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Melancholic depression is a subtype of major depressive disorder, which comes with its own set of characteristics. While there is no consensus yet among mental health practitioners on whether it is different or just a part of depression, one thing is clear: it is an extremely concerning mental health condition.
Around 30 percent of Americans faced elevated depressive symptoms in 2021 according to a study published in The Lancet Regional Health—America, in which individuals were in low moods regularly and faced difficulties in completing their day-to-day tasks. Among them, researchers speculate that around 25 to 30 percent suffer from melancholic depression, which is also known as melancholy.
Melancholic depression has been shown to cause changes to the brain that other forms of depression do not. These include changes to sensory processing, mood regulation, decision making, and empathy.
Signs and Symptoms of Melacholic Depression
Melancholic depression has many of the same signs and symptoms as depression, but there are a few key differences. Melancholy is more common among men who are 40 and above.
Melancholy causes people to have lower moods and difficulties with sleep than regular depression. These individuals need to force themselves to get out of bed and start their day. They do not have regular sleep hours and get up earlier in the mornings than usual when they face a low mood.
Melacholic people cannot maintain their standard of performance at work. They struggle with completing the study requirements at school or tasks at home. They are not able to connect deeply with the people around them. Feeling excessively and disproportionately guilty is common.
Melancholic depression leads to a lack of enthusiasm when hearing positive news and activities that brought joy earlier do not seem quite the same. People with melancholic depression often make statements of despair, which are not about grief or loss that they have experienced but are instead about their own situation.
Individuals who are melancholic suffer from musco-skeletal pain quite often and also physical restlessness. They have a low appetite, which causes unintentional weight loss. They are unable to concentrate for long on tasks at hand and cannot receive new information with alertness.
A unique symptom of melancholic depression is the persistence of nonreactive moods or indifference toward any positive news that they receive, even if directly connected to them.
Causes for Melancholic Depression
Melancholy is caused by several factors and mental health practitioners have not been able to narrow it down to one specific cause. Genetic predisposition, previous trauma, changes to the brain, and hormonal imbalance are all factors that can lead to melancholy. Melancholic depression causes individuals to have less effective connections between parts of the brain that are related to concentration and attention.
Melancholic depression has been shown to be more common among those who have a genetic predisposition as a result of having family members who have had mood disorders.
Trauma in the form of negative life events or life stressors may be another possible cause of melanchology in an individual. More often than not, they also have a genetic predisposition and face various traumas.
Elevated cortisol levels in the bloodstream have been linked to melancholic depression. The interaction of the three parts of the endocrine system, adrenal glands, pitutary glands, and hypothalmus causes the increase in cortisol levels.
Changes in seasonal weather, such as falling temperatures and low amounts of sunlight, have been shown to be additional precipitating factors.
Treatment for Melancholic Depression
Melancholy has a specific type of treatment plan as it does not respond to medication used for other types of depression. Therapy is a part of the treatment, and it involves changing negative behaviors and beliefs. It also allows the individual to find new and healthy ways to cope with their problems linked to depression.
Individuals underdoing therapy for melancholic depression need tools to adjust to their problems irrespective of the cause. They learn to identify the causes of their mental anguish while setting short-term and long-term goals that give them a greater sense of control over circumstances.
Medications are absolutely vital to the treatment plan and are prescribed by either a physician or a psychiatrist. Medications effective for melancholy include Selective Serotonin Reuptake Inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOIs), Norepinephrine Reuptake Inhibitors (NDRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), and new antidepressants.
Electroconvulsive therapy has been shown to have a positive effect on those suffering from melancholy and the treatment involves passing electrical impulses through the brain to trigger small, brief seizures. The treatment is administered over a period of a few weeks over 6 to 12 sessions.
Conclusion
Although melancholic depression is a serious medical issue, there is hope for those who suffer from the condition. The first step toward treatment involves the individual accepting that they have a problem and seeking professional help.
Setting reasonable goals, seeking information about melancholy, using stress management techniques, and taking care of themselves help individuals overcome the debilitating effects and move to living a normal life.
Steve Verghese is a trained psychologist with an MSc in Counseling Psychology from the Indian Institute of Psychology and Research.
