Clark Lawlor,From Melancholia to Prozac: A History of Depression

Reviewed by: Jennifer Radden, University of Massachusetts Boston, USA

Clark Lawlor has written a history of melancholy and depressive states that begins with the earliest ideas of the Greek humoralists and ends with the theories and observations of modern day psychiatry and its critics. Because of this span, his work is inevitably selective and simplified. Yet Lawlor has managed to distill much history, science, clinical lore, and contemporary controversy into a remarkably readable and elegantly written volume, which can be expected to interest, amuse, and edify the lay reader, orient the more scholarly one, and draw many towards the intriguing history of melancholy and depression.

From the point of view of the broad historical narrative, little is entirely new here, and Lawlor refrains from opining on the several controversies that he describes in these pages, such as the challenge raised by the presumed identity between the different iterations of the conditions he describes, and the status of mania in relation to each of them. As an engaging introduction to the subject, its strength lies with his illustrations and elaborations on the now familiar story. Choice and unusual passages from the sufferers of these conditions are added—Margaret Cavendish, Duchess of Newcastle (1661-1717), and poetess Charlotte Smith (1749-1806), to name two—as well as other snippets from the history of science and psychology. And the book begins with a masterful prologue using Samuel Johnson’s own and Boswell’s words to provide a compelling recounting of Johnson’s famous sufferings.

After the preface on Johnson, Lawlor sorts his chapters into rough historical eras, one devoted to the Greco-Arabic doctors, Aristotle and the tragedians, whose influence we find in medieval writing; another on the renaissance ideas introduced by Burton and Ficino; a third about the transition from, as he puts it, spleen to sensibility, that occurred between the early modern and modern eras; then to the Victorians, and the beginnings of psychiatry as a recognizable precursor of today’s. After that, two chapters provide the twentieth and twenty-first century backdrop, from Freud and other psychoanalysts, then Meyer, and Kraepelin, through what Lawlor entitles the “‘New’ depression of pathological sadness” emerging in the 1970s and 80s. A final chapter on what has come to be known as the antidepressant era, is appropriately cautious about the blessings of psychopharmacology, with an acknowledgment of the complexities introduced by the power of the placebo effect on depression sufferers. Here, there is some discussion of new directions: a call, as Lawlor says, to reinstate a model of the human that escapes the reductionism of biochemical definitions; a mending of the unwarranted separation between depression and anxiety; acknowledgment that environmental effects must be taken into account as well as individual chemistry, and recognition of the healing power of talk. These last discussions are somewhat sketchy; in places they even read as rushed. They deserve more sustained attention than Lawlor provides, to my mind, for they are each of immense cultural, medical, and societal importance. Our hope must be that they will stimulate closer-grained evaluations by others.

In keeping with its attractive accessibility, From Melancholia to Prozac contains a chapter-by-chapter bibliographical guide for further reading, which is imaginative and thorough. However, it does omit one of the best recent sources on seventeenth century melancholy, Lund’s Melancholy, Medicine and Religion in Early Modern England (2010). There is also a useful glossary of technical terms, and some interesting and lovely illustrations, including the evocative Melancholie by Degas (1874) gracing its cover. (It is regrettable that in such a handsome book, the dust jacket confuses Robert Burton, the author of the Anatomy of Melancholy with the adventurous Richard, who lived two centuries later.)