Editor’s Comment

The last twenty years or so have witnessed an unprecedented expansion in the number of people in western societies apparently suffering from mental ill-health, especially depression. The percentage of the United States population under treatment for depressive symptoms, for example, has shot up from 2.1% in the early 1980s to 3.7% only two decades later, an increase of 76% over the period (Horwitz and Wakefield 4). As many commentators have pointed out, this expansion, while it may reflect deteriorating mental health in the population, also owes much to trends in the way that depression has come to be diagnosed as well as to the activities of the pharmaceutical industry, which actively promotes depression as a diagnostic outcome. In particular, the diagnostic methods codified in the American Diagnostic and Statistical Manual of Mental Disorders, currently in its fourth edition, have provided warrant for the diagnosis of depression to be applied to large numbers of people probably suffering from nothing more (or less) than normal sadness.

Whatever suspicions may attend the rise of depression as a medico-social phenomenon, there can be no doubt about its prominence within western societies. Studies suggest that a significant proportion of the population will be afflicted by depression at some point in their lives, and a range of treatments, from therapy and psychoanalysis to various types of medication, has been devised for the condition. In recent years, there has also been a veritable deluge of popular books on depression, either personal testimonies (often of the most harrowing kind) written by sufferers, self-help manuals, or more skeptical studies, intent on critiquing the depression “industry” in general. Yet for all that depression has become a universally recognized phenomenon; it was not until the nineteenth century that it became recognized as a medical condition in its own right. This generates the question: what was depression like before “depression” existed as a standardized medical concept with a recognizable cluster of symptoms? It was exactly this question that prompted the formation of the three-year research project entitled “Before Depression: The English Malady, 1660–1800” by an academic team drawn from the universities of Northumbria and Sunderland, funded by a grant from the Leverhulme Trust. The essays published in this issue, and also those forthcoming in the next issue of Studies in the Literary Imagination (Fall 2011), are all based on public lectures delivered between 2007 and 2009 as part of the remit of the wider project.

The state that we now refer to as depression can also be encountered within the eighteenth century, though we have to look for it among a range of roughly equivalent and differently named conditions, such as “melancholy,” “hypochondria,” and the “spleen.” The latter two terms also reflect common medical suppositions of the time, namely that mental ailments were linked closely to, and indeed perhaps directly caused by, problems affecting the proper functioning of the physical body. A particular association was often drawn between melancholy feelings and disturbances in digestion, which, interfering with the traffic of animal spirits to the brain, could cause problems with the imagination itself. The philosopher David Hume and the poet Samuel Taylor Coleridge are two prominent figures of the era who tend to discuss problems of depression and digestion almost in the same breath, or who—to put the matter differently—regularly somatized their melancholy in terms of stomach complaints. The philosopher David Hartley believed that melancholy came about in women because of a volatility affecting the uterus, whereas male depression hatched out of the “Organs of Digestion” (Hartley 399).

Eighteenth-century medical men occupied themselves with identifying and treating an improbably diverse spectrum of melancholy symptoms. As well as the gastric problems referred to above, symptoms included wakefulness and insomnia, excessive sensitivity to perceived slights and snubs, conviction of sin and the traumatic anticipation of damnation, inexplicable unhappiness, and general sadness and fatigue. The cures administered might seem equally improbable, if not in many cases ill-advised and dangerous. Depletion of the body, either through bleeding or purging, was common, as were hot and cold bathing, blistering, and even trepanning. Yet alongside invasive treatments of this...