Mourning and Melancholia Revisited

The Distinctions between Sadness, Mourning and Depression

Having read quite a bit about topics of psychological interest in various publications over the years, it seems to me that it would be helpful to clarify the differences between sadness, mourning and depression.  For those of you who are suffering from depression and reading these words, you know what depression is all too well, and you know that it is something that takes hold of the mind much more aggressively and completely than sadness, or even mourning. 

Sadness is a basic emotion that we feel when something that we need or expect to have from our environment is not there or is denied us.  It is akin to disappointment, which is what we feel when something we hope for or expect is not forthcoming.  These are basic emotions which are part of everyday life.  In a healthy individual sadness and disappointment may affect us for a short while, but we can recover pretty easily from them and go on to other experiences.

Mourning is an emotional state that is a response to the loss of something, or more often, someone significant in our lives.  It is an enduring state that takes over the mind for days or weeks. Mourning is also part of the natural order of things.  Over time we come to accept our loss, make peace with it and recover. 

Depression is different from either of these.  It is an enduring, heavy sense of mourning which feels like a leaden blanket over life. 

Every morning the depressed person wakes up and feels, “Oh, no.  Now I have to get up.  But I can’t, it’s impossible.  I want to stay here in my bed forever and not have to get up.”  Then he or she hears the world clamoring for her.  The baby needs to be changed.  The other kids need breakfast and to be seen off to school.  She thinks,” How will I get through the day?”  When she can put it off no longer, she gives a mighty heave and pulls herself out of bed.

He hears the alarm ring.  He knows that if he doesn’t get to work and produce he will be fired and not be able to support the family.  The thought will make him panicky so he doesn’t want to think that.  When he thinks about work he feels anxiety and pressure, but he just can’t move.  He thinks, “How will I get through the day?”  When he can put it off no longer, he gives a mighty heave and gets to his feet. 

Mornings are horrible for people suffering from depression. 

Sometimes it gets a little easier once you get going.  The distraction of what needs to get done kind of pulls you along a little and dilutes the feelings.  But not always.

Depression makes every day feel like a gray weight.  The ability to think, to feel and to care is lost.  It feels as if each day is a reminder of how drab, heavy and meaningless life is.  What’s the point of going on living this way?   Unlike sadness or mourning, depression is an illness.  But there is real hope.

Depression Can Be Cured

This statement may come as a surprise to some readers.  Most people are aware that depression can be managed with medication.  In fact, medication is the first and often, the only resort for many.  However the original goal in the treatment of depression and other psychological illnesses was always cure. 

Psychology means, “The study of the psyche”.  The psyche is the unconscious mind.  The possibility that the unconscious mind can be accessed and studied was first discovered at the end of the 19^th and the beginning of the 20^th centuries.  The initial attempts to cure psychological illnesses met with great success.   Over time more and more was discovered about the terrain of the unconscious mind, and this knowledge was expanded into systems of theory and practice which proved to be successful in alleviating, and in many cases curing, psychological suffering.  Cure is made possible when the root cause of the illness is unearthed, and its origin is most often found in the unconscious.  For those of us who do this work, medication has been a great aid for us.  Depression medication, when properly administered by a qualified psychiatrist, enables the leaden blanket to thin out a bit, making the patient more able to access the outside world and his connections to other people.  This greatly aids us in engaging the patient to do the work necessary to get to the root causes of his or her depression.

To sum up:

·         Depression is a psychological illness.  It is not to be conflated with human unhappiness or even with the normal mourning process.

·         Struggling through life with depression drains the suffering person of his vitality.

·         When talking about cure it is obvious that there are always caveats.  Prognosis is assessed using many factors including but not limited to age of onset, duration, and co-morbidity.  However cure is possible.  Medication in the service of psychological intervention is a great help.