Melancholy: an elusive dimension of depression?

This paper presents a view of melancholy based on Kierkegaard's insight of the self, showing that this dimension of depression is anticipatory of threat to well-being. The view of self, contrasted with a view presuming a connection between two factors only--body and mind--has a third factor or ethico-spiritual element. Taken as an explanatory category, this factor allows for making a distinction between melancholy as crisis and melancholy as ailment, and has implication for detecting and treating the latter. That is, in the initial patient-physician dialogue, the physician might be expected to indicate whether she/he is open to consider the possibility of a third factor as an explanatory category in the formation of self-hood. Such indication would provide for patients with an inkling of their own condition, a basis for making a choice about whom they will accept as caregiver.