Melancholic Depression – Symptoms, Diagnosis, and Treatment

Kurt Goodwin

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Living Hope PsychiatryLiving Hope Psychiatry

Melancholic depression is a major depressive disorder (MDD) that manifests with melancholy characteristics.

Even though melancholy sadness used to be considered a unique mental disease, the American Psychiatric Association (APA) no longer recognizes it.

Instead, melancholia is currently considered a distinguishing characteristic of MDD, a subtype of major depressive illness.

MDD is a severe mental health disorder marked by feelings of despair and hopelessness that are continuous and severe for an extended period.

The illness may hurt many aspects of one's life, including employment, education, and interpersonal relationships.

It may also affect one's attitude and conduct and various bodily processes such as food and sleep. As a result, people suffering from MDD often lose interest in things they used to like and have difficulty getting through the day.

They may also get the impression that life isn't worth living sometimes.

The degree and kind of symptoms associated with MDD vary widely from person to person.

MDD manifests itself in different ways in different individuals. Some persons suffer typical symptoms, while others acquire new disorders such as melancholia.

Better treatment can control most symptoms with treatment, including medication and talk therapy.

Melancholic depression Manifestation

People who suffer from melancholic depression may exhibit signs of MDD, such as the following:

  • A failure to respond positively to good news and occurrences
  • A sense of being nervous or irritated
  • A substantial reduction in body weight
  • Difficulties focusing, making judgments, remembering things thinking or speaking about dying or suicide attempt attempting to commit suicide
  • Disruptions to one's sleep
  • Eating much or too little, sleeping too much or too little, experiencing changes in bodily movement (for example, jiggling your leg when you didn't use to), and other symptoms.
  • For an extended time, you may experience persistent acute melancholy.
  • Lack of enjoyment in all of one's everyday activities
  • MDD symptoms such as a continuous sense of uncontrolled guilt, worse in the mornings, are common.
  • Sentiments of hopelessness and unworthiness on a profound level
  • Weary or lacking energy and losing interest in once pleasurable things

Melancholic Depression Diagnosis

A person suffering from depression and melancholia is diagnosed with "major depressive disorder with melancholic characteristics," which is a kind of depression. To make this determination, a doctor will often ask one or more of the following points:

  • Is starting your day in the morning a real struggle?
  • What time of day are you most likely to have a flare-up?
  • What are your sleeping habits?
  • What has happened to your sleeping habits?
  • How would you describe a typical day in your life?
  • Is there anything new in your day-to-day routine?
  • Do you still feel excited about the things you used to?
  • When you're feeling down, what do you do?
  • Is it more difficult for you to focus than usual?

Melancholic Depression Treatment          

The treatment of MDD is often accomplished by using newer antidepressants, such as selective serotonin reuptake inhibitors (SSRIs).

Well-known drugs such as fluoxetine (Prozac), citalopram (Celexa), and paroxetine (Paxil) are included in this category (Paxil).

The older antidepressants, such as tricyclic antidepressants or monoamine oxidase inhibitors (MAOIs) and serotonin-norepinephrine reuptake inhibitors, such as venlafaxine, may, on the other hand, be more effective in treating MDD with melancholy symptoms (Effexor). It results in increased levels of these "feel good" chemicals in the body and the brain.

Sometimes, atypical antipsychotics like Abilify (aripiprazole) are used to enhance the benefits of antidepressants, such as in the case of schizophrenia.

In addition to medicine, talk therapy is often used to treat persons who suffer from MDD with melancholy aspects, according to the American Psychological Association. A combination of these two therapy approaches is often more beneficial than each option used on its own in most cases. It is common for people to see their therapist frequently to address their symptoms and other difficulties.

It may instruct individuals on how to:

  • Respond to a crisis or other stressful situations; replace negative ideas and actions with positive, healthy ones. Replace negative beliefs and behaviors with good, healthy ones.
  • Boost your communication abilities
  • Overcome obstacles and find solutions to issues
  • Boost one's self-esteem, reclaim one's feeling of fulfillment and control over one's life

Group therapy may be beneficial similarly since it allows you to express your thoughts with others who understand your situation.

Either electroconvulsive treatment (ECT) or cognitive behavioral therapy (CBT) may be used to reduce the symptoms of MDD with melancholy aspects in severe instances.

As part of this therapy plan, it is necessary to connect electrodes to the skull so that electrical impulses may be sent to the brain, resulting in minor seizures.

Although electroconvulsive therapy (ECT) is now widely accepted as a safe and efficient treatment for mood disorders and mental diseases, it still has a negative connotation.

The medication may thus not be utilized as the primary therapy for symptoms of melancholia due to this limitation. Combining medicine, talk therapy, and electroconvulsive therapy (ECT) may be the most effective treatment for MDD with melancholy aspects.

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