This severe depression affects people who have difficulty getting involved in life and projecting themselves into something good.
Far from being a simple blues as many imagine, melancholy is a real illness who can lead the one who suffers from it to the suicide. “There melancholy is a disease to the extent that it constitutes a severe form of depression which fits into a type of so-called psychotic personality, that is to say a functioning which tends towards a permanent depressiveness, and in which the link with reality is often altered“explains Dr. Véronica Olivieri-Daniel, clinical psychologist and psychoanalyst.
What are the symptoms ?
A person suffering from melancholic depression is in a state of great psychological suffering, leading to generalized disgust for existence. “Melancholy is a kind of annihilation, of absolute and total loss of will to liveof inability to imagine anything other than morbid, painful, catastrophic situations. The most telling symptoms are:
- a major loss of vital energy,
- L’lack of reaction to pleasant stimulation,
- A significant neglect with anorexia and weight loss,
- a significant guilt,
- a marked depressed mood.
Melancholy can generate, in the event of chronic development, a reduced intellectual abilitiesand even push to suicide. “In melancholy statestotal despair, the impossibility of believing in healing, delusional ideas of catastrophe, end of life or end of the world occur”, adds Dr. Véronica Olivieri-Daniel. “It is not the symptomatic expression that determines a pathology, it is its background. In other words, you can be seriously melancholic without ever crying.“, specifies our interlocutor.
Exacerbated symptoms in “delusional” melancholy
We speak of “delusional melancholy” or “anxious melancholy”, characterized by a overwhelming anxiety, increased agitation, loss of self-esteem, deep hopelessness, intense guilt and suicidal thoughts. In this form of melancholy, all the signs of the illness are exacerbated, it is therefore more serious than its classic form.
Often associated with bipolar disorder
Melancholy occurs relatively often in bipolar disorder. “Concretely, bipolar disorder is characterized by an alternation between major depressive episodes and manic episodesthat is to say agitation, excitement, general acceleration of thought of the actions carried out, impossibility of settling down, thinking, sleeping or sometimes even eating. Melancholy does not always alternate with these manic episodes but it is common because when a patient is melancholic or very seriously depressed, high dosages of antidepressants can tip them into opposite states of mania.”explains Dr. Véronica Olivieri-Daniel.
What is the cause of melancholic depression?
Melancholy often occurs following a traumatic event. But most of the time, the disease was already pre-existing, and the event in question revealed it.
When and who to consult?
Melancholic depression requires fast support, from the first symptoms, in order to promote the chances of recovery. As soon as self-devaluation, discouragement, loss of interest in oneself and others, inability to project oneself, sadness, agitation and other characteristic signs of melancholy hinder daily activities, it is necessary to consult a psychiatrist.
“Melancholy never goes unnoticed, but there is no diagnosis strictly speaking. This severe depression is part of a personality that makes repeated depressive episodes, who has always had a depressive type of functioning, and who has difficulty getting involved in life, projecting himself into something goodindicates Dr. Véronica Olivieri-Daniel. We do not become melancholic overnight, it is part of a complex picture of major depression, associated with a personality defined as borderline or psychotic“.
What are the treatments ?
This form of depression requires emergency hospitalization and initiation of antidepressant treatment. In certain forms of melancholy, notably those with a delusional side or a phenomenon of stupor with immobility and muteness, a treatment called seismotherapy Or electroconvulsive therapy using electrical stimulations delivered to the skull can be considered as an emergency.
Thanks to Dr. Véronica Olivieri-Daniel, clinical psychologist and psychoanalyst.