The Anatomy of Melancholy

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.”