Melancholic Depression
Melancholic depression is a subtype of major depressive disorder (MDD) characterized by a distinct set of symptoms and features.
Definition
Melancholic depression is defined as a type of depression that is marked by a loss of interest or pleasure in activities that were once enjoyed, along with a lack of response to normally pleasurable stimuli.
Symptoms
- Lack of interest or pleasure in activities
- Significant weight loss or gain
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Recurrent thoughts of death or suicidal ideation
Diagnostic Criteria
To diagnose melancholic depression, the following criteria must be met:
- The patient must have a major depressive episode
- Either a lack of interest or pleasure in activities or a lack of response to normally pleasurable stimuli must be present
- At least three of the following symptoms must be present: significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt
Treatment
Treatment for melancholic depression typically involves a combination of medication and psychotherapy.
- Medications: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs)
- Psychotherapy: cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), psychodynamic therapy
Prognosis
The prognosis for melancholic depression is generally good, with most patients responding to treatment.
However, some patients may experience a more chronic course of illness, and may require ongoing treatment to manage symptoms.
Differential Diagnosis
Melancholic depression must be differentiated from other types of depressive disorders, including:
- Major depressive disorder (MDD)
- Persistent depressive disorder (dysthymia)
- Adjustment disorder with depressed mood
Epidemiology
Melancholic depression is estimated to affect approximately 1-2% of the general population.
It is more common in women than men, and tends to occur more frequently in older adults.
Article last updated on: 28th April 2025.
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