Melancholic Depression

Melancholic depression is a severe form of depression in which the individual will often feel like life appears meaningless. It can be both unipolar or bipolar in how it occurs, however it is typically the type experienced by those with bipolar disorder. Melancholic depression is typically the one that is experienced by those who are hospitalised by depression.


For those with melancholic depression, emotions are constantly changing. These changes can result in the individual’s personality changing completely. The core symptoms of melancholic depression are the following:

  • Lack of energy
  • Fatigue even when attempting mundane tasks such as getting up
  • Difficulty focusing on anything
  • The inability to experience pleasure; you are indifferent to almost everything
  • Sleeping all the time


Melancholic depressives may also ruminate over the same thoughts and experiences, and feel excessive guilt. Unfortunately, individuals who suffer from this type of depression do not respond to psychotherapy such as CBT or DBT, at least not before successful drug treatment. This means it is essential that they seek help from a doctor.


Treatment for melancholic depressives is primarily electro-convulsive therapy (ECT). This is a form of therapy that is reserved for serious psychiatric conditions.

A current is passed through the brain in order to product a fit. Evidence shows that severe depression is typically caused by problems with certain brain chemicals, and ECT causes the release of said chemicals. This means they are more likely to work and assist in recovery. It has been shown to have an added effect on severe depression and appears more effective than medication alone. Because of its nature, it is reserved for depression that is considered life-threatening.

If a patient with severe depression refuses ECT, then different types of medication will be tried. Like any significant treatment, consent must be given before ECT can be carried out, and the doctor will explain what it involves and have it on file that you understood and agreed to it.

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