The Signs and Causes of Melancholy
Richard Baxter
(Church Minister)
1670 AD

1. In 1670 AD, Richard Baxter, Church Minister, took the view that insanity and depression were caused by life circumstances, moral choices and sins of an individual, that induced bad "melancholy blood". Although his etiology is humoral, it important to realize that he believed that sin and emotion actually were the foundational cause of melancholy blood, which then caused insanity! 1. sin. 2. bad blood. 3 insanity. "Root and Foundation, is usually a Depravation of the Mass of Blood, which is the Vehicle of the Spirits, and that is usually accompanied with some Diseases of the Stomach, Spleen, Liver" First on his list of causes of melancholy was: "SINFUL Impatience, Discontents and Cares, proceeding from a Sinful Love of some bodily Interest, and from want of sufficient Submission to the will of God, and Trust in him, and taking Heaven for a satisfying Portion. This is one of the most common Causes". He then goes on to list things like: "when they are in Debt to others", "the secret Root or Cause of all this, is the worst Part of the Sin, which is too much Love to the Body and this World". He also identifies high self esteem and a lack of contentment as a cause: "not sufficiently humbled for our Sin, or else we should be thankful for the lowest State, as being much better than that which we deserved". He also identifies cognitive dissonance (bad conscience) as a trigger of insanity: "great Cause is the Guilt of some great and wilful Sin, when Conscience is convinced, and yet the Soul is not converted". His cure of insanity was to repent: "repent, to love God and your Neighbour, to live soberly, righteously and godly, to pray at all; here you must strive, and not excuse it by any Backwardness; for it is that which must needs be done, or you are lost". Although he believed typical Hypocrites junk medicine, he attributed depression and mental illness to freewill choices as the primary cause, which in turn cause the blood to become melancholy. So the real problem lay in fixing the mind, not the body! Repentance, he believed, would correct the melancholy blood and restore the person to normal. (The Signs and Causes of Melancholy, Richard Baxter, 1670 AD)
2. RICHARD BAXTER (1615-91 The Signs and Causes of Melancholy. With Directions Suited to the Case of those who are Afflicted with it. Collected out of the Works of Mr. Richard Baxter, For the Sake of Those, who are Wounded in Spirit. By Samuel Clifford, Minister of the Gospel (1716), A: pp. 1-4, B: pp. 32-38, C: pp. 79-85. Baxter was born in Shropshire and was originally a member of the Established Church, being made a deacon by the Bishop of Worcester in 1638. During the Civil War he became an army chaplain with the Puritans, though his role during the Commonwealth was restricted by ill health to preaching and writing. He left the Established Church after the Act of Uniformity in 1662, and in 1685 was imprisoned for publishing a sedition. A Nonconformist divine of immense reputation and learning, he wrote some two hundred works, out of which his follower Samuel Clifford collected the extracts that make up The Signs and Causes of Melancholy. Like his fellow divine Timothy Rogers, Baxter has two distinct perspectives on melancholy, or 'trouble of mind'. One is his conviction of the absolute reality of the suffering, his awareness of the rootedness of mental illness in the individuality of one's thought patterns, one's everyday existence, one's social circle and sense of self. The other is his equally firm acceptance of the great movements of sin and virtue, the sway between God and the devil, as worked out through human affairs. If therefore, Baxter takes sufferers seriously, following their intricate currents of thought and feeling, he also standardises the kinds and stages of their suffering in terms of a predisposed interpretation of what they signify. If the first tendency serves to address the individuality of the melancholiac, the second, equally important, acts as reassurance against such a sense of universal isolation, of being abandoned by God, as Hannah Allen describes. Like Rogers, too, Baxter is careful to keep a focus on the social context of melancholy, and on the responsibility to be acknowledged by others for the welfare and restoration of the sufferer, developing thereby the force of a religious community in fostering and enabling God's work. The first extract below is Baxter's opening chapter on 'The Nature of Melancholy', in which he attempts to bring together the physiological and the spiritual factors behind the illness. Extract B is part of his chapter on 'The Causes of Melancholy' while the final passage is taken from the long series of advices that constitute Chapter IV, 'Directions to the Melancholy'." (Patterns of Madness in the Eighteenth Century, A Reader, Allan Ingram, 1998 AD, p 44)

THE Disease called Melancholy is formally in the Spirits, whose Distemper unfits them for their Office in 'Serving the Imagination, Understanding, Memory and Affections; so that by their Distemper the thinking Faculty is Diseased; and becomes like an inflamed Eye, or a Foot that is sprained or out of Joynt, disabled for its proper Work.

THE matter which is the Root and Foundation, is usually a Depravation of the Mass of Blood, which is the Vehicle of the Spirits, and that is usually accompanied with some Diseases of the Stomach, Spleen, Liver or other Parts, which are for the due Concoction, Motion and Purification of the Blood, which Diseases are so various, that they are seldom the same in many Persons, and hardly known to the Wisest Physicians.

SUCH a black distinct Humour called Melancholy, which hath of old been accused, is rarely, if ever found in any, unless you will call either Blood, or excrementitious Humours by that Name, which are grown black by Mortification, for want of Motion and Spirits: But the Blood it self may be called Melancholy Blood, when it hath contracted that Distemper and Pravity by Feculency, Sluggishness or Adustion, which disposeth it to the Melancholy Effects.

BUT sometimes Persons that are suddenly cast into Melancholy by a Fright, or by the Death of a Friend, or by some great Loss or Cross, or some sad Tidings even in an Hour; which shews that it cometh not always from any Humour called Melancholy, nor from any foregoing Disease at all.

BUT the very Act of the mind doth suddenly disorder the Passions, and disturb the Spirits, and the disturbed Spirits in time vitiate the Blood, which containeth them, and the vitiated Blood doth in time vitiate the Viscera, and Parts which it passeth through, and so the Disease beginning in the Senses and Soul, doth draw first the Spirits, and then the Humours, and then the Parts into the Fellowship, and Soul and Body are Sick together.

WITH some their Melancholy being raised by Crosses or Distemper of Body, or some other Occasion, doth afterwards bring in Trouble of Conscience, as its Companion. With others, Trouble of Mind, is their first Trouble, which long hanging on them, at last doth bring the Body also into a Melancholy Habit: And then Trouble increaseth Melancholy, and Melancholy again increaseth Trouble, and so round.

I do not call those Melancholy, who are rationally sorrowful for Sin, and sensible of their Misery, and Solicitous about their Recovery and Salvation, tho' it be with as great Seriousness as the Faculties can bear, as long as they have sound Reason, and the Imagination, Fantasie or Thinking Faculty, is not Crazed or Diseased: But by Melancholy I mean, this Diseased Craziness, Hurt or Error of the Imagination, and consequently of the understanding...

HAVING in the foregoing Chapter shewed the Signs of Melancholy, we shall next proceed to speak of the Causes thereof, which are,

I. SINFUL Impatience, Discontents and Cares, proceeding from a Sinful Love of some bodily Interest, and from want of sufficient Submission to the will of God, and Trust in him, and taking Heaven for a satisfying Portion. This is one of the most common Causes.

I must necessarily use all these words to shew the true Nature of this complicate Disease of Souls. The Names tell you that it is a Conjunction, of many Sins, which in themselves are of no small malignity; and were they the Predominant Bent and Habit of Heart and Life, they would be the signs of a graceless State: But while they are hated and overcome not Grace, but our Heavenly Portion is more esteemed, and chosen, and sought, than earthly Prosperity, the mercy of God through Christ doth pardon it; and will at last deliver us from all. But yet it beseemeth, even a pardoned Sinner to know the Greatness of his Sin, that he may not favour it, nor be unthankful for Forgiveness. I will therefore distinctly open the Parts of this Sin, which bringeth many into dismal Melancholy.

IT is presupposed that God trieth his Servants in this Life, with manifold Afflictions, and Christ will have us bear the Cross and follow him in submis-sive Patience. Some are tried with painful Diseases, and some with wrongs by Enemies, and some with the unkindness of Friends; and some with Slanders, and some with Persecution, and many with Losses, Disappointments and Poverty.

1. AND here Impatience is the Beginning of the working of the Sinful Malady. Our Natures are all too regardful of the Interest of the Flesh, and too weak in bearing heavy Burdens; and Poverty hath these Trials, which full and wealthy Persons that feel them not, too little Pity; especially in two Cases.

1. WHEN Men have not themselves only, but Wives and Children in want to quiet.

2. AND when they are in Debt to others, which is an heavy Burden to an Ingenious Mind; tho' Thievish Borrowers make too light of it. In these Straits and Trials Persons are apt to be too sensible and Impatient, when Creditors are calling for their Debts, and they have it not to pay them, it's hard to keep all this from going too near their Heart, and hard to bear it with obedient quiet Submission to God; especially for Women, whose Nature is weak, and liable to too much Passion.

2. AND this Impatience turneth to a settled Discontent and Unquietness of Spirit, which affecteth the Body it self, and lieth all Day, as a Load, or continual Trouble at the Heart.

3. AND Impatience and Discontent do set the Thoughts on the Rack, with Grief and continual Cares, how to be eased of the troubling Cause; they can scarce think of any thing else; and these Cares do even feed upon the Heart, and are to the Mind as a consuming Feaver to the

4. AND the secret Root or Cause of all this, is the worst Part of the Sin, which is too much Love to the Body and this World. Were nothing over-loved, it would have no Power to Torment us; if Ease and Health were not over-loved, Pain and Sickness would be the more Tolerable; if Children and Friends were not over-loved, the Death of them would not overwhelm us with immoderate Sorrow; if the Body was not over-loved, and worldly Wealth and Prosperity over-valued, it were easie to endure hard Fare and Labour, and Want, not only of Superfluities and Conveniences, but even of that which is necessary to Health, yea, or Life it self, if God will have it so, at least to avoid Vexations, Discontents and Cares, and inordinate Grief and Trouble of Mind.

5. THERE is yet more Sin in the Root of all, and that is, it sheweth that our Wills are yet too Selfish and not subdued to a due Submission to the Will of God; but we would be as Gods to our selves, and be at our own Chusing, and must needs have what the Flesh desireth: We want a due Resignation of our selves, and all our Concerns to God, and Live not as Children in due Dependence on him for our daily Bread, but must needs be keepers of our own Provision.

6. AND this sheweth that we are not sufficiently humbled for our Sin, or else we should be thankful for the lowest State, as being much better than that which we deserved.

7. AND there is apparently much Distrust of God, and Unbelief in these troubling Discontents and Cares; could we trust God as well as our selves; or as we could trust a faithful Friend, or as a Child can trust his Father, how quiet would our Minds be in the Sense of his Wisdom, All-sufficiency and Love ....

II. ANOTHER great Cause is the Guilt of some great and wilful Sin, when Conscience is convinced, and yet the Soul is not converted; Sin is beloved and yet feared: Gods wrath does terrifie them; and yet not enough to over-come their Sin: Some live in secret Fraud and Robbery, and many in Drunkenness, in secret Fleshy Lusts, either self-Pollution or Fornication, and they know that for such things, the wrath of God cometh on the Children of Disobedience;1 and yet the Rage of Appetite and Lust prevaileth, and they despair and Sin, and if God convert these Persons, the Sins which they now Live in, may possibly hereafter plunge their Souls into such Depths of Sorrow, in the Review, as may swallow them up. And when Men truly converted, yet dally with the Bait, and renew the wounds of their Consciences by their Lapses, it is no wonder if their Sorrows and Terrors are renewed. Grievous Sins have fastened so on the Consciences of many, as to cast them into incurable Melancholy and Distraction.

Direct. 6. BE most in those Duties which you are best able to bear: Which with most is Prayer with others, Hearing and good Discourse. As a Sick Man whose Stomach is against other Meats, must Eat of that which he can Eat of. And God hath provided variety of Meats, that one may do the Work, when the other are wanting.

THEY who are not able to be much in solitary Thoughtfulness, without Confusions and distracting suggestions, and hurrying vexatious Thoughts, must set themselves for the most part to those Duties, which are to be done in Company by the help of others; and must be very little in solitary Duties: For to them whose natural Faculties are so weak, it is no Duty, as being no means to do them the desired good; but while they strive to do that which they are naturally unable to endure, they will but confound and distract themselves, and make themselves unable for those other Duties, which yet they are not utterly unfit for. To such Persons therefore instead of much Time in secret Thoughtfulness, it must suffice that they be brief in secret Prayer, and take up with such occasional abrupter Meditations, as they are capable of, and that they be the more in Reading, hearing Conferences, and Praying and Praising God with others.

DO not misunderstand me: In Cases of absolute necessity, I say again, you must strive to do it, what ever come of it. If you are backward to believe, to repent, to love God and your Neighbour, to live soberly, righteously and godly, to pray at all; here you must strive, and not excuse it by any Backwardness; for it is that which must needs be done, or you are lost.

BUT a Man that cannot read, may be saved without his Reading, as a Man in Prison or Sickness, may be saved without hearing the Word, and without the Church Communion of Saints: And so a Man disabled by Melancholy, may be saved by shorter Thoughts and Ejaculations, without set and long Meditations, and secret Prayers: And other Duties which he is able for, will supply the want of these.

Direct. 7. AVOID all unnecessary Solitariness, and he as much as possible in honest cheerful Company. You have need of others, and are not sufficient for your selves: And God will use and honour others as his hands, to deliver us his Blessings. Solitariness is to those that are fit for it, an excellent Season for Meditation and converse with God and with our Hearts: But to you it is the Season of Temptation and Danger. If Satan tempted Christ himself, when he had him Fasting and solitary in a Wilderness, much more will he take this as his Opportunity against you. Solitude is the Season of Musings and Thoughtfulness, which are the things you must flee from, if you would not be deprived of all.

NOT that I would have you as the foolish Sinners of the World do, to drink away Melancholy, and keep Company with sensual vain and unprofitable Persons, that will draw you deeper into Sin, and so make your Wound greater instead of Healing it, and multiply your Troubles when you are forced to look back on your sinful loss of Time: But keep Company with the more cheerful Sort of the Godly. There is no Mirth like the Mirth of Believers, which Faith doth fetch from the Blood of Christ, and from the promises of the Word, and from experience of Mercy, and from the serious fore-apprehensions of our Everlasting Blessedness. Converse with Men of strongest Faith, that have this heavenly Mirth, and can speak experimentally of the Joy of the Holy Ghost; and these will be a great Help to the reviving of your Spirits, and changing your Melancholy Habit so far as without a Physician it may be expected. Yet sometimes it may not be amiss to confer with some that are in your own Case, that you may see that your Condition is not singular. For Melancholy People in such Distresses are ready to think, that never any was in the Case that they are in, or at least never any that were truly godly: When you hear People of the most upright Lives, and that truly fear God, to have the same complaints as you have your selves, it may give you hopes that it is not so bad as you before did imagine.

Direct. 8. WHEN Blasphemous or disturbing Thoughts look in or fruitless Musings; presently meet them, and use that Authority of Reason, which is left you to cast them and command them out. If you have not lost it, Reason and the Will have a command over the Thoughts, as well as over the Tongue, or Hands or Feet. And as you would be ashamed to run up and down, or fight with your Hands and say, I cannot help it: So should you be ashamed to let your Thoughts run at random or on hurtful Things, and say I cannot help it: Do you do the best you can to help it? Cannot you bid them be gone? Cannot you turn your Thoughts to something else? Or cannot you rouze up your self and shake them off? Some by casting a little cold Water in their own Faces, or bidding another do it, can rouze them from Melancholy musings as from Sleep.

OR if you can no otherwise command and turn away your Thoughts, rise up and go into some Company, or to some Employment which will divert you, and take them up. Tell me what you would do, if you heard a Scold in the Street reviling you, or heard an atheist talk against God, would you stand still to hear them, or would you talk it out again with them, or rather go from them, and disdain to hear them, or debate the Case with such as they. Do you the like in your Case: When Satan casts in ugly or despairing or murmuring Thoughts, go away from them to some other Thoughts or Business. If you cannot do this of your self, tell your Friend when the Temptation cometh, and it is his Duty who hath the Cure of you, to divert you with some other Talk, or Works, or force you into diverting Company. Yet be not too much troubled at the Temptation, for trouble of Mind doth keep the evil matter in your Memory, and so increase it, as Pain of a Sore draws the Blood and Spirits to the Place. And this is the design of Satan, to give you troubling Thoughts, and then to cause more by being troubled at those, and so for one thought and Trouble to cause another, and so on as Waves in the Sea, do follow one another.

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