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Melancholia (depression with melancholic features)

3-minute read

Many people experience depression, but depression affects people differently. One type of depression is sometimes known as melancholia, or melancholic depression.

What is melancholia?

The word ‘melancholia’ was used from the time of the ancient Greeks to describe feeling intensely sad and hopeless. Melancholic depression is usually a severe illness. It makes people lose interest in almost all activities and has other distinct symptoms.

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. However, it can also go the other way and these things can speed up.

People with melancholia might also:

  • be very down and flat, especially in the morning
  • show very little emotional expression or response
  • lose their appetite and lose weight
  • sleep badly and wake early in the morning
  • have trouble concentrating and remembering things
  • have strong feelings of hopelessness or guilt
  • think about suicide

Diagnosis of melancholia

The first step to getting a diagnosis of depression, including depression with melancholic features, is to see a doctor or mental health professional. The doctor may refer the person to a psychiatrist for a more in-depth assessment.

Treatment of melancholia

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

A treatment called electroconvulsive therapy (ECT) is sometimes recommended when other treatments for depression have failed. Some people with melancholia find it keeps coming back. Further information and support is available for the person with melancholia and for their friends and family.

Where to get help and more information

If you are having a personal crisis:

  • Lifeline (anyone having a personal crisis) - call 13 11 14 or chat online, 24 hours a day
  • Suicide Call Back Service (anyone thinking about suicide) - call 1300 659 467, 24 hours a day

If you want general mental health support and information, the Black Dog Institute has further information on depression.

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

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Last reviewed: April 2020

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