What is Melancholic Depression? Symptoms, Causes, Treatment

Melancholia is a form of depression that impacts roundabout 15% to 30% of people with a depressive episode. Today, we’ll discuss what is melancholic depression; its symptoms, causes, and treatment.

What is Melancholic Depression? 

Melancholic depression is a type of MDD (major depressive disorder) presenting the features of melancholia or melancholic. It is important to mention here that melancholic depression used to be a separate category and distinct disorder. However, APA (American Psychological Association) doesn’t identify it as a distinct mental condition. Nowadays, experts consider melancholia as a subcategory of MDD (major depressive disorder) and a specifier of MDD.

Speaking of MDD, it is a significant mental illness characterized by strong and persistent feelings of hopelessness and sadness. The condition impacts various areas of your daily life like relationships, school, and work. It would affect your behavior and mood along with various other physical functions like sleep and appetite. Often, people with MDD don’t have an interest in their routine life activities that used to be enjoyable, and now they find it difficult to finish the day. Occasionally, they also feel that life is not worth living.

The type and severity of MDD symptoms are different for different people. Some people exhibit the symptoms of conventional or traditional MDD; others would develop the additional symptoms of catatonia and melancholia. You can manage its symptoms with proper treatment of talk therapy and medication.

Symptoms of Melancholic Depression 

People with melancholic depression would exhibit the following symptoms of MDD like;

  • Suicide attempt
  • Talking or thinking about suicide and death
  • Finding it difficult to remember things, make a decision, or concentrate
  • Experiencing the changes in body movements like jiggling legs
  • Sleeping too little or too much
  • Eating too little or too much
  • Irritable or anxious feelings
  • Feeling fatigued or lower energy
  • Losing interest in such activities that you used to enjoy
  • Feelings of extreme sadness persistently over time

Some of the melancholic symptoms of MDD are as follows;

  • Aggravating symptoms of MDD in the morning
  • Feelings of inappropriate and intense guilt persistently
  • Losing weight significantly
  • Disruption in sleep
  • Worthlessness and despair feelings
  • Low reaction to the positive events and news
  • Losing pleasures in the daily routine activities

The symptoms of melancholia would occur among people that frequently exhibit the symptoms of severe MDD episodes. Often, it happens among people that have MDD conditions with psychotic features.

Causes of Melancholic Depression 

Researchers believe that hormonal changes and changes in the brain play a major role in developing melancholia. It is because the adrenal glands, pituitary glands, and hypothalamus are not working correctly. However, such glands release chemicals that manage appetite and stress. You can call the pathway HPA (hypothalamic-pituitary-adrenal) axis.

In melancholia, your body has a high level of a steroid hormone called cortisol; adrenal glands develop it when you’re under a lot of stress. The HPA axis manages it; and it influences various areas of your body like memory, metabolism, and appetite.

Neurons are those that make changes in the brain signals; the signals impact how you react to your surrounding environment.

Diagnosis of Melancholic Depression 

The mental health professional or the doctor would diagnose melancholia by studying the symptoms of the patients. Since APA doesn’t consider melancholia a distinct and a separate condition and considers it as a subtype of MDD. In order to diagnose melancholic depression, the doctor would ask the following questions;

  • Having difficulty focusing and concentrating more than usual
  • If anything is improving your mood
  • Enjoying the same thing that you already did it
  • Change in your daily routine
  • The typical and casual day looks like to you
  • Change in your sleep pattern
  • Your sleeping routine
  • The symptoms are aggravating in the morning or evening
  • Having trouble getting out of bed in the morning  

Treatment of Melancholic Depression 


Doctors usually prescribe the following medicines to treat the symptoms of melancholic depression;

  • Venlafaxine
  • SNRIs
  • Monoamine oxidase inhibitors (MAOIs) as antidepressants
  • Abilify (aripiprazole)

The medicines stop the norepinephrine and serotonin level in the brain, and it amplifies “feeling good” chemicals in the brain.


Talk therapy is a common treatment method for people with melancholic depression. Usually, therapists apply the integration of two or more treatment methods (medicines and therapy) for better results. You have to meet with the therapist regularly at the scheduled time. The focus of the therapeutic treatment is on the following;

  • Regaining control in your life and a sense of satisfaction
  • Higher self-esteem
  • Solving the problems and coping with the challenges
  • Improving your communication skill
  • Replacing negative behaviors and beliefs with positive ones
  • Adjusting to the crisis and other stressful situations

Conclusion: What is Melancholic Depression? Symptoms, Causes, Treatment 

After an in-depth study of what is melancholic depression; its symptoms, causes, and treatment; we have realized that melancholia could badly disturb your routine life. If you’re experiencing its symptoms, then you should consult with the therapist and work on a treatment plan.