Philosopher Soren Kierkegaard, in his Sickness Unto Death (1849), suggested that despair could be understood as comprising three stages: Spiritlessness, which applies to those who outwardly seem well-adjusted and successful yet inwardly live in a state of deep and perilous despair; despair in weakness and despair about weakness, which has to do with a refusal to become authentically and fully one’s self and the existential guilt (what Sartre called mauvaise foi or “bad faith”) of this cowardly refusal to move forward and frustrating inability to retreat back to their former identity; and, thirdly, the despair of defiance, which pertains to the capacity of despair to turn, sometimes quite suddenly, to elation, excitement, optimism, enthusiasm, hypomania or mania and frenetic creative activity as so often seen in extremis during the manic phase of bipolar disorder.

on “clinical despair”

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