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Essential Facts about Melancholic Depression

written by: Terrie Schultz • edited by: jen2008 • updated: 10/12/2010

Melancholic depression, or melancholia, is a type of major depression with specific characteristics. Read on to learn the symptoms and causes of melancholic depression.

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    What is Melancholic Depression?

    Depression is a mood disorder that may persist for extensive periods of time, often lasting for weeks, months, or even longer. Major depression can have a debilitating effect on the life of the sufferer. Melancholic depression is a specific subtype of major depression. It is one of the most severe types of depression and affects mood, thinking, perception and physiology. Psychosis is present in about thirty percent of those with severe melancholic depression, and individual's hospitalized for depression are often suffering from melancholia.

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    Symptoms of Melancholic Depression

    The symptoms of melancholic depression are very specific. They include:

    • A "distinct quality of mood" that differs from ordinary sadness or grief
    • Anhedonia, a state of being unable to derive pleasure or interest in things or activities that were previously enjoyable, such as food, socializing, or sexual activity
    • Substantial weight loss or anorexia, often due to lack of interest in food
    • Insomnia or sleep problems
    • Waking up early in the morning
    • Mood affected by time of day, worse in the morning
    • Strong feelings of guilt or worthlessness
    • Loss of libido

    Another specific symptom of melancholic depression is psychomotor retardation or psychomotor agitation. Psychomotor retardation appears as sluggishness, with a slowing down of speech, confusion, and impaired coordination. Psychomotor agitation, which is less common, is a state of over-activity or restlessness that may include pacing, twirling the hair, gesturing extensively, speaking incoherently, or aggression. Psychomotor agitation is not the same as the manic state that occurs in those suffering from bipolar disorder. This symptom is more common in middle aged or older individuals.

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    Causes of Melancholic Depression

    The primary factors causing melancholic depression are genetic and biological. There is frequently a family history of depression, which indicates a genetic cause is making individuals more vulnerable to the condition. While the first episodes are often triggered by a stressful event such as the loss of a loved one, subsequent bouts of melancholic depression can arise spontaneously without any apparent reason. This suggests that once the person has experienced a depressive episode, they become more susceptible to future episodes.

    Biologically, melancholic depression is believed to be caused by a chemical imbalance or malfunctioning of the neurotransmitters in the brain. Neurotransmitters are biochemicals whose function is to send and receive signals in the brain. They are released from one nerve cell, or neuron, and cross a gap called a synapse to carry a message to a neighboring neuron. In the case of melancholic depression, the neurotransmitters are not functioning properly, giving rise to an alteration in mood. Noradrenaline and dopamine are two types of neurotransmitters that are thought to be malfunctioning in cases of melancholic depression.

    While there is no absolute cure for melancholic depression, it is treatable. Individuals who have symptoms of depression should consult their doctor for diagnosis and treatment.