A depressed person being tormented by sinister spectres. Print from 1788.

Rosina Honnerlag-Zellweger (1746–1828) was no stranger to mental suffering as she lived with her husband, Doctor Bartholome, in a house adjoining a private clinic for the mentally ill. Yet she herself repeatedly struggled with an ‘anxious affliction’, for which she sought advice by letter from a pastor she did not know, whose book of consolation had always given her strength.

Portrait of Rosina Honnerlag-Zellweger who lived with her husband at the Sonnenhof psychiatric clinic in Trogen.

In this passage, she clearly describes a depressive episode: “(…) a dark despondency took hold of me so severely that I did not enjoy a single joyful moment for nearly 3 months. Yet this gloom was not a doubt in God’s grace (…) but very painful thoughts, or rather a melancholic delusion that followed me day and night and never left me alone, even during prayer (…).”

One of the words Rosina Honnerlag-Zellweger used to describe her affliction was ‘melancholy’. This term was very common from the 16th century onwards. It could denote a slightly negative mood, a longing for past times or places, or else a full-blown illness that incapacitated people and even drove them to break a great taboo and end their own life.

‘Melencolia I’, produced in 1514, is one of Albrecht Dürer’s three master engravings. The complex symbolism still remains something of a mystery.

In the centuries pre-dating modern psychiatry, melancholic people were described in many different ways, using terms such as sad, morose and lonely, but also anxious and distrustful. Those who suffered from this condition also exhibited a pensive side, excessive irritability, and were described as agitated and as having an exaggerated sensibility. They could show an exuberant imagination, but also in the worst case, obsession. However, melancholy was not a diagnosis as it was not necessarily deemed an ailment or a form of insanity.

People who were deemed melancholic were often treated with helplessness and misunderstanding by those around them. This is why sufferers often tried to hide their condition. We can see this in the letters written by Rosina Honnerlag-Zellweger: “I endured this state (of dark melancholy) as silently as possible (…). I also feared that someone would discover it, would not believe my complaints, because I knew well that afflictions of this kind receive less sympathy and compassion among people who have never experienced similar fates than physical or other types of suffering (…)!”

For a long time, people did not even entertain the possibility of medical treatment for melancholy as it was seen more as a theological or pastoral issue. So the terms used to describe it in the 16th century were still quite vague; often “insanity” was cited as a cause of suicide, for example, or that someone was not “in their right mind” – or the act was explained by the fact that the devil had led someone so far into temptation that they had sacrificed their life.

This image from 1731 shows melancholy and other conditions inflicted on people by the devil.

Many authors picked up on the theme of melancholy in the 17th century. Yet still this depressive state was not interpreted as an illness, but as a theological challenge. It was thought that the devil was tempting sufferers to test their faith.

The right treatment was therefore obvious: diligent prayer, seeking solace in the word of God, and obtaining spiritual counsel. These attacks by the devil were described as hidden agonies of the soul, which were more severe than physical pain; however, some people also embraced them as a test from God. Many books of consolation were published to help people in this fight by comforting doubters and strengthening their faith. They were essentially preaching in book form.

A particularly popular one was by Otto Casmann written in 1612, whose title set out exactly what it promised: “Comfort, peace, and joy of the melancholic conscience; or an inward and very comforting address and exhortation in the person of Jesus Christ, to all melancholic, sorrowful, penitent Christian hearts”.

Rosina Honnerlag-Zellweger also sought solace in book form, which she found in the Handbibel für Leidende, a moving collection of spiritual reflections and meditations inspired by the book of Psalms, written by Johann Kaspar Lavater.

As early as the 17th century, however, isolated cases showed that not all scholars saw melancholy as the work of the devil. Doctors increasingly published their diagnoses of this state. For example, Basel city physician Felix Platter compiled a clear classification of mood disorders for the first time in his collection of medical records in 1614. He viewed mental illnesses not as demonic, but as natural phenomena and believed that a scientific medical explanation had to be sought for patients suffering from melancholy. The dissertation, published in Basel in 1615 by Baptist Pestalozzi, also took the view that melancholy was due to an imbalance in the humours and could therefore be treated medically.

Medicine at that time was holistic in the truest sense of the word: mind, body and soul were seen as an inextricable whole and any illnesses or conditions had to be treated accordingly. In the chapter on illnesses that affect the mind focusing on melancholy, Bernese doctor Johann Friedrich von Herrenschwand described in 1788 how melancholy manifests itself. It involved a person being completely consumed by a fixed idea. The book recommended that the patient first undergo bloodletting, and then take laxatives, bathe, and follow a light diet.

These practices were thought to help as they “brought about a purging”. According to the ancient practice of humorism, melancholy was associated with black bile. It was considered one of four basic temperaments and was caused by, among other things, thickened blood and constipation. The origin of the term ‘melancholy’ is derived from this as the Greek word for black is melas, and for bile is cholé.

Humorism attributed a person’s health and character to the balance of the four humours or bodily fluids. An imbalance was thought to cause illnesses and psychological traits.

The recommended medical treatment can therefore be seen as a sort of cleansing ritual – but rather than purging the devil, this was about drawing tainted humours from the blood and intestines. Nothing was thought to be more beneficial than diluting melancholy. At the same time, support for the soul remained important: Doctor von Herrenschwand advised moderate exercise and said that one should try “to subtly amuse and distract sufferers in various ways without them noticing the intention and to seek to dissuade them from the idea they are consumed by, either through reason or through benevolent ruse.”

Over the course of the 18th century, the medical interpretation of this affliction started to take hold, yet treatment by doctors remained uncommon. Those with serious mental illness were usually left to fend for themselves or to be cared for by their families. If someone was admitted to a monastery, hospital or even to prison, no efforts were made to actually cure them. The sick were shut away from society, usually by the authorities. Family members therefore tried to hide such afflictions as the conditions in hospitals were invariably precarious and dismal.

‘Melancholia’, painted by Domenico Fetti, circa 1615.

Unfortunately there were also always people who were broken by their inner torment and who chose to end their own lives. Back in the 16th century, the reasons for suicides were only documented in exceptional cases. Only from the mid-17th century did speculation regarding the reasons for suicide crop up in official documents. They mostly referred to mental confusion, economic difficulties, religious despair or family disputes. The contemporary word ‘sui-cide’ shows how people who took their own lives were seen: in Christian teaching, this act is a grave sin, as the person is interfering with God’s plan and sinfully determining the length of their life.

These battles are also evident in the letters written by Rosina Honnerlag-Zellweger: “The thought that plagues me the most is that the delusion will lead me to take my own life. (…) In short, the emotional state has taken hold, and no remedy can help; on the contrary, I’ve often noticed that the more I try to fight these thoughts, the more they follow me!”

‘The Melancholic Temperament’, engraving produced in 1566.

The sin of suicide was punished in the reinforcement of the taboo by not allowing the deceased to be laid to rest in the sacred earth of the cemetery, and therefore not being able to be resurrected at the end of time according to the Christian belief system. The dead were denied a proper burial. Instead, their bodies were burned, packed in barrels and thrown into rivers, or buried in the wilderness or on land belonging to relatives.

Exceptions were increasingly made, however, for example if someone had lived a particularly God-fearing life up to that point, or if they had been repentant in their hour of death. Yet the directives from on high were clear: even if someone who had taken their own life got a burial, it would not be officially announced, and it would take place at an unusual time – for example on a Sunday or in the dark – without any singing or bell-ringing, and without a sermon.

It was no longer the act itself that was punished, but the intention – and it was up to the authorities to decide whether the act had been committed sacrilegiously or in a state of mental anguish. It is therefore unsurprising that family members often did everything they could to protect their dead relatives from the shame of suicide by removing obvious signs of the act, or by insisting to the authorities how devout the person had always been and how out of character it was for them to do such a thing. The authorities often yielded and a sympathetic understanding increasingly prevailed.

Rosina Honnerlag-Zellweger’s letters show the extent to which melancholy could shatter people’s lives – and how, in the early modern period, this affliction sat between religious interpretation, medical explanation and social taboo.

Nicole Billeter

A history of the melancholic mind