Students of language learn delightful words for which no good English equivalent exists: sehnsucht (German), poshlost (Russian), or duende (Spanish); rich bottomlands of human experience—good and bad—left inexplicably fallow by Anglo-Saxons. Even when stolen wholesale into English, such words are like the Elgin marbles: mysterious though denuded of context, at once beautiful and broken. A simple, one sentence English definition of such a word must be assumed incomplete, if not plain wrong.

To any list of untranslatables, add acedia, from the Greek akedia (without + care or grief), toward which the English “accidie” gestured in Chaucer’s time, but no longer.

For Evagrius Ponticus, a late fourth century monk and ascetic, acedia was the most troublesome of the eight bad thoughts to which spiritual solitaries are prone: a listlessness and inability to work, pray, rejoice or rest leading to discouragement, abandonment of community and, ultimately, despair. It puffs up with thoughts of accomplishments to come, then crushes with unmet expectations, making the whole enterprise appear worthless illusion, a fool’s errand.

In the West, acedia was soon folded into the sin of sloth, thereafter taking a long, complicated path to near-oblivion. A rising bourgeoisie reduced “sloth” to mere laziness while Romantics celebrated the painful torpor of acedia as an ideal state for poetic inspiration. Monks and theologians still speak of acedia, but in secular discourse, it’s little more than an obsolete term for depression. As in so many things, we moderns know less than our forebears.

Kathleen Norris’ Acedia and Me: A Marriage, Monks, and a Writer’s Life, is one of several recent attempts to return acedia to (at least) a corner the public square. If you’ve ever grappled with “the noonday demon” or deadened your creative gifts through withering self-critique, I recommend it.

Early in her book, Norris quotes medical historian Bill Bynum, “there is an often repeated trajectory in medical history, from sin through crime and vice, ending in disease.” At the hospital where I work, this is cause for celebration, another triumph of scientific progress over religious obscurantism.

Indeed, there is much to commend the reconfiguration of mental illness as illness rather than moral failure. Equally commendable are recent discoveries in the physical and biochemical correlates of mental illness. The medical treatments resulting from these advances have transformed many lives and literally saved others. In my various roles as doctor and patient, I know a little about what antidepressants and the like can and can’t do.

The temptation though, as with so many things in science and its applications, is to wield Occam’s razor less like a philosopher and more like Sweeney Todd. One only has to consider the words of Evagrius or Kathleen Norris to know there’s more to acedia than depression. And there’s more to depression than neurotransmitters; of that I’m sure.

To crib from the twentieth century philosopher, Ludwig Wittgenstein, monasticism and psychiatry (along with the latter’s sibling, popular psychology) developed very different “language games.” Words of each tradition—even some that look and sound identical—defy translation, in part because these traditions learn and use words differently in pursuit of different goods and ends.

This is not the place to rehearse the histories of these traditions or why one discourse has apparently triumphed. Nor need I ask when was the last time you heard a major news source quote one of the desert fathers, if your local bookstore carries Monasticism Today, or how often you’ve seen a television commercial telling sad and listless watchers to ask their doctor about Evagrius’ Praktikos. It’s rare—if not downright astonishing—when someone like Paul McHugh, MD, the former Director of Psychiatry at Johns Hopkins University, comes out and says:

Psychiatry is a rudimentary medical art. It lacks easy access to proof of its proposals even as it deals with disorders of the most complex features of human life—mind and behavior. Yet, probably because of the earlier examples of Freud and Jung, a belief persists that psychiatrists are entitled to special privileges-that they know the secret of human nature-and thus can venture beyond their clinic-based competencies to instruct on non-medical matters: interpreting literature, counseling the electorate, prescribing for the millennium.

Even when psychiatry limits its instruction to what sounds like its rightful domain, it often leverages what’s known or possible beyond proportion. To cite just one example, psychiatrist Peter Kramer’s book, Listening to Prozac, argues that the new antidepressants might be used to change not only mood, but personality itself. (Whether Kramer thought this was a good thing or not is unclear; his book has been variously interpreted.)

That’s precisely what led Carl Elliott, a philosophically-minded physician, to write Better than Well: American Medicine Meets the American Dream. Those interested in sampling this debate might read their dueling essays: Elliott’s “Pursued by Happiness and Beaten Senseless” and Kramer’s “The Valorization of Sadness.”

Yet even when Elliott, whose work I very much admire, counters Kramer by describing the varieties of alienated experience, I can’t help but think there are words better suited to his task.

Trouble is, of course, those words don’t translate. Not only are there no pills for acedia (the desert fathers—and mothers!—recommend work and the patient cultivation of joy and gratitude), the word itself is out of place in a conversation about selective serotonin reuptake inhibitors. Like parallel lines stretching to infinity, there is no point of intersection.

Yet even in the twenty-first century, there are some—like Kathleen Norris—who ponder the mystery of acedia and struggle to re-clothe it in proper context. She won’t be making any pharmaceutical commercials or chatting with Dr. Phil. She doesn’t speak the language—so much the better! She’s taken on contrarian’s task, I suppose, but eminently worthy, and I’m grateful for her example.