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Re: Melancholia

Posted by ginny on May 1, 2000, at 16:33:10

In reply to Melancholia, posted by Ginny on April 27, 2000, at 20:51:48

> What is melancholia? Is there any difference between melancholia and depression?

There may not be another human being on this board interested in this topic, but here are a couple of paragraphs ripped from the Merck Manual on the topic of melancholia versus atypical depression. I had thought that maybe melancholia is a particularly crippling subcategory of depression, but I conclude from this reading that melancholia is garden variety unipolar depression with no obvious external cause.

Incidentally, does anyone know where a connoisseur of wretchedness could find a DSM IV on the web?

Anyhow, here is the Merck murk:

Melancholia (formerly endogenous depression) has a qualitatively distinct clinical picture, characterized by marked psychomotor slowing (of thinking and activity) or agitation (eg, restlessness, wringing of the hands, pressure of speech), weight loss, irrational guilt, and loss of the capacity to experience pleasure. Mood and activity vary diurnally, with a nadir in the morning. Most melancholic patients complain of difficulty falling asleep, multiple arousals, and insomnia in the middle of the night or early morning. Sexual desire is often diminished or lost. Amenorrhea can occur. Anorexia and weight loss may lead to emaciation and secondary disturbances in electrolyte balance.

In atypical depression, reverse vegetative features dominate the clinical presentation; they include anxious-phobic symptoms, evening worsening, initial insomnia, hypersomnia that often extends into the day, and hyperphagia with weight gain. Unlike patients with melancholia, those with atypical depression show mood brightening to potentially positive events but often crash into a paralyzing depression with the slightest adversity. Atypical depressive and bipolar II disorders overlap considerably.




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