They cannot escape this deadly affliction, whatever company they enter. “The fatal arrow clings to the side,” as with a deer that has been struck: whether it runs, walks or rests, with the herd or alone, this grief remains. Indecision, inconstancy, emptiness of mind, their fear, torment, anxiety, jealousy, suspicion and the rest continue, and they find no relief. So the man complained in the poet:

“I return home sorrowful, my mind almost Distracted, bewildered by distress. I sit down: servants hurry up and take my slippers off; I see others hastening to spread the couches And prepare the meal; each did his utmost To soften that misery for me.”

He came home sorrowful and troubled in mind. His servants did everything they could to please him: one pulled off his socks, another prepared his bed, a third his supper. All did their utmost to ease his grief and cheer him. He was profoundly melancholy; he had lost his son: “that tormented him.” That was his heartache, his pain, his agony, which could not be removed.

This often makes them weary of their lives, and deadly thoughts of doing violence to themselves enter their minds. “Weariness of life” is a common symptom. “Slowly and joylessly the hours pass.” They soon tire of everything: now they will stay, now leave; now, in bed, they will get up; now up, they will go to bed; now pleased, then displeased again; now they like everything, soon dislike it all, weary of all. “There follows now a desire to live, now a desire to die,” says Aurelianus, book 1, chapter 6.

But for the most part “they condemn life,” discontented, disturbed and distressed by every slight occasion or object, or by none at all: often tempted, I say, to do away with themselves. “They do not wish to live; they do not know how to die”: they cannot die, they will not live. They complain, weep and lament, and think they lead a most miserable life. No one was ever so badly off or in such a state before; every poor person they see is most fortunate compared with them; every beggar who comes to the door is happier than they are.

They would willingly exchange lives with them, especially if they are alone, idle and separated from their usual companions, troubled, displeased or provoked: grief, fear, agony, discontent, weariness, sluggishness, suspicion or some such passion takes forceful hold of them. Yet soon afterwards, when they return to company they like or are pleased, “they condemn their judgement in turn, and delight in the comfort of life,” as Octavius Horatianus observes, book 2, chapter 5: they condemn their former dissatisfaction and are quite content to live.

And so they continue until some fresh discontent troubles them again, and then they are weary of their lives, weary of everything; they wish to die and show a necessity to live rather than a desire. The emperor Claudius, as Suetonius describes him, had a touch of this disease: when tormented by stomach pain, he thought of taking his own life.

Julius Caesar Claudinus, consultation 84, had a Polish patient so affected that, through the fear and sorrow that continually disturbed him, he hated his own life and wished every moment for death and release from his misery. Mercurialis had another, and another who often thought of killing himself; this continued for many years.

Suspicion and jealousy are general symptoms. They are commonly distrustful, fearful, apt to misunderstand and exaggerate, “easily angered,” irritable, petulant, ill-tempered and ready to snap at the slightest occasion, “at their dearest friends,” and without a cause: “whether given or not,” there will be “offence taken.”

If people speak in jest, he takes it in earnest. If they are not greeted, invited, consulted, called to give advice, and so on, or if any mark of respect, small courtesy or ceremony is omitted, they think themselves neglected and despised; for a time this tortures them. If two people talk together, converse, whisper, joke or tell a story in general terms, he immediately thinks they mean him and applies everything to himself: “he thinks it is all said about him.”

Or if they talk to him, he is ready to misconstrue every word and give it the worst meaning. He cannot bear anyone to look steadily at him, scarcely even to speak to him, to laugh, joke, act familiarly, clear the throat, point, cough, spit or sometimes make any noise at all. He thinks they are laughing or pointing at him, doing it to shame him, plotting against him or despising him. Everyone is looking at him; he turns pale, turns red, sweats with fear and anger lest someone notice him.

He broods over it, and long afterwards this mistaken idea of an insult troubles him. Montanus, consultation 22, gives the example of a melancholic Jew who was “angrier than the Adriatic,” so waspish and suspicious, “so easily angered,” that no one knew how to behave in his company.

They are inconstant in all their actions, giddy, restless, unable to decide on any business. They will and will not, swayed back and forth by every slight occasion or spoken word. Yet once they have made up their minds, they are obstinate and hard to reconcile. If they abhor, dislike or take offence, once fixed in it they cannot be moved by any advice or persuasion, even towards something far better.

Yet in most things they waver, cannot decide or think matters through, because of fear. “They act, and soon regret their action” (Aretaeus), “miserly, and shortly afterwards extravagant.” Now extravagant and then covetous, they act and soon repent of what they have done, so that they are troubled either way: whether they act or do not, lack or possess, succeed or fail. Disturbed on every side, soon tired and always seeking change—restless, I say, fickle, forever fleeing—they cannot bear to stay long in one place.

“At Rome, longing for the country; in the country, He praises the distant city to the skies——”

Nor can they bear any company for long, or persevere in any action or business.

“And like the children of the rich, he asks For finely chopped pap, and angrily refuses his nurse’s lullaby.”

Pleased one moment, displeased the next: as someone bitten by fleas, or unable to sleep, turns back and forth in bed, so their restless minds are tossed about and change. They have no patience to read a book through, finish a game or two, walk a mile, sit for an hour, and so on; elated and cast down in an instant, encouraged to undertake something and discouraged again by a spoken word.