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.
