INVOLUTIONAL MELANCHOLIA

INVOLUTIONAL MELANCHOLIA

 There is no manic phase, no elation, in this psychosis; only severe depression. The disorder generally is associated with middle age when physical and social changes may lead a person to conclude that his or her usefulness is over. Melancholia amounts to an extreme exaggeration of normal fears about aging. It is accompanied by the danger of suicide. Other personality types also show traits somewhat similar to those of psychotics. The schizoid personality keeps to him as much as possible, is uncomfortable and nervous in company, daydreams extensively, and may find more pleasure in his fantasies than in the real world.

The paranoid personality is suspicious of other people, though not to the point of believing they are actually plotting to harm him. It is very difficult to decide at what point these personality traits begin to pass over to genuine psychosis. The psychoses mentioned above are believed by one school of psychiatrists to be functional-that is, they spring from psychological not organic causes. However, there is a growing conviction among some psychiatrists, particularly in the case of schizophrenia, that some subtle metabolic or chemical disturbance may be involved and that eventually the exact disturbance may be determined, allowing schizophrenia to be treated and perhaps even prevented through specific medical therapy.

Several mental disturbances spring directly from physical causes and are known as organic psychoses. Victims may have the same symptoms as those with functional psychoses, but their problem lies with physical damage to the brain by tumor, stroke, infection, or from other sources. The most common organic psychosis is the one that may accompany senility. Even when the basic problem is organic, there are often psycho- logical ramifications which may require treatment.