Winter 2008: Letter from the President

James W. Wagner, President, Emory University

Ann Borden

The Mystery of Melancholy

By James W. Wagner

In a fascinating biography titled Lincoln’s Melancholy, Joshua Wolf Shenk describes the lifelong mental affliction of the sixteenth U.S. president. Twice as a young man Lincoln seriously considered suicide in the face of existential despair. Again and again, both during his life and after, friends and even those who met him only briefly remarked on the gloom that often engulfed him, the sorrow that frequently darkened his face, the tears he sometimes wept in public. Depression seems to have been a defining characteristic of this great man.

One of the unanswerable questions, of course, is whether Lincoln would have achieved his profound wisdom without the spiritual and mental burden that drove him all his life to seek meaning and, in the end, to find it in the battle against slavery. Clearly he had extraordinary intelligence and will. But what is the relationship between genius and aberrance, between social status and mental health, and between the amelioration of symptoms and the changing of personality?

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The answers to such complex questions must themselves be fairly complex, and they require discovery in a range of fields, from psychiatry and neuroscience to social psychology, evolutionary biology, literature, and religious conceptions of identity. No doubt the answers will change from decade to decade. Advanced as our current treatments for severe depression now seem, it is easy to wonder whether our great-grandchildren will view antidepressants and electroconvulsive therapy in the same way we view treatments common in Lincoln’s day—such therapies as blood-letting, icy baths, ingestion of black pepper and mercury—all aimed at forcing “bad humor” out, but perhaps just as likely to deepen the pain.

One place where mental health might be expected to flourish is a place where “the life of the mind” is given preeminence—a university. Sadly, as far too many news accounts reveal, the gates of a campus are no safeguard against the pressures of modern life and the frailty of human spirit that often combine to unravel happiness and reason. The catastrophe at Virginia Tech last spring; past suicides on many campuses, including our own; bizarre behavior that feels threatening and leads to the exclusion of some community members—these phenomena underscore not only how vulnerable a campus is but also how mysterious is the line between mental health and mental illness.

The stigma often attached to depression has only recently begun to fade. At Emory we have sought to address this and other issues of mental health through a variety of means, from experimental approaches like deep brain stimulation, to increased resources for counseling and education, and greater mutual attentiveness as a community.

Much as a healthy focus on diet and exercise has helped to decrease heart disease, so certain practices being developed at Emory, including forms of meditation, may help to reduce depression’s impact on individuals and society.

We also have taken steps in the past year to diminish our vulnerability, enhancing procedures and systems to identify problems and to alert the community in case of emergencies. But in some ways these practical measures are the easier of the two challenges. More difficult is the job of determining what constitutes and nurtures a healthy mind—how it functions physiologically, how it responds socially, how it carries forward a historical sense of identity and personality.

Among the epidemics wreaking havoc in this first decade of the twenty-first century—AIDS, malaria, diabetes, obesity, Parkinson’s, Alzheimer’s, to name a few—the growing ravages from depression constitute grave reason for concern. What about the human condition in our day has led to an increasing prevalence of this age-old malady of the heart and mind? Even as we work to overcome the social stigma of this condition, we must focus the energies of the social and medical sciences and the humanities to help the wider world contain the epidemic and reduce the sum of human anguish.

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