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dysthymia, melancholia

Posted by Elizabeth on June 5, 1999, at 13:28:24

In reply to Re: MAOIs--JD, Eliz, Dysthymia, posted by JD on June 4, 1999, at 8:43:28

I've been reading a book, _Dysthymia and the Spectrum of Chronic Depressions_, that I wholeheartedly recommend. It goes into all the different forms that chronic depression can take - sometimes it manifests as life-long low energy and disinterest, other times as chronic rejection-sensitivity and irritability. Dysthymics usually don't show the prominent "vegetative" (somatic) symptoms that you see in major depression, though I think that chronic sleep problems are probably common.

Usually there's at least some degree of mood reactivity (ability to be cheered up when good things happen) in chronic depression, whereas total anhedonia is the main defining feature of melancholia. FWIW, the other symptoms and associated features of melancholic depression (besides the general features of major depression that we all know and love :-P) are: waking up early in the morning ("terminal" insomnia - a rather scary-sounding name!), loss of appetite,
guilt (culture-bound?) or self-reproach, feeling worst first thing in the morning, and psychomotor changes (appearing slowed-down or agitated). It responds well to tricyclics and ECT, possibly not as well to SSRIs (although I wonder if high-dose SSRIs have been tested).

> As for numerous postings, I'm hardly one to talk, though typically I'm shooting off my amateur-psychopharmacologist mouth to people like you to offset my own multiple frustrations over meds.

You're a kindred spirit, JD.




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