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The affect corresponding to melancholia is mourning or grief—that is, longing for something that is lost.
SIGMUND FREUD1
In this chapter, in which I indicate how I approach the large and controversial field of depressive disorder,2 we broaden the canvas temporarily to take account of losses due to causes other than death.
First, let us consider in what ways a person who is sad, and perhaps temporarily depressed, differs psychologically from someone who is chronically depressed or perhaps diagnosed as suffering from a depressive disorder.
Sadness is a normal and healthy response to any misfortune. Most, if not all, more intense episodes of sadness are elicited by the loss, or expected loss, either of a loved person or else of familiar and loved places or of social roles. A sad person knows who (or what) he has lost and yearns for his (or its) return. Furthermore, he is likely to turn for help and comfort to some trusted companion and somewhere in his mind to believe that with time and assistance he will be able to re-establish himself, if only in some small measure. Despite great sadness hope may still be present. Should a sad person find no one helpful to whom he can turn, his hope will surely diminish; but it does not necessarily disappear. To re-establish