Several chapters describe the author's everyday interactions with family, friends, and coworkers. These sections serve to show the earnest, sincere, hardworking, and habitually successful nature of this patient and her husband. There is no character flaw, maladaptive habit, or stressful event at the root of melancholia. For example, the author describes a medical examination as an adolescent in which she felt humiliated, and there was no behavioral disturbance at the time. If such an event were to cause melancholia, we psychiatrists would be overwhelmed with patients suffering from this type of depression, but we are not. The author also puzzles over causality, particularly that her brother's horrific experience pulling burned bodies from rubble at the Pentagon following the September 11, 2001, terrorist attacks did not precipitate a depressive episode (p. 199). Indeed, one of her sisters suffers from early-onset recurrent melancholia.