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What Is Melancholia?


Updated June 15, 2014

Question: What Is Melancholia?
Answer: Melancholia is a profound presentation of depression. With this form of depression, there is a complete loss of pleasure in all or almost everything. The start of these episodes is usually not caused by a specific event, and even when something good happens, the individual's mood does not improve, not even for a short time. Melancholic features can be associated with a major depressive episode of Major Depression or Bipolar Disorder I and II.

Possible Presentations:
(at least three of these symptoms must be present for a diagnosis by DSM criteria)

  • A distinct depressed mood - one is not simply sad or down due to a life event such as the death of a loved one
  • Depression is consistently worse in the morning
  • Early morning waking - at least two hours earlier than normal
  • Psychomotor disturbances - either retardation (slowing of normal movement) or agitation
  • Anorexia or weight loss
  • Excessive or inappropriate guilt
People at increased risk for melancholia:
  • Older people
  • Inpatients
  • Those who experience psychotic features
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