Why anguish?

Topography of depressive experiences. A dialectic approach

This article aims to offer clinical descriptions and philosophical interpretations of the ontological nature of depressive experiences trying to address issues related to the contemporary diagnostic paradigm and values-based practices which shape clinical decisions. At the core of this contribution there is the idea that the variety of depressive experiences might be understood acknowledging the qualitative difference in the ontology underlying each form of depression. We argue that there is a fundamental difference between melancholia as a disease and those melancholic traits which characterizes human existence as such: while the former indicates a qualitative alteration of the global human experience, constituting psychopathological experience, the latter describes a style of disproportion of existence not pathological per se at all. Moreover, we defend the hypothesis that melancholia (in a medical sense) is a distinct unity of mental alteration, and should not be conflated with the multivarious kind of experiences merged under the name of depression, the variety of which may be understood as disorders of the personal development. It is in this context that the leading element of anthropological disproportions impact the role of pre-reflective and transcendental structures, polarizing the self and the world in a three-way topography: 1. depression as an excessive symmetric proportion between self and world; 2. depression as a disproportion between the self and the world (detriment of the self); 3. depressions as impoverishment of the transcendental value of the world.