What Is Melancholic Depression?

Melancholic depression is a form of major depressive disorder (MDD) which presents with melancholic features. Although melancholic depression used to be seen as a distinct disorder, the American Psychiatric Association (APA) no longer recognizes it as a separate mental illness. Instead, melancholia is now seen as a specifier for MDD — that is, a subtype of major depressive disorder.

MDD是一种重要的心理健康状况，其特征是持久和强烈的悲伤和绝望感。该疾病会影响生活的许多领域，包括工作，学校和人际关系。它也可能影响情绪和行为以及各种身体功能，例如食欲和睡眠。患有MDD的人通常会对曾经喜欢的活动失去兴趣，并且难以度过一天。有时，他们可能还会觉得生活不值得生活。

The severity and type of MDD symptoms vary greatly from person to person. Some people experience traditional symptoms of MDD, while others develop additional syndromes, such as melancholia and catatonia. Most symptoms can be managed with treatment, which may consist of medication and talk therapy.

People with melancholic depression may experience symptoms of MDD, such as:

  • 长时间的极端悲伤感
  • loss of interest in activities that were once enjoyable
  • 缺乏能量或感到疲劳
  • feeling anxious or irritable
  • eating too much or too little
  • 睡太多或太少
  • experiencing changes in body movement (for example, jiggling your leg when you didn’t before)
  • difficulty concentrating, making decisions, and remembering things
  • thinking or talking about death or suicide
  • 自杀企图

他们也可能会遇到MDD的忧郁功能，其中包括：

  • 在所有或大多数日常活动中失去快乐
  • 对积极新闻和事件的反应不足
  • 深深的绝望和毫无价值的感觉
  • sleep disruptions
  • significant weight loss
  • persistent feeling of excessive or inappropriate guilt
  • 早晨更糟的MDD症状

在经常出现MDD症状的人中，忧郁的特征更有可能发生。在那些具有精神病特征的MDD的人中，他们也更经常看到它们。

The APA no longer recognizes melancholic depression as a distinct form of depression, and it is listed as a type of MDD. When someone shows signs of depression and melancholia, the diagnosis is “major depressive disorder with melancholic features.” To make this diagnosis, a doctor will usually ask some of the following questions:

  • 您是否难以起床并在早上开始？
  • Are your symptoms generally worse in the morning or in the evening?
  • How do you sleep?
  • Has there been a change in your sleep patterns?
  • What does a typical day look like for you?
  • 最近你的日常生活改变了吗?
  • 您喜欢曾经做过的同样的事情吗？
  • What, if anything, improves your mood?
  • Do you have more trouble concentrating than usual?

MDD通常用较新的抗抑郁药处理，例如选择性5-羟色胺再摄取抑制剂（SSRIS）。这些包括众所周知的药物，例如氟西汀（百忧解），西妥位丙酰胺（Celexa）或帕罗西汀（Paxil）。但是，许多具有MDD具有忧郁特征的人可能对较老的抗抑郁药（例如三环抗抑郁药或单胺氧化酶抑制剂（MAOI）以及5-羟色胺 - 氯肾上腺素再摄取抑制剂，例如Venlafafaxine（Effexor）（Effexor）。这些药物有助于抑制大脑中5-羟色胺和去甲肾上腺素的细分，从而导致这些“感觉好”化学物质的量更高。有时，某些非典型抗精神病药（例如Abilify（Aripiprazole））可用于增强抗抑郁药的作用。

除了药物外，talk therapyis commonly used to treat people who have MDD with melancholic features. A combination of these two treatment methods is usually more effective than either approach on its own. Talk therapy involves meeting with a therapist on a regular basis to discuss symptoms and related issues. It can show people how to:

  • adjust to a crisis or other stressful event
  • 用积极的健康代替负面信念和行为
  • 提高沟通能力
  • cope with challenges and solve problems
  • increase self-esteem
  • 恢复生活中的满足感和控制

小组疗法可以以类似的方式提供帮助，并使您能够与可以交往的人分享自己的感受。

在严重的情况下，可以进行电击疗法（ECT），以帮助缓解具有忧郁特征的MDD症状。该治疗方法涉及将电极连接到将电脉冲向大脑发送的头部，从而引发轻度癫痫发作。现在，ECT被认为是对情绪障碍和精神疾病的安全有效治疗，但围绕它仍然存在污名。结果，它不可用作忧郁症症状的主要治疗方法。但是，用药，谈话疗法和ECT的结合可能是具有忧郁特征的MDD的最佳治疗方法。

If you think someone is at immediate risk of self-harm or hurting another person:

  • 致电911或您当地的紧急号码。
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

如果您认为某人正在考虑自杀，请从危机或预防自杀热线中获得帮助。在800-273-8255尝试国家预防自杀生命线。

资料来源：民族自杀预防生命线and药物滥用和心理健康服务管理