What is Melancholic Depression?

This video describes melancholic depression. When we talk about melancholic depression and we look at the DSM, we can see that what we're really speaking of is a specifier named “with melancholic features.” This specifier can be assigned to several different disorders including major depressive disorder, persistent depressive disorder, and bipolar disorder. Melancholic depression is not a distinct diagnostic classification, rather a specifier we see with other disorders. In order for an individual to have that specifier assigned to a primary diagnosis, they'd have to meet the full criteria for that diagnosis and then additional criteria for the ‘with melancholic features” specifier. The most severe part of the current major depressive episode is what we're looking at to apply the symptom criteria. The criteria are divided into two parts: A and B. For Criterion A, one of two symptoms is required: loss of pleasure in all or almost all activities and a lack of reactivity to stimuli that would usually be pleasurable. Criterion B contains six symptoms and at least three are required. Number one is a depressed mood characterized by profound despondency or despair. Number two is depression that is worse in the morning. Number three is early morning awakening. Number four is marked psychomotor agitation or retardation. We oftentimes see this one endorsed when someone has melancholic depression. Number five is significant weight loss or anorexia. Number six is inappropriate or excessive guilt. There are specific characteristics that are associated with melancholic depression outside of what we see in the symptom criteria. We know that melancholic depression is more likely to occur in individuals who are having a severe major depressive episode. It's also more likely to occur in inpatient populations as opposed to outpatient. Individuals with melancholic depression were more likely to have a trauma history. The concept of melancholic depression is not without controversy. It's been studied for quite a bit of time and it's been assigned a number of names throughout the different research studies that have been published about it including: melancholia, psychotic depression, typical depression, and endogenous depression, autonomous depression, and core depression.