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Melancholia

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In the traditional language of psychiatry, melancholia denotes a type of depressive state characterized by its intensity and its responsiveness to biological antidepressant agents. The experience of the melancholic individual, often called "mental suffering," is characterized by profound sadness and lack of interest in the outside world. Melancholia brings about a form of pessimism that sees the future as blocked and unchangeable. Such pessimism is accompanied by ideas of guilt and unworthiness, which find expression through self-accusation and can even give rise to delusion. Hypochondriacal ideas are also frequent. In addition, the subject complains of emotional numbness and the painful sentiment of being unable to love. Mental suffering engenders a continual desire for death. Hence, the subject runs the risk of suicide. Melancholia is accompanied by a marked slowdown in psychomotor activity, sometimes leading to stupor. Classic signs of the illness are anorexia and weight loss, insomnia and disturbed sleep patterns, and an improvement in clinical symptoms in the evening.
An episode of melancholic depression can be unique or recurrent, in which case it becomes part of the framework of a manic-depressive illness that is unipolar (recurring melancholic episodes) or bipolar (recurring melancholic and manic episodes). The bipolar situation reveals a fundamental characteristic of melancholia: it can reverse itself spontaneously or under the effect of drug treatments, into a state of manic excitation.
Depression. Freud read Karl Abraham (1927b) noted the relationship between mourning and depression, and he distinguished melancholia as an example from neurotic depression, which results from the failure to satisfy drives because of how repressed unconscious factors. For Abraham, the super-ego could go overboard and cause harm structure of melancholia is closer to that of obsessive neurosis on account of the individual subject; intense hostility toward the melancholic's "super-ego becomes over-severeoutside world. In both illnesses, abuses hostility considerably reduces the poor egoability to love, humiliates it and ill-treats itthis reduction is responsible for the onset of the illness. But in melancholia, threatens it the projection of hostile drives is combined with their repression. Abraham proposed a psychopathological model of psychotic depression, based on the Freudian model of paranoia, in which libidinal hatred, projected onto the outside world, reverts back onto the subject in the direst punishments" form of depressed feelings of being detested and of guilt ("New Introductory Lectures" 22.61the source of masochistic pleasure).
In "Mourning and Melancholia" (1916-1917g [1915]), Freud based his thinking on how melancholia and mourning converge. They are both triggered by the same phenomenon, namely loss. They differ in that although mourning occurs after the traditional language death of psychiatrya loved one, <i>in melancholia</i> denotes the lost object is an object of love and therefore is not truly dead. Melancholic individuals may, in some cases, know that they have lost something, but they never know what they have lost, for the loss is inaccessible to consciousness. The clinical signs of melancholia and mourning are identical, except that melancholia is accompanied by a type loss of self-esteem. Unlike people in mourning, melancholic individuals suffer from a loss involving the ego, which they describe as poor and without value. They reproach themselves but do not experience shame, for their reproaches are really directed not at themselves but at lost objects. Their egos are split: one part, the critical faculty, takes as its object another part, which is identified as the lost object by means of depressive state a narcissistic mechanism. This process implies that the object choice is narcissistic and characterized by its intensity a strong fixation on the object but a weak cathexis of it, with cathectic energy always readily withdrawn into the ego. For melancholia to occur, the object relationship must be ambivalent: hate and its responsiveness to biological antidepressant agentslove must be in contention. The experience Once love for the object has taken refuge in narcissistic identification, hatred can function against the part of the ego identified with that object. There it obtains sadistic satisfaction, as reflected in the melancholic individual's suicidal desires. Such desires result in hatred of the object being redirected back upon the self. The ambivalence, often called "mental sufferingconstitutional or associated with the circumstance of loss," is characterized by profound sadness leads to love and lack hate doing battle against one another in various parts of interest the unconscious psyche until love escapes into the ego to preserve itself and melancholia finds expression in the outside worldtypical form we are familiar with. This confrontation always ends in exhaustion, whether the unrelenting struggle with the lost object stops on its own or the object is abandoned because it is without value.  In "Melancholia brings about a form and Obsessional Neurosis" (1927a) Abraham investigated the relation between manic-depressive states and the pregenital stages of pessimism that sees libidinal organization. After clarifying the connection between sadism and anal eroticism, he divided the anal-sadistic phase into two periods. In the earliest period, the future as blocked drives obtain satisfaction by rejecting and unchangeabledestroying the object. Such pessimism During this first period the libido of the melancholic individual begins to regress. The libidinal regression does not end with the first period, however, but continues through the oral-cannibalistic stage by introjecting the lost object. This is accompanied by ideas a refusal to eat, a key indicator of guilt and unworthiness, which find expression throughmelancholic depression.Abraham concluded by listing five factors whose "interaction causes the specific clinical manifestations of melancholia." These are the constitutional reinforcement of oral eroticism in melancholics, the fixation of the libido on the oral phase of its development, the injury to infantile narcissism caused by disappointment in love from the maternal object, the overcoming of this injury prior to the control of oedipal desires, and the repetition of this primary disappointment later in the life of the subject.
== References ==
<references/>
# Abraham, Karl. (1927a). Melancholia and obsessional neurosis. In Selected papers of Karl Abraham, M.D. (Douglas Bryan and Alix Strachey, Trans.; pp. 422-432). London: Hogarth. (Original work published 1924)
# Abraham, Karl. (1927b). Notes on the psychoanalytical investigation and treatment of manic-depressive insanity and allied conditions. In Selected papers of Karl Abraham, M.D. (Douglas Bryan and Alix Strachey, Trans.; pp. 137-56). London: Hogarth. (Original work published 1911)
# Freud, Sigmund. (1916-1917g [1915]). Mourning and melancholia. SE, 14: 237-258.
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