Dürer, Depression, and Melencolia

Abstract

INTRODUCTION Albrecht Durer (1471-1528) was a prolific Renaissance printmaker and painter from Nuremberg, Germany. Of the many artistic works that he created, none has stimulated as much reflection and interpretation as his engraving entitled Melencolia I. The term “melancholy” dates back to the ancient theory of humorism, which postulated that a person’s health and temperament were controlled by the four body humors of black bile, yellow bile, phlegm, and blood. An overabundance of black bile was believed to cause excessive moodiness and inward reflection, characteristics similar to what we would call depression today. The word melancholy (melencolia being the archaic spelling) is a combination of the Greek words “melano” (black) and “chole” (bile). The central focus of this work is a despondent winged figure, her head resting on her hand as if its weight were too heavy to bear. The hair is tangled and her appearance unkempt. An emaciated-looking dog is curled at her feet while scattered about are various idled tools of creativity such as the caliper she holds in her hands. Over her right shoulder a downcast, scribbling cherub keeps vigil. Directly above her head an hourglass shows the sands of time quickly running out. The “magic” square next to the hourglass contains various numbers which add up to 34 in all directions. The two bottom center numbers, 15 and 14, reflect the date of the work — 1514. The seven-rung ladder in the background is commonly thought to be an allegorical reference to the seven metals of the ancient tradition of alchemy, with the large polyhedron at the bottom representing the base metal lead. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), melancholia is described as a more severe form of depression, characterized by both a pervasive loss of interest or pleasure and an inability to respond to pleasurable stimuli. The World Health Organization calls depression the leading cause of disability worldwide and in 2000 ranked it as the fourth highest contributor to the global burden of disease.1 Although depression is one of the most common disorders encountered in primary care, studies indicate that the illness continues to be significantly underdiagnosed and undertreated.2 Durer’s forlorn angel is an artistic and vivid reminder of the severe morbidity associated with depression, a disorder that today can generally be successfully managed if it is properly diagnosed and treated.