Melancholy is a state of intense depression. She is treated with antidepressants and anxiolytics, sometimes tremor therapy. Attacks of melancholy tend to recur.
What are the causes of melancholy and where does it come from? In this article, discover everything you need to know about melancholia, its characteristics, and how to treat it.
What is melancholy?
Melancholy is characterized by:
- deeply painful depression;
- loss of interest in the outside world;
- loss of the ability to love;
- inhibition of all activity;
- the decrease in the feeling of self-esteem which is manifested by self-reproach.
A distinction is made between melancholy in the context of manic depression and melancholy of involution.
Melancholy may represent the phase of sad mood and depressed feelings of manic depression, a mental condition characterized by alternating bouts of melancholy and manic bouts.
Who is most affected by involutional melancholy?
Involutional melancholia or melancholic syndrome appears after 50 years, especially in women. This melancholy is characterized by:
- an absence of personal psychiatric history;
- a background of obsessive personality (meticulousness, search for order, stubbornness);
- hypochondriac fears;
- hysterical manifestations;
Involutional melancholy often occurs following bereavement, social difficulties, or professional difficulties.
The signs of melancholy
The most common symptoms of melancholia are:
- generalized negativism and self-deprecation;
- disinterest in the world and in oneself (“nothing interests me”, “it’s not worth taking an interest in anything”).
Symptoms of melancholy are associated with other signs of depression, including:
- sleep disturbances (insomnia);
- a general slowdown, with a loss of energy and motivation associated with fatigue;
- psychomotor retardation.
The symptoms are a little different according to the two categories of melancholia.
Stuporous melancholy is characterized by a predominant physical and psychic slowing down, which leads to inertia, dumbness, and withdrawal.
Anxious melancholy, or delusion, in which agitation and anxiety are major, with despair, loss of self-esteem, frequent suicidal thoughts with a risk of acting out.
Melancholy, therefore, requires treatment and sometimes even hospitalization.
The treatment of melancholy
The treatment of melancholy combines both anti-depressants and psychotherapy.
Electroconvulsive therapy (ECT) or shock therapy is effective in cases of deep melancholia.
The principle of electroconvulsive therapy consists of facilitating an alternating current between two electrodes placed on either side of the skull. The electrical intensity causes a convulsion.
The main advantages of ECT are its speed of action and the importance of its beneficial effect on the most acute symptoms.
If the melancholy corresponds to the melancholic access of manic depression, the treatment is based on taking “mood stabilizers” drugs that stabilize the mood.
During depressive episodes, an antidepressant may be associated with it, and during manic episodes, an antipsychotic.
If the suicidal risk is high, or if the melancholy is so severe that the person no longer eats, hospitalization in psychiatry can take place with the establishment of antidepressant treatment or shock therapy.
The use of antidepressants and sedative neuroleptics generally makes it possible to obtain a cure in one or two weeks in two out of three cases.
Recurrence of melancholy
The risk of recurrence of melancholia is high, especially in the context of a manic-depressive illness.
How to prevent melancholy?
The prevention of new episodes is carried out by a mood-regulating treatment, and not by an antidepressant alone.
Supportive psychotherapy is essential. It can be psychodynamic, cognitive-behavioral, or family psychotherapies.
It is also recommended therapeutic education (ET), which has an important role. ET helps the person concerned to know his disease and prevent relapses and avoidable complications.
These programs help develop self-monitoring skills and better manage stressors.
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