From the Introduction

After receiving a prescription for one of the most popular anti-depressant drugs and picking them up from her chemist, a young woman returned home and opened the small packet. She had imagined a yellowish bottle filled with tightly packed capsules, like vitamin pills. Instead she found flat metallic wrapping, with each pill separated from its neighbour by a disproportionate expanse of empty foil. ‘Each pill is in total solitude,’ she said, ‘like in metal shells looking at each other. They are all in their individual little prisons. Why aren’t they all together in one box, loose and free?’ The way the pills were packaged troubled her. ‘They’re aligned like obedient little soldiers--why doesn’t at least one of them break rank?’ Her next thought was to swallow all the pills together. When I asked her why, she said, ‘So they don’t feel so lonely and claustrophobic.’
    Although anti-depressant drugs are prescribed to millions of people in the Western world, with figures rising steadily in other countries, it seems to have occurred to no one purveying a medical cure for depression that the remedy may function as a mirror for the malady. The solitary pill sends back a cruel message to whoever opens the packet. This bleak image of separated units conveys the negative side of modern individualism, where each of us is taken to be an isolated agent, cut off from others and driven by competition for goods and services in the market-place rather than by community and shared effort.
    Of course, the packaging of anti-depressants has its reasons. Isolating the pills allows the user to keep track of how many they have taken. It allows, one might say, a better management of the depression. There might even be the thought that by separating each pill with a plane of empty foil or plastic the user is discouraged from taking too many. But how many people, we might wonder, have stared at the wrapping of their anti-depressants with thoughts similar to those of the young woman above?
    We could see this situation as a metaphor for the way that depression is so often treated in today’s society. The interior life of the sufferer is left unexamined, and priority given to medicalizing solutions. Following the instructions for the pill-taking becomes more important than examining the person’s actual relation to the pills. Depression here is conceived of as a biological problem like a bacterial infection, which requires specific biological remedy. Sufferers have to be returned to their former productive and happy states. In other words, the exploration of human interiority is being replaced with a fixed idea of mental hygiene. The problem has got to be rid of rather than understood.
    Could this way of looking at depression be a part of the problem itself? As so many different aspects of the human condition are explained today in terms of biological deficits, people become emptied of the complexity of their unconscious mental life. Depression is deemed to be the result of a lack of serotonin rather than a response to experiences of loss and separation. Medication aims to restore the sufferer to the optimal levels of social adjustment and utility, with little regard for the long-term causes and possible effects of their psychological problems.
    Yet the more that society sees human life in these mechanistic terms, the more that depressive states are likely to ramify. To treat a depression on the same model as, say, an infection requiring antibiotics, is always a dangerous decision. The medicine will not cure what has made the person depressed in the first place, and the more that the symptoms are seen as signs of deviance or unadapted behaviour, the more the sufferer will feel the weight of the norm, of what they are supposed to be. They become casualties of today’s view of human beings as ‘resources’, in which a person is just a unit of energy, a packet of skills and competencies which can be bought and sold in the market-place. If that is what human life has become, is it surprising that so many people choose to refuse this fate, losing their energy and their market potential as they fall into depression and misery?
    I argue in this book that we need to give up the concept of depression as it is currently framed. Instead, we should see what we call depression as a set of symptoms that derive from complex and always different human stories. These stories will involve the experiences of separation and loss, even if sometimes we are unaware of them. We are often affected by events in our lives without realizing their importance or how they changed us. In order to make sense of how we have responded to such experiences, we need to have the right conceptual tools, and these, I think, can be found in the old notions of mourning and melancholia. Depression is a vague term for a variety of states. Mourning and melancholia, however, are more precise concepts that can help shed light on how we deal—or fail to deal—with the losses that are part of human life.
    In popular psychology, mourning is often equated with the idea of getting over a loss. But do we ever get over our losses? Don’t we, rather, make them a part of our lives in different ways, sometimes fruitfully, sometimes catastrophically, but never painlessly? A more careful, detailed view of mourning would explore its mechanisms and vicissitudes. As for melancholia, this is usually considered an outdated category, a topic of historical curiosity, or as a poetic term for a mood of self-absorbed sadness. As we will see, there is much more to it than that, and it can help us to understand some of the most serious cases of depression in which a person is convinced that their life is worthless and unliveable.

From The New Black. © 2008 by Darian Leader. All rights reserved.