the history of American drug use, the proliferation of SSRIs and other psychiatric drugs serves a primary purpose of “[providing] explanatory relief for people — when people don’t know how to make sense of the problems they are going through, that they can name a condition and take a drug, that just does a lot of meaning-making work in their lives.” Diagnostic medicine and pharmacology have come together to provide those in pain with ready-made meaning in their hardest periods. The fact that patients can now be diagnosed with major depression or bipolar disorder “with melancholic characteristics” shows just how desperate we are to find a simple explanation for this centuries-old condition.2 The melancholic does not have something eternal or immaterial about them that creates this painful existence, they are just sick and they need their medicine. Out of this grows the two ways we can respond to the melancholic: with a smiling pity for the medicated and therapized, and with scorn3 for the obstinate patient reusing to “try.”
The acceptance of this dichotomy removes all responsibility we collectively have to engage earnestly with the difficult people who live this way. Unlike schizophrenia or bipolar disorder, melancholia does not lead to the explosions or implosions that may force the issue on others. It leads to a continued flattening of the will. It creates a person for whom living is not a question of future pleasure or pain, but of a painful eternal present. It creates someone eminently ignorable. They do not even tend towards suicide like the wildly depressed — for them there is no need. To be dead is to be, flattened, without potential. The melancholic has already made themselves this way, without having to go through with the irreversible act. They already have no future. Things will not get worse, because they are somehow always worse. This truth is the only thing that they have. It is the floor upon which they can lie, looking up at the world mercifully bearing down.
- Of course, it makes sense that the closest thing a Dominican friar conceptualized to our secular melancholy was the boredom that draws some away from God.
- Even those professionals who allege to support recognizing melancholia as a legitimate state do so only to try and further medicalize it by deeming it “a distinct mood disorder” worth including in the Diagnostic and Statistical Manual of Mental Disorders.
- This scorn takes on a distinctly Cioranian character, responding to the apparent aggression of the melancholic from whom we see no growth by assuring us that “we rightly scorn those who have not made use of their defects, who have not exploited their deficiencies, and have not been enriched by their losses.”
Jitter 