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Melancholia (melancholic depression)

5-minute read

If you or someone you know is at immediate risk of harm from suicide, call triple zero (000). You can call Lifeline on 13 11 14 for crisis support or if you are thinking about suicide.

Key facts

  • One type of depression is sometimes known as melancholia, or melancholic depression.
  • Melancholic depression is usually severe.
  • Most people with melancholic depression experience ‘slowing down’ of their speech, thoughts and movements, together with a complete loss of enjoyment in their usual activities.
  • Melancholic depression can be successfully treated with psychotherapy, antidepressant medicines and other physical treatments such as electroconvulsive therapy (ECT).
  • Your doctor and psychiatrist can recommend the best treatment plan for you.

What is melancholia?

The word ‘melancholia’ has been used since the time of the ancient Greeks to describe feeling intensely sad and hopeless. Melancholic depression, also known as ‘major depression with melancholic features’, is usually a severe illness. It makes people lose interest in almost all activities and has other distinct physical symptoms.

What are the symptoms of melancholia?

The symptoms of melancholia are similar to the general symptoms of depression but are usually more severe. Most people with melancholia slow right down. Their movements, thoughts and speech can be very slow. Less commonly, people with melancholia can experience agitation and restlessness.

People with melancholia might also:

Symptoms are usually worse in the morning.

If you or someone you know is at immediate risk of harm from suicide, call triple zero (000). You can call Lifeline on 13 11 14 for crisis support or if you are thinking about suicide.

How will I be diagnosed with melancholia?

The first step to get help for any mental health problem is to see your doctor or a mental health professional. This includes depression with melancholic features. Your doctor may refer you to a psychiatrist for a more in-depth assessment and treatment plan.

How will I be treated for melancholia?

The treatment of depression, including melancholic depression, may involve antidepressant medicines or psychotherapy. A mental health treatment plan can help with the cost of psychotherapy.

Physical treatments such as electroconvulsive therapy (ECT) are sometimes recommended if you have severe symptoms or if other treatments for depression have failed.

Further information and support is available for the person with melancholia and for their friends and family.

Where can I get help and more information?

If you are having a personal crisis:

  • Lifeline (for anyone having a personal crisis) — call 13 11 14 or chat online, 24 hours a day
  • Suicide Call Back Service (for anyone thinking about suicide) — call 1300 659 467, 24 hours a day
  • Black Dog Institute has further information on depression and general mental health support.

If you need someone to talk to, or want to find out more, these organisations can help you:


Beyond Blue (Types of depression), Black Dog Institute (Signs and symptoms of depression), Black Dog Institute (Treatments for Depression), RANZCP (The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders), The Conversation (Back to black: why melancholia must be understood as distinct from depression)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: August 2022

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