Every note should be savored, "as if one wanted to suck melancholy out of every single one, with voluptuousness and pleasure," the 60-year-old Brahms said about one of his late piano pieces. The composer's openly admitted melancholy stimulated his creativity – and yet repeatedly threatened to turn into depressive episodes. The sad mood, which in the so-called four-juice theory was explained by an excess of black bile, has made an astonishing career in European cultural history, especially in art history – from Albrecht Dürer to W. G. Sebald. But what does it mean in a medical context? What does modern psychotherapy have to say about the cult of melancholy in literature, art and music?