Every breeze terrifies him; every sound makes him start.

Another, through shyness, suspicion and timidity, will not be seen outside; he loves darkness as dearly as life and cannot endure the light or sit in well-lit places. With his hat always pulled down over his eyes, he would willingly neither see nor be seen: Hippocrates, On Madness and Melancholy.

He dares not enter company for fear of being mistreated or disgraced, making some mistake in his gestures or speech, or becoming ill. He thinks everyone watches him, singles him out, mocks him and bears him malice. For the most part they fear being bewitched, possessed or poisoned by their enemies, and sometimes suspect their closest friends. He thinks something speaks or talks inside him, or to him, and that he belches up the poison.

Christophorus à Vega, book 2, chapter 1, had a patient so troubled that no persuasion or medicine could bring him out of it. Some fear they will develop every dreadful disease they see in others, hear of or read about, and therefore dare not hear or read about any such subject, not even melancholy itself, lest by applying what they hear or read to themselves they should aggravate and increase it.

If they see someone possessed or bewitched, an epileptic seizure, a man shaking with palsy or dizzy, staggering or standing in a dangerous place, and so on, it runs through their minds for many days afterwards. They fear the same will happen to them, that they are in similar danger, as Perkins rightly observes in his Cases of Conscience, chapter 12, section 2; and often, through the force of imagination, they bring it about.

They cannot bear the sight of anything terrifying—a monster, a man being executed, a corpse—or to hear the Devil named, or encounter any tragic account, without quaking with fear. “They seem to themselves to dream of Hecates” (Lucian)—they dream of hobgoblins—and may be unable to put it out of their minds for a long time afterwards.

They apply everything they hear, see or read to themselves, as I have said. Felix Plater notes this of some young physicians who study to cure diseases, catch them themselves, become ill, and apply to their own persons every symptom they find described in others.

And therefore—“I give this warning again, though it may disgust the reader: I would rather have ten words too many, even repeated ten times, than one word missing”—I would advise anyone who is presently melancholic not to read this account of symptoms, lest he unsettle himself or become temporarily worse and more melancholic than before.

Take this as a general statement about them all: “They are always complaining and frightened over empty things,” says Aretius. They complain of trifles and fear without a cause, always thinking their own melancholy the most grievous, and no one so badly afflicted as they are. Though it may be nothing by comparison, surely no one was ever so troubled, or troubled in this particular way.

They are as truly tormented and distressed, in as great an agony over trifles and trivialities—things they will afterwards laugh at themselves for—as if these were matters of the greatest substance and importance, genuinely to be feared; and they cannot be reassured. Settle one fear, and they are instantly troubled by another, always afraid of something they foolishly imagine or conceive for themselves, which perhaps never existed, can never exist, is never likely to exist.

The slightest occasion troubles their minds. They are restless, always complaining, grieving, fretting, suspecting, resenting, dissatisfied, and cannot be freed while melancholy continues. Or if their minds are quieter for the moment and free from fears of external things and events, their bodies are still out of tune. They suspect some part or other is wrong: now their head aches, or their heart, stomach, spleen or some other organ is disordered; they will certainly develop this or that disease.

Always troubled in body, mind or both, and continually afflicted by wind, a disordered imagination or some incidental bodily disturbance. Yet for all this, as Jacchinus notes, in every other respect they are wise, steady and judicious, and do nothing unbecoming to their dignity, character or position, except for this foolish, ridiculous and childish fear.

It tortures and torments their souls so greatly and so continually. Like a barking dog that always yelps but seldom bites, this fear constantly troubles them and, as long as melancholy lasts, cannot be escaped.

Sorrow is the other distinguishing mark and inseparable companion, as inseparable as Saints Cosmas and Damian, a “faithful Achates,” as all writers testify: a common symptom, a continual one, and always without any evident cause. “They all grieve, and if you ask them to give a reason, they cannot”: always grieving, but unable to say why. “Unsmiling, sad, deep in thought,” they look as though they had just come out of Trophonius’s cave.

And although they often laugh and seem extraordinarily merry, as they will in spells, in an instant they are extremely downcast again, dull and heavy, “at one and the same time” merry and sad, but mostly sad. “Whatever pleases passes away; unwelcome things cling more firmly.” Sorrow stays with them continually, gnawing as the vulture did at Tityos’s entrails, and they cannot escape it.

No sooner are their eyes open after terrible and troubling dreams than their heavy hearts begin to sigh. They are always fretting, fuming, sighing, grieving, complaining, finding fault, repining, resenting, weeping—“self-tormentors,” vexing themselves, disturbed in mind by restless, unsettled thoughts; discontented over their own affairs, other people’s, or public affairs that do not concern them, things past, present or to come. The memory of some disgrace, loss, injury, insult or the like troubles them afresh now that they are idle, as though it had just happened.

Or they are distressed by some danger, loss, poverty, shame or misery that, as they fear and suspect, will certainly come. “Mournful Ate” frowns upon them, so that Aretaeus aptly calls it “anguish of mind,” a torment of the mind, a perpetual agony. They can scarcely be pleased or relieved, although other people consider them most fortunate: whether they go, stay, run or ride,

——“behind the rider sits black care.”