La mort ne vous concerne ni mort ni vif : vif parce que vous êtes ; mort parce que vous n'êtes plus.

Anne-Louis Girodet de Roussy-Trioson. Funéirailles d'Atala. 1808

Depression, most people know, used to be termed ‘‘melancholia’’. . . Melancholia would still appear to be a far more apt and evocative word for the blacker forms of the disorder, but it was usurped by a noun with a bland tonality and lacking any magisterial presence, used indiVerently to describe an economic decline or a rut in the ground, a true wimp of a word for such a major illness . . .

The Swiss-born psychiatrist Adolf Meyer had a tin ear for the finer rhythms of English and therefore was unaware of the semantic damage he had inflicted by oVering ‘‘depression’’ as a descriptive noun for such a dreadful and raging disease. Nonetheless, for over seventy-five years the word has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.

A scientific classification of behavior disorders is still an unreachable goal. The eVorts in the past two centuries are reminiscent of the many attempts to bring order into the universe of plants and animals before the singular rules of Linnaeus and Mendel allowed meaningful classifications to emerge. The maladaptive variations in human mood, thought, and motor behavior observed over the millennia oVer a myriad of images that have captured the attention of one observer or another who attempted to formulate these observations into an understandable framework. More organized systems emerged at the end of the Eighteenth Century with the attentions of German and French physicians.

The classifications often lacked a central thesis and, for the most part, clinicians have been attracted by one aspect of behavior or another, allowing the behaviors to be classified by the dominant symptom or presumed etiology. Patients have been lumped or split into classes or described as categories or continua according to idiosyncratic opinions.