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Why melancholia must be understood as distinct from depression

https://theconversation.com/back-to-black-why-melancholia-must-be-understood-as-distinct-from-depression-38025

theconversation.com

Why melancholia must be understood as distinct from depression
Melancholia has a strong genetic contribution, so it's largely biologically underpinned rather than caused by social factors (stressors) or psychological factors, such as personality style.

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Melancholic depression

  • Melancholic depression, as described by Hippocrates, was considered a unique condition that struck people out of the blue.
  • It is now known as "endogenous depression" (coming from within) and different from depression in response to external stressors.
  • In 1980, depressive disorders were remodeled as a single entity that only varies by degrees of severity.

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Sadness and depression

  • The extension of "clinical depression" to include sadness created concern. Everyone feels down or sad sometimes, and usually, these moods pass without long-term consequences.
  • Clinical depression is more severe, such as losing sleep or thinking life isn't worth living and extends for a longer period. Lumping them together and ignoring the differing causes may lead to an inappropriate therapeutic approach.
  • This model also treats melancholia as a major depression "specifier" and not as a disorder in its own right.

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Melancholia: A distinct pattern

  • Melancholia shows a clear pattern of symptoms and signs.
  • Sufferers experience a gloominess and have no desire to socialize.
  • They also lack energy and have difficulty concentrating.
  • Episodes typically appear from nowhere.

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Melancholia: Physical underpinnings

  • Individuals suffering from melancholia report a family history of "depression," bipolar disorder, or suicide.
  • Melancholy is biologically underpinned rather than caused by external stressors or psychological factors, such as personality type.
  • Treatment consists of antidepressant drugs and electroconvulsive therapy (which is rarely needed.)

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