What is Melancholic Depression?

What is Melancholic Depression?

Melancholic Depression is also known as Melancholia is a type of major depressive disorder (MDD) characterized by sadness.

This type of depression is more common in middle-aged and older adults than in children and adolescents.

This disorder affects many areas of life.

People with major depressive disorder frequently lose interest in previously appreciated activities.

They struggle to get through the day, with this kind of depression there is a complete loss of pleasure in almost everything.

Statistics show that this form of depression affects 15% to 30% of people with depression. Although this kind of depression was once considered a unique mental condition, the American Psychiatric Association (APA) no longer recognizes it as such.

Instead, melancholia is now thought to be a distinguishing feature of major depressive disorder (MDD), a subtype of major depressive illness.

Depression Therapists in Colorado

Kimberly Nefflen, LPCC

Kimberly Nefflen, LPCC

Colorado Springs, Colorado
(719) 602-1342
Heather Comensky, LPC

Heather Comensky, LPC

Aurora, Colorado
(720) 449-4121
Maria Roncalli, LPC

Maria Roncalli, LPC

Colorado Springs, Colorado
(719) 203-7021
Rebecca Johnson, LPCC, NCC

Rebecca Johnson, LPCC, NCC

Pueblo, Colorado
(719) 696-3439
Barbra Styles, LPC, LAC

Barbra Styles, LPC, LAC

Colorado Springs, Colorado
(719) 345-2424
Kelsey Maestas, LPCC

Kelsey Maestas, LPCC

Pueblo, Colorado
(719) 696-3439
Tracey Lundy, LCSW

Tracey Lundy, LCSW

Colorado Springs, Colorado
(719) 452-4374
Cassondra Chagnon, LPCC

Cassondra Chagnon, LPCC

Colorado Springs, Colorado
(719) 481-3518
Whittney Romero, MA, LPCC

Whittney Romero, MA, LPCC

(719) 345-2424
Andreea Felea, LPC

Andreea Felea, LPC

(719) 602-1342

Causes of Melancholic Depression

Melancholic depression is a result of changes in your brain and hormonal pathways. It is a genetic condition, often associated with a family history of mood disorders or suicide. In comparison to other depression subtypes, social and psychological factors rarely play a role in melancholic depression.

A person suffering from melancholy may have fewer neurons connecting to their insular (the part of the brain responsible for attention). It is a situation when the hypothalamus, adrenal glands, and pituitary glands are not functioning correctly as they should, these changes can have an impact on a person's appetite stress levels, and other factors.

Psychomotor slowness, pervasively sad mood, lack of response, and loss of interest are key characteristics. They distinguish melancholic depression from non-melancholic depression.

In this distinction, psychomotor retardation and delusional symptoms are cardinal symptoms.

Melancholic depression can lead to high-level production of Cortisol, which is a steroid hormone released by the adrenal glands when you are under stress. This, in turn, affects the proper function of your brain, metabolism, body, and appetite.

Symptoms of Melancholic Depression

People with Melancholic Depression tend to show the typical major depressive disorder (MDD) symptoms, while others develop additional syndromes including melancholia or catatonia.

  • Intense and persistent feelings of sadness and guilt
  • Fatigue
  • Feeling anxious
  • Feeling of worthlessness
  • Lack of sleep or too much sleep
  • Trouble concentrating, drawing conclusions, and retaining information
  • Lack of interest in previously enjoyable activities
  • Suicide thoughts and attempts.

Signs to Watch Out For

Symptoms and signs of Melancholic depression tend to be worse in the morning, when there is less sunlight, on shorter days and when the temperature is low.
  • Changes in body movement include; slowed movement of your head, limbs, and jiggling of the leg
  • Weight loss
  • Changes in speech, such as speaking at varying volumes or halting when speaking.
  • Frequently touching your body or face
  • The hunched posture.
  • Musculoskeletal pains
  • Postpartum depression or sadness that occurs shortly after childbirth, can also cause melancholy symptoms. Melancholic and non-melancholic depression have significantly different appearances.

How Can I Get Rid of Melancholic Depression?

Melancholic Depression is treated in different ways, it involves a combination of meditation and therapy.

Treatment, which may include medication and talk therapy, can help with the majority of symptoms.

By Antidepressant

Melancholia is often better treated with older medications (MAOIs and TCAs) than with newer ones (SSRIs). The older medications, on the other hand, have a high number of adverse effects. Individuals who require medication should consult with a mental health practitioner to discuss the benefits and drawbacks of each drug.

Psychiatrists can prescribe antidepressants such as.
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Paroxetine (Paxil)
  • Fluoxetine
  • Monoamine Oxidase Inhibitors (MAOIs)
  • Serotonin-norepinephrine reuptake inhibitors
  • Citalopram

By Therapy

Therapy is commonly employed in conjunction with medicine to treat melancholia. In most cases, combining these two therapy modalities is more beneficial than each approach alone.

Physiotherapy or talk therapy is regular meetings with a therapist to discuss symptoms and related difficulties. With physiotherapy, a person would learn to recognize when their guilt or shame is out of control. They can learn to challenge negative thinking with more balanced viewpoints with effort.

Physiotherapy or talk therapy can help show one how to:

  • Cope and manage challenges when they arise.
  • Increase your ability to communicate.
  • Respond to a crisis.
  • Alter unhelpful thoughts and habits with positive and healthy ones.
Group therapy may also benefit someone with melancholic depression. A person can talk with others who have the same problem in group therapy. Group therapy can provide emotional support to someone who has separated themselves due to depression.

Electroconvulsive Therapy

In some cases to assist reduce symptoms of MDD with melancholy aspects, Electroconvulsive Therapy (ECT) may be used. In severe cases of depression that have failed to respond to previous therapies, doctors may utilize electroconvulsive therapy (ECT). 

They may also utilize electroconvulsive therapy (ECT) on seniors who have had a negative reaction to medicines. ECT is now a lot safer than it was previously due to modern studies. However, because of the possibility of memory-related side effects, many experts only prescribe it as a last resort.

According to Mental Health America, a technique known as Cranial Electrotherapy Stimulation (CES) may one day take the role of ECT. Unlike ECT, CES can be performed without the assistance of a doctor.

However, for major depression disorder (MDD) with melancholic depression, a combination of medication, talk therapy, and ECT may be the most effective treatment.

Alternative treatments, such as acupuncture, may be used by someone suffering from melancholic depression. 


Because melancholic depression is marked by deep emotions of melancholy, loss of pleasure, and a lack of interest or pleasure in activities, it can have a significant impact on a person's ability to operate in so many areas of life.

If you feel you could be suffering from melancholic depression, you will need to go see a doctor.


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June 21st, 2024

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