Melancholic Depression - Discussion

Melancholic depression is one of the most severe depressive disorders or mental illnesses, and this is due to its psychotic nature.

The defining factors of this particular type of depression is a marked lack of pleasure in normally enjoyable activities, and is also accompanied by psychomotor disturbances such as low energy levels, inability to concentrate, lethargic movements, insomnia, loss of appetite and agitation.

This type of depression is relatively rare and affects a very small population; generally less than 5% in the modern West. The incidence of this disorder is equally distributed and is likely to affect as many men as women.

The spontaneous remission rate for melancholic depression is said to be very low. Treatment normally involves physical intervention via antidepressant drugs and the condition is said to be rarely cured by counseling and psychotherapy.

The warning signs, symptoms and diagnostic criteria for this type of depression, which is classified as a sub-type of major depression, include the following:

  • Loss of pleasure in most activities.
  • Mood fluctuations, and a lack of mood response to activities that are commonly perceived as enjoyable activities.
  • A consistent feeling of depressed mood (which is different from feelings of loss experienced after the death of a loved one).
  • Depression gets increasingly worse in the morning.
  • Awakening consistently about 2 hours ahead of wake time.
  • Marked slow movements and agitation.
  • Excessive and disproportionate amounts of guilt experienced.

Treatment of Melancholic Disorder

Melancholic depression does not respond well to psychotherapy and counseling, since it is a fairly severe psychotic mental disorder. Hence, treatment mainly comprises of physical intervention via drugs that involve antidepressant medications, and an extended follow up period.

Electroconvulsive therapy (ECT) or “shock treatment” is also used as a treatment modality for melancholic disorder. Under anesthesia, the patient is given a brief and very mild electric shock which lasts for a fraction of a second and is delivered to the brain through electrodes. This type of treatment is said to be quite effective for psychotic depression such as melancholic depression disorder.

Hospitalization is sometimes also required if the depression is severe and the afflicted and depressed person is feeling suicidal. As is supposed to be the case for all other forms of treatment, medical professionals will explain and discuss the advantages, possible side-effects and alternative options for treating the melancholic form of depression.

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