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Melancholic Depression : Causes, Symptoms, Treatment, Diagnosis

What is Melancholic Depression?

Melancholic depression is a type of mental health condition or severe depression. According to the American Psychological Association, melancholia is a type of depression.(1)

Melancholic depression is a form of major depressive disorder that has melancholic features. It is characterized by intense and continuous feelings of sadness and hopelessness. It can affect life in many areas including work, school, and relationships. It is known to alter mood and behavior.

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People with melancholic depression lose interest in activities and have trouble getting through the day.

The severity of melancholic depression varies in individuals. Most people experience the main symptoms of melancholic depression while others may additionally have catatonia.

Causes of Melancholic Depression

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The start of the episode of melancholic depression is not caused by a specific event. There is no improvement in the mood even if anything good happens. The exact cause of depression is not known but genetics, family history, past trauma, and brain chemistry are known to play a role.(2)

A neuroimaging study found a signature marker that was found only in people with melancholic depression and was not present in those with non-melancholic depression.(4)

Symptoms of Melancholic Depression

The symptoms experienced by people with melancholic depression include:

  • Anxiousness and irritability
  • Lack of interest in activities they once enjoyed
  • Persistent feeling of sadness
  • Excessive sleeping or sleeping very less
  • Lack of energy and feeling of fatigue
  • Eating either too much or too little
  • Suicidal attempts
  • Thinking about death
  • Difficulty in concentrating on work, making important decisions, and remembering things
  • Changes in body movements
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There may be feeling of melancholia including:

  • Lack of pleasure in most or all of the daily activities
  • Significant weight loss
  • Sleep disruption
  • Feeling of worthlessness
  • Excessive guilt
  • Worsening of the symptoms of melancholic depression in the morning

The melancholic features mostly are seen in people who frequently experience severe symptoms of depression.

How is Melancholic Depression Diagnosed?

Melancholic depression is listed as a type of major depressive disorder. Therefore, if the symptoms of depression and melancholia are seen in people, the following is enquired:

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  • Does a person have difficulty getting out of bed and getting started
  • Are the symptoms worse in the morning
  • Has the sleeping pattern changed
  • Has the daily routine changed
  • Does a person enjoy things he used to earlier
  • Is there anything that improves mood
  • Has the daily routine changed
  • Is there difficulty in concentrating

Certain blood tests are ordered by the doctor to rule out other causes of depression. The tests include:

  • Vitamin D
  • Free thyroxine
  • Toxins
  • Thyroid-stimulating hormone

Treatment of Melancholic Depression

Melancholic depression is treated with antidepressants. These medications inhibit the breakdown of serotonin and norepinephrine in the brain, which results in a higher amount of feel-good chemicals. Antipsychotics are also used to augment the effects of antidepressants.

Apart from medications, talk therapy is also used in the treatment of depression with melancholic symptoms.

Talk therapy involves meeting the therapist and discussing the symptoms and related issues. It can be helpful in:

  • Adjusting to a crisis or stressful event
  • Putting in positive beliefs and replacing the negative ones
  • Increasing self-esteem
  • Improving communicating skills
  • Regaining a sense of satisfaction and control

Group therapy is another similar way that can be helpful in giving a person a chance to share feelings with people who can relate.

Electroconvulsive therapy is performed to relieve symptoms of melancholic depression. It involves attaching electrodes that send multiple impulses to the brain, triggering a mild seizure. It is considered a safe and effective treatment for depression.

A combination of medication, talk therapy, and electroconvulsive therapy can be best to treat melancholic depression.

Coping with Depression

As melancholic depression is characterized by feelings of sadness, lack of interest, and loss of pleasure, it can affect many areas of life. It is important to speak with a doctor and talk about the symptoms in detail.

Medication and various therapies help in coping with melancholic depression, there are also a few ways the effect of these interventions can be enhanced.

Lifestyle modifications can be helpful in improving mood. These include: (3)

Melancholic depression may make the above listed activities difficult, but as the medications start showing the effect it would be easier to incorporate these changes into the lifestyle.

Melancholic depression can affect work, school, and home life. There are effective treatments that can help a person overcome the feeling related to it. Anyone with feelings of depression should go for a doctor’s advice and get treated accordingly.

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