Psychology: The New Black: Mourning, Melancholia and Depression By Darian Leader Hamish Hamilton, 223pp. £17.99As Darian Leader points out in his rigorous and engaging study of the nature of depression, the overworked word itself has been subject to some semantic slippage.
A term that, to those who have been there, rather accurately describes the sense of being physically crushed, has become a catch-all for simply feeling down. In truth, the bodily depredations of the disease are among its least bruited by patients or professionals. There is of course the crying, the weight loss, the fatigue and the raw, legible evidence of adventures with Stanley knives behind locked doors. But there is also the shuddering wakefulness at 4am, entombed in the dark like something out of Poe; the pendulum of fear in the solar plexus as dawn falls; the point beyond which suicide seems pointless because you feel like you're already dead. Left untreated, wrote the philosopher EM Cioran, depression would eat away even at the fingernails.
THOUGH WE TEND to acknowledge colloquially that depression is essentially a disorder of the spirit, the physical symptoms are also, as Leader avers, those that respond most impressively to the modern pharmacopoeia. The success, since the 1990s, of Prozac and its optimistically named ilk, has encouraged an idea of depression as more accurately an organic ailment, a chemical deficit that can readily be righted, as though health and happiness were a matter of emotional hydraulics. The upshot, argues Leader (though he is hardly the first to say it), is that our contemporary cure for depression is almost literally skin-deep: the patient loses that dull grey loser look, and rejoins the ranks of the sane and (perhaps more to the point) productive. Depression becomes a momentary downturn in the economy of our moods; drugs stimulate the system once more, and a spot of cognitive-behavioural therapy (CBT) calms the emotional market in the medium term.
Until, that is, the next heart-sink blip on the chart. For what is lost in this picture of the efficient medical management of depression is all hope of an explanation for the slump, all chance of discovering a truth about ourselves that might teach us more than merely how to skirt the next psychic recession. What is lost, in other words, is experience as such. We hand our bodies over to global drug corporations, and our minds to the technicians of CBT: none of it teaches us anything. Leader's most audacious suggestion in The New Black - audacious because of the economic stakes around this disease today - is that we should ditch the notion of depression tout court, and return to two concepts that appeal precisely to the idea of individual experience: mourning and melancholia.
By "melancholia", Leader does not mean the kind of languid maundering that we usually intend by that word nowadays. Nor has he in mind the long historical valence of the term: a capacious diagnosis that took in a preponderance of black bile, anxiety or mania, florid delusions and, of course, a general catastrophe of the patient's mood. In Freud's 1917 essay Mourning and Melancholia, Leader uncovers a more precise meaning of melancholia: the patient's dismal estimate of his or her own value, the feeling that the self per se has already been lost, that one's "I" has shrunk to the merest sliver of moral worth or character. (The melancholic, wrote Samuel Butler in 1659, "keeps the worst company in the world, that is, his own".) In this, says Freud, the depressive is not factually mistaken: the ego has indeed dwindled, the personality atrophied, the will given up the ghost. In short, we appear dead to ourselves and the world, and we mourn, without solace, our own passing.
For Freud, such a state is both a dark mirror, and sometimes a direct consequence, of actual grief. Leader argues that we have lost the ability to mourn adequately, that our response to loss is now most damningly summed up by the very metaphors we use to describe it: we speak of "closure" at the end of a relationship, and of "getting over" a bereavement. Grief, we like to believe, arrives in discrete stages: shock, disbelief, anger, acceptance and so forth. Such hasty, crude tallying of our emotional accounts obscures the unconscious processes at work: the necessary identification with the dead that comes with grief, the pathological over-identification that follows on a loss unacknowledged. Drawing on case studies from his own therapeutic practice, and citing such psychoanalytically attuned contemporary artists as Susan Hiller and Sophie Calle, Leader elegantly outlines the modern depressive's characteristic pose: a backward glance at one's own being.
THIS IS A rich, cogently argued and (in terms of medical and social policy) very timely book. But it is hard not to conclude that Leader's spirited defence of the talking cure is evidence not of Freud's ideas having been neglected, but of their wider success. That is to say, he writes as though the only possible interpretations of contemporary depression are on the one hand a strict biologism accompanied by faith in pharmaceuticals, and on the other a focus solely on the individual grieving psyche with its unconscious urges. Leader mentions the importance of community to the work of mourning, but only glances off the question of a depressive politics, of global capital's somatic soothing of its justified discontents. Cioran knew better: "We must learn how to explode! Any disease is better than the one provoked by a hoarded rage."
Brian Dillon is the author of a memoir, In the Dark Room (Penguin, 2005) and UK editor of Cabinet, an art and culture quarterly. He is working on Tormented Hope: Nine Hypochondriac Lives
