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
- Older people
- Inpatients
- Those who experience psychotic features

