April 22, 2024

Melancholic Depression

Melancholic depression is a major form of depression that is often associated with Bipolar Disorder I or Bipolar Disorder II.  It is often biochemically-based and can be inherited from the patient’s parents.  Although stressful or traumatic incidents may increase the likelihood of developing it, melancholic depression can develop without these factors.

Symptoms of Melancholic Depression

The Diagnostic and Statistical Manual of Mental Disorders includes a total of eight symptoms that are common among sufferers of melancholic depression.  In general, melancholic depression seems to affect older individuals and appears in both genders in equal ratios.

To be diagnosed with melancholic depression, a patient must present four of the eight following symptoms:

Loss of Pleasure in Activities

No Reaction to a Normally Pleasant Event

These first two symptoms are related to each other.  The patient may feel a loss of pleasure in normal activities that they once enjoyed.  Before they began to experience depression they may have had a hobby or favorite pastime and as their depression worsens they begin to take less enjoyment out of it.

Likewise, if the patient experiences a normally positive or pleasant event, they may not have a reaction.  Although it may improve their mood slightly, they will revert back to their former negative outlook.  No matter what new, pleasant event occurs, the patient suffering from melancholic depression retains the same outlook on life and has little or no reaction to new occurrences.

Severely Depressed Mood

Over time, patients with melancholic depression will experience a severely depressed mood.  They may experience a sense of loneliness or unexplained sadness.  During every aspect of daily life, this outlook remains the same and is a marked contrast to their former attitude.

Wake Up Early – Unable to Return to Sleep

Depression is Worse in the Morning

Two of the symptoms are present in early morning hours.  Patients may wake up hours before the normal time and be unable to return to sleep.  Without any kind of outside influence like a loud noise or alarm, they awaken more than two hours before the normal time.  Once they are awake, they may feel an automatic sense of depression overtake them.  Patients with melancholic depression typically report that their depression is worse in the morning.

Weight Loss

Physically, a patient may show signs of weight loss.  Their overwhelming feelings of melancholy or disillusionment lead them to be disinterested in life or in eating.  Overtime, this results in a loss of weight that may appear to outsiders like anorexia.

Change in Energy Level

Patients will often exhibit one of two extremes.  On the one side of the spectrum, they may have slower movements, decreased levels of activity and a slower reaction time.  Patients on the opposite sign of the spectrum have faster movements, increased agitation and increased activity levels.  These symptoms are respectively caused psychomotor retardation and psychomotor agitation.  Although patients may alternate between the two, they normally just experience one or the other.

Excessive Guilt

Last on the list of symptoms is excessive guilt.  Patients who are experiencing Melancholic depression may suffer from inappropriate feelings of guilt.  Although these feelings of guilt are normally in response to an occurrence or situation, the intensity of guilt expressed does not correspond to the event that occurred.

Man with DepressionCauses and Risk Factors of Melancholic Depression

With melancholic depression, physical and biological factors are normally the cause.  Individuals may carry a genetic disposition toward the developing the disorder.  If the patient has had close family member, sibling or parent who has suffered from depression, the patient is more likely to develop some form of depression including melancholic depression.

Although popular culture views depression as a reaction to a life event, melancholic depression is normally more closely related to an individual’s genetics.  With this genetic disposition, individuals who have a traumatic event in their lives are more likely to suffer from depression as a result.

The genetics inherited from a person’s parents may change the way their brain’s biochemistry works.  Scientists now believe that some people have neurotransmitters that do not function correctly.  These neurotransmitters are responsible for carrying brain signals.

In a person with melancholic depression the neurotransmitters cease to carry all of the signals.  Although the brain is still somewhat of a mystery to modern science, scientist have hypothesized that the lack of the chemicals noradrenaline and dopamine are responsible for this.

This feature makes treatment of melancholia depression far different than the medicine prescribed for Non-melancholic depression.  The other forms of depression are believed to be caused by a lack of serotonin.  To treat it, doctors prescribe drugs that increase levels of serotonin in the brain.  Melancholic depression requires medication that treats either a noradrenaline or dopamine deficiency.

Age and illness can also change the way these neurotransmitters function.  Not only does illness cause a sense of pain or discomfort, certain cancers can even produce cancer.  Likewise, neurotransmitters may not function as well as an individual grows older.  As the mind ages, circuits within the brain may be disrupted and cause melancholic depression.

Treatment of Melancholic Depression

Typically, a physician will prescribe some version of an antidepressant.  Depending on an assessment of the patient’s condition, the physician may recommend a short-term or long-term course of treatment.

In combination with this, the patient may be recommended to visit a therapist or psychologist who can help treat them with cognitive behavior therapy.  Within a one-on-one setting or group, the patient will discuss their current issues and learn to develop new behavior and set goals.  They will learn how to handle interpersonal relationships and traumatic events in a positive, constructive manner.

In severe cases of melancholic depression, the patient may be prescribed electroconvulsive therapy.  Although it sounds scary this therapy has a good success rate.  This therapy involves inducing tiny seizures using a method much like electroshock.  Reserved for the most challenging cases, electroconvulsive therapy will only occur in a doctor’s office or within a hospital setting to ensure the safety of the patient.

Throughout the whole treatment process, patients can seek support from their friends and family.  Social interaction and changes in lifestyle factors have shown to improve the condition of patients and prevent relapses.

With proper treatment, a patient suffering from melancholic depression can make a complete recovery.  Afterward, they should always maintain a healthy lifestyle to prevent another incidence of melancholic depression.


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