ABSTRACT
We have seen that in the stupors unhappy situation may produce in the mentally unstable a regression with loss of energy and, as the regressive ideas are not combatted but accepted, a reaction of apathy. The mental content of the patients shows preoccupation with death, and to a less extent autoerotic practices and “spoiled-child” behaviour. Quite similar, even identical, regressions seem to take place in the Involution Melancholias, but the loss of energy seems to have, as a rule, more physical basis (senescence) than in the stupors, while the regressive ideas are not accepted and the struggle against them results in a clinical picture contrasting markedly, as a rule, with that of stupor. The essential difference is concerned with the disparity in age between the two groups. The stupor patients are the youngest of our manic depressive cases, while the melancholia reaction belongs more to the advancing years of life. A young person can play with the idea of death, but the instinct of self preservation is alert to defend the individual against what is a real and imminent danger in the later years of life. This is why essentially the same ideas may lead to quite different reactions at different age periods. So, instead of death ideas and autoeristism being accepted with apathy, reduction of mentation and onanistic practices, the melancholics usually react with dramatic fear of being killed, compensatory physical activity and hypochondria. It is our problem now to demonstate these processes and trace their evolution.
