The terminal loss of active hope - that which strives against heavy odds to affect an improvement (as distinct from wishful or magical thinking as in "in sure and certain hope of the resurrection to eternal life through our Lord Jesus Christ, " ) leads to a permanent state of low-grade, unenlightening grief, what they used to call melancholy. Now, of course, every kind of sadness is lumped into a big shapeless bag with 'depression' stamped on it.