Mental Health Friday 2023-06-23
On Mental Health Friday, we post, in alphabetical order, one per week, information on mental health disorders. Mental Health Friday is for informational purposes only, and is in no way meant to diagnose, treat or cure any disease. Please do not self diagnose and seek professional help for what ails you.
Link: FindTreatment.gov is an online source of information for persons seeking substance use and/or mental health treatment facilities in the United States or U.S. Territories.
Melancholia
By Editorial Team
Melancholia, also referred to as melancholic depression or simply melancholy, is a psychological condition characterized by profound and persistent feelings of sadness, hopelessness, and a general loss of interest or pleasure in daily activities. It is considered a subtype of major depressive disorder (MDD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Symptoms and Diagnostic Criteria:
Melancholia shares many symptoms with major depressive disorder, but it is distinguished by a specific set of features that are typically more severe. These include:
Persistent depressed mood: Melancholic individuals experience a deep and pervasive sadness that lasts most of the day, nearly every day.
Anhedonia: A diminished or complete lack of interest or pleasure in activities that were once enjoyable.
Psychomotor disturbances: These can manifest as either psychomotor retardation (slowed movements, speech, and overall physical activity) or psychomotor agitation (restlessness, pacing, and fidgeting).
Feelings of guilt or worthlessness: Melancholic individuals often harbor intense self-blame, excessive guilt, or a strong sense of inadequacy.
Changes in appetite and weight: There may be a significant decrease or increase in appetite leading to weight loss or weight gain.
Sleep disturbances: Insomnia is common, particularly early morning awakening, but hypersomnia (excessive sleepiness) may also occur.
Loss of energy or fatigue: A constant feeling of being tired and lacking energy.
Difficulty concentrating: Problems with focus, memory, and decision-making are prevalent.
Suicidal thoughts: Melancholia may increase the risk of suicidal ideation or suicide attempts.
To be diagnosed with melancholia, an individual must exhibit at least one of the first three symptoms along with at least four other depressive symptoms for a duration of at least two weeks.
Biological Factors:
Melancholia is associated with various biological factors:
Neurotransmitter imbalances: Imbalances in neurotransmitters such as serotonin, norepinephrine, and dopamine are often observed in individuals with melancholia. These imbalances can disrupt mood regulation and contribute to depressive symptoms.
Hormonal dysregulation: Abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress response, have been found in melancholic depression. Elevated levels of cortisol, the primary stress hormone, are often present.
Genetic predisposition: There is evidence that melancholia can run in families, suggesting a genetic component. Specific genes related to neurotransmitter functioning and stress response have been implicated.
Psychological Factors:
Various psychological factors contribute to the development and maintenance of melancholia:
Negative cognitive patterns: Melancholic individuals tend to have distorted thinking patterns characterized by pessimism, self-blame, and a focus on negative experiences.
Personality traits: Certain personality traits, such as high levels of neuroticism or introversion, are associated with a higher risk of developing melancholia.
Early life experiences: Traumatic events, adverse childhood experiences, or chronic stress can increase vulnerability to depression, including melancholia.
Treatment Options:
Melancholia often requires a combination of treatments, including:
Psychotherapy: Different forms of therapy, such as cognitive-behavioral therapy (CBT) and psychodynamic therapy, can help individuals identify and challenge negative thought patterns, develop coping strategies, and work through underlying emotional issues.
Medication: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs), may be prescribed to alleviate depressive symptoms. In some cases, electroconvulsive therapy (ECT) may be considered.
Hospitalization: Severe cases of melancholia, especially those involving high suicide risk, may require hospitalization to provide a safe and supportive environment and intensive treatment.
It’s important to note that melancholia can significantly impact an individual’s daily functioning, relationships, and overall quality of life. Seeking professional help from a mental health provider is crucial for proper diagnosis, treatment planning, and support.