Melancholic depression

Melancholic Depression

Melancholic depression, also known as depression with melancholic features, is a subtype of clinical depression recognized in both the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and Fifth Edition (DSM-5).

Definition

Melancholic depression is characterized by a severe form of depression where many of the physical symptoms of depression are present. One of the key features of melancholic depression is the patient's lack of response to pleasurable activities. Patients typically exhibit a depressed mood that is distinctly different from the kind of feeling experienced following the death of a loved one.

A person displaying signs of melancholic depression.

Diagnostic Criteria

According to the DSM-IV and DSM-5, for a diagnosis of melancholic depression, the patient must exhibit a loss of pleasure in all or almost all activities, a failure to react to usually pleasurable stimuli or a mood that does not significantly brighten in response to positive events, along with at least three of the following:

• A distinct quality of depressed mood characterized by profound despondency, despair, and/or moroseness or by lack of mood reactivity
• Depression that is regularly worse in the morning
• Early morning awakening (at least two hours before the usual time)
• Marked psychomotor retardation or agitation
• Significant anorexia or weight loss
• Excessive or inappropriate guilt

Etiology

The exact cause of melancholic depression is not fully understood, but it's believed to be more biologically based than other forms of depression. It may involve abnormalities in the function of brain circuits or pathways that regulate mood and the circadian rhythm.

Treatment

Treatment for melancholic depression often involves a combination of antidepressant medications and psychotherapy. In some cases, especially when the depression is severe and not responsive to other treatments, electroconvulsive therapy (ECT) may be considered.

Prognosis

With appropriate treatment, individuals with melancholic depression can achieve significant improvement. However, due to the severe nature of the condition, long-term management may be necessary to prevent relapse.

See Also

• Major depressive disorder
• Bipolar disorder
• Psychiatry
• DSM-5

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