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In this paper the author briefly reviews the history of the psychoanalytic study of manic phenomena and develops the thesis that mania and pathological euphoria in general represent a derivative of melancholia, particularly of the anxiety which accompanies depression, thus placing melancholia at the core of manic depressive psychosis. He holds that certain clinical phenomena corroborate his premise: cases when suicide occurred in the course of manic symptoms, the so-called mixed manic depressive states, cases of mania following a bereavement, and the passage from melancholia to mania in the course of electroshock therapy. Hypomania represents an outgrowth of the need to forget and deny the depression and therefore is a defensive mechanism. The transition from melancholia to mania occurs by way of the interposition of a severe state of anxiety which leads to a clouding of consciousness out of which the manic excitement proceeds. In different cases this sequence of events may take very different intervals of time to develop.
Recamier states that these concepts are confirmed by the psychological nuances of the manic symptomatology. The euphoria is not a genuine joy but rather is characterized by a state of excitement with theatrical undertones. The manic patient cannot be serious; he cannot be anything but jocular as he must deny reality. This leads to a delusional state which is the precondition for the euphoria. The considerations outlined above are valid for all cases of pathologic euphoria.