The word ‘melancholia’ was used from the time of the ancient Greeks to describe feeling intensely sad and hopeless.

Melancholia or Melancholic depression is usually a severe illness. It makes people lose interest in almost all activities and has other distinct symptoms.

Melancholia or 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, Psychiatrics no longer recognizes it as a separate mental illness. Instead, melancholia is now seen as a specifier for major depressive disorder (MDD)— that is, a subtype of major depressive disorder.

In other words, major depressive disorder (MDD) is a significant mental health condition characterized by persistent and intense feelings of sadness and hopelessness. The disorder can affect any areas of life, (for example work, school, and relationships etc).

It may also impact mood and behavior as well as various physical functions, such as appetite and sleep, sexual life etc. People with major depressive disorder (MDD) often lose interest in activities they once enjoyed and have trouble getting through the day. Occasionally, they may also feel as if life isn’t worth living.

The severity and type of major depressive disorder (MDD) symptoms vary greatly from person to person. Some people experience traditional symptoms of major depressive disorder (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.

Symptoms of Melancholia

People with melancholic depression may experience symptoms of major depressive disorder (MDD), such as:

• Persistent feelings of extreme sadness for a long period of time.
• Loss of interest in activities that were once enjoyable.
• Having a lack of energy or feeling fatigued.
• Feeling anxious or irritable.
• Eating too much or too little.
• Sleeping too much or too little.
• 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.
• Suicide attempt.

They may also experience melancholic features of major depressive disorder (MDD), which include:

• Loss of pleasure in all or most daily activities.
• Lack of reactivity to positive news and events.
• Deep feelings of despair and worthlessness.
• Sleep disruptions.
• Significant weight loss.
• Persistent feeling of excessive or inappropriate guilt.
• Symptoms of MDD that are worse in the morning.

Melancholic features are more likely to occur in people who frequently experience severe symptoms of major depressive disorder (MDD). They are also seen more often in those who have major depressive disorder (MDD) with psychotic features.

Diagnosing of Melancholia

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:

• Do you have difficulty getting out of bed and getting started in the morning?
• 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?
• Has your daily routine changed recently?
• Do you enjoy the same things you once did?
• What, if anything, improves your mood?
• Do you have more trouble concentrating than usual?

Allopathic Treatments for Melancholia

Major depressive disorder (MDD) is often treated with newer antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs). These include well-known medications, such as fluoxetine, citalopram, or paroxetine. However, many people who have major depressive disorder (MDD) with melancholic features may respond better to older antidepressants such as the tricyclic antidepressant drugs or monoamine oxidase inhibitors (MAOIs), as well as serotonin-norepinephrine reuptake inhibitors, such as venlafaxine. These drugs help inhibit the breakdown of serotonin and norepinephrine in the brain, resulting in higher amounts of these “feel good” chemicals. Sometimes, certain atypical antipsychotics such as Abilify (aripiprazole) may be used to augment the effects of antidepressants.

In addition to medication, talk therapy is commonly used to treat people who have major depressive disorder (MDD) with melancholic features.

In allopathy, 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
  • replace negative beliefs and behaviors with positive, healthy ones
  • improve communication skills
  • cope with challenges and solve problems
  • increase self-esteem
  • regain a sense of satisfaction and control in life

Homeopathic Treatment of Melancholia and Depression

Arsenicum album

Great anguish and restlessness. Changes place continually. Fears, of death, of being left alone. Great fear, with cold sweat. Thinks it useless to take medicine. Suicidal. Hallucinations of smell and sight. Despair drives him/her from place to place. Miserly, malicious, selfish, lacks courage. General sensibility increased. Sensitive to disorder and confusion.

Headaches relives by cold, other symptoms worse. Periodical burning pains, with restlessness; with cold skin. Hemicrania, with icy feeling of scalp and great weakness. Sensitive head in open air. Delirium tremens; cursing and raving; vicious. Head is in constant motion. Scalp itches intolerably; circular patches of bare spots; rough, dirty, sensitive, and covered with dry scales; nightly burning and itching; dandruff. Scalp very sensitive; cannot brush hair.

Argentum Nitricum

Patient thinks his/her understanding will and must fail. Fearful and nervous; impulse to jump out of window. Faintish and tremulous. Melancholic; apprehensive of serious disease. Time passes slowly. Memory weak. Errors of perception. Impulsive; wants to do things in a hurry. Peculiar mental impulses. Fears and anxieties and hidden irrational motives for actions.

Emotional disturbances cause appearance of hemicranial attacks. Sense of expansion. Brain-fag, with general debility and trembling. Headache from mental exertion. Vertigo, with buzzing in ears and with nervous affections. Aching in frontal eminence, with enlarged feeling in corresponding eye. Boring pain; better on tight bandaging and pressure. Itching of scalp. Hemicranial bones feel as if separated.

Anxiety that is due to uncertainty like claustrophobia, hypochondria, fear of heights, or fear of everyday things. Uncertainty-based anxiety could be accompanied with digestive disturbance, like diarrhea, and sweets cravings.

 Borax

Sepia

Marked indifferent behavior along with symptoms of depression. Indifferent to those loved best. Averse to occupation, to family. Irritable; easily offended. Dreads to be alone. Very sad. Weeps when telling symptoms. Miserly. Anxious toward evening; indolent, lack of interest in any activities or entertainment, sitting quietly in loneliness. Extreme irritability with intense sadness, gloominess, depression in women arising after childbirth or around their menopause time.

Calcarea Carbonica

Apprehensive; worse towards evening; fears loss of reason, misfortune, contagious diseases. Forgetful, confused, low-spirited. Anxiety with palpitation. Obstinacy; slight mental effort produces hot head. Averse to work or exertion.

Sense of weight on top of head. Headache, with cold hands and feet. Vertigo on ascending, and when turning head. Headache from over lifting, from mental exertion, with nausea. Head feels hot and heavy, with pale face. Icy coldness in, and on the head, especially right side. Open fontanelles; head enlarged; much perspiration, wets the pillow. Itching of the scalp. Scratches head on waking.

Anxiety worsens when plans are changed, and they show difficulty in “going with the flow.”

Kalium phosphoricum

Anxiety, nervous dread, lethargy. Indisposition to meet people. Extreme lassitude and depression. Very nervous, starts easily, irritable. Brain-fag; hysteria; night terrors. Somnambulance. Loss of memory. Slightest labor seems a heavy task. Great despondency about business. Shyness; disinclined to converse. depression attended with extreme weakness, sadness, gloominess, aversion to talking, continual weeping, moaning, negative thinking and excessive weakness/fatigue. Sleeplessness/insomnia, weak memory, dullness of mind and anxiety about future.

Occipital headache; better, after rising. Vertigo, from lying, on standing up, from sitting, and when looking upward. Cerebral anaemia. Headache of students, and those worn out by fatigue. Headaches are relieved by gentle motion. Headache, with weary, empty, gone feeling at stomach.

Morose, irritable; tearful; averse to be talked to; everything is too much; depression. Lethargy. Cannot recall names or words; mind sluggish, but will act if aroused. Extreme lassitude and depression; apprehensive. Exhaustion after moderate mental effort. Flies into a passion and can hardly articulate; tongue feels thick. Restless. Nervous; starting. Perverted affections; cruel to husband; to baby. Indifferent and captious.

Giddy when out of doors but feels better when facing sun. Seasick without nausea. Occipital headache, lasting all night; frequent waking, woke with pains in occiput and loins, feels better lying on back, passed off after rising. Sensation of a band round forehead just above eyes.

Lycopodium for Melancholia, Depression, Stress and Anxiety

Silent, melancholy, and peevish humour; despair of eternal salvation. Desponding, grieving mood. Sadness when hearing distant music. Anguish especially in epigastrium, with melancholy and disposition to weep especially after a fit of anger or on the approach/presence of other person(s). Sensitive disposition.

Dread of men; desires to be alone, or else aversion to solitude. Must laugh if any one looks at her/him to say anything serious. Inclined to laugh and cry at same time. Irritability and susceptibility, with tears. Irascibility. Obstinacy. Estrangement and frenzy, which manifest themselves by envy, reproaches, arrogance, and overbearing conduct. Disposition to be very haughty when sick; mistrustful; does not understand anything one says to them; memory weak.

Avaricious. Character, mild and submissive. Complete indifference. Aversion to speaking. Fatigue from intellectual exertion, and incapability of devotion to mental labour. Giddiness. Inability to express oneself correctly; misapplication of words and syllables. Confused speech. Confusion about everyday things, but rational talking on abstract subjects. Inability to remember what is read, stupefaction, dulness, fear speaking in public and have stage fright, they hide it well. They might cover it up with talking loudly or too frequently.

Phosphorus for Melancholia

Affections of the mind in general; amativeness; dizziness, nymphomania, melancholy and sadness, sometimes with violent weeping, or interrupted by fits of involuntary laughter. Laughs at serious things. Stupor, low, muttering delirium; loquacious. Thinks she/he is several pieces, and cannot adjust the fragments. Stupor from which she/he could be aroused for a moment only to lapse back into a muttering lethargy; and forgetfulness.

Great apathy; very sluggish; dislike to talk; answers slowly or not at all. Anguish and uneasiness, especially when alone, in stormy weather, principally in evening, with timorousness and fright. Anguish respecting the future; or respecting the issue of the disease. Susceptibility to fright. Fear in evening, fear of darkness; of spectres; of things creeping out of corners.

Hypochondriacal sadness. Disgust to life. Apathy alternating with angry words and acts. Becomes easily vexed and angry, which makes him exceedingly vehement, from which she/he suffers afterwards. Any lively impression = heat, as if dipped in hot water. Great irascibility, anger, passion, and violence. Involuntary and spasmodic weeping and laughter. Misanthropy. Repugnance to labour. Shamelessness, approaching insanity. Great indifference to everything, and even to patient’s own family. Great forgetfulness, especially in morning. Great flow of ill-assorted ideas.

Zoomagnetic condition; state of clairvoyance. Ecstasy. When anxious or vexed, their thoughts get scattered and they have a difficult time focusing or getting things done. Their anxiety may be tied to a need for approval in social circles or from romantic partners.

Pulsatilla and Melancholia

This remedy is particularly applicable for complaints which are found to occur in patients of a mild, yielding, or good-natured disposition; also in those who by, their sickness, or naturally, are very easily excited to tears-they are very apt to burst into tears whenever spoken to, or when they attempt to speak, as in giving their symptoms, & c.

Affections of the mind in general; covetous; mistrustful; absent-minded; low-spirited. Melancholy with sadness, tears, great uneasiness respecting one’s affairs or about the health; fear of death (tremulous anguish, as if death were near), care and grief.

Involuntary laughter and weeping. Great anguish and inquietude, mostly in precordial region, sometimes with inclination to commit suicide, palpitation of heart, heat, and necessity to loosen the dress, trembling of hands, and inclination to vomit.

Fits of anxiety, with fear of death, or of an apoplectic attack, with buzzing in ears, shiverings, and convulsive movements of fingers. Apprehension, anthropophobia, fear of ghosts at night or in evening, with an impulse to hide or to run away, mistrust and suspicion. Covetousness. Taciturn madness; with sullen, cold, and wandering air, sighs, often seated with the hands joined, but without uttering any complaint. Despair of eternal happiness, with continual praying. Discouragement, indecision, dread of occupation, and obstructed respiration. Disposition envious, discontented, and covetous, exhibiting itself in a wish to appropriate everything. Caprice, with desire at one time for one thing, at another time for something else, either being rejected as soon as obtained.

Hysterical laughter after meals. Hypochondriacal humour and moroseness, feels better to evening, often with repugnance to conversation, great sensitiveness, choleric disposition, cries, and weeping. Ill Humour, sometimes with a dread of labour, and disgust or contempt for everything. Inadvertence, precipitation, and absence of mind. Difficulty in expressing thoughts correctly when speaking, and tendency to omit letters when writing. Giddiness; patient neither knows where he is nor what he does. Great flow of very changeful ideas. Nocturnal raving; violent delirium and loss of consciousness. Frightful visions. Weakness of memory. Fixed ideas. Stupidity.

Silica for Melancholia, Depression, Stress and Anxiety

Despondency, melancholy, and disposition to weep. Nostalgia. Anxiety and agitation; yielding, anxious mood. Taciturnity; concentration in self. Inquietude and ill humour on the least provocation, arising from excessive nervous debility. Scruples of conscience (about trifles). Restless and fidgety; great liability to be frightened, especially by least noise.

Discouragement. Moroseness, ill humour, and despair, with intense weariness of life. Wishes to drown herself/himself. Disposition to fly into a rage, obstinacy, and great irritability. The child becomes obstinate and headstrong; cries when kindly spoken to. Excitement with easy orgasm of blood. Repugnance to labour. Apathy and indifference. Weakness of memory. Incapacity for reflection. Great distraction. Tendency to misapply words in speaking. Fixed ideas; the patient thinks only of pins, fears them, searches for them, and counts them carefully.

Patients who fear experiencing new things, talking in front of people, and getting a lot of attention. They tend to become workaholics to soothe their fears.

Stramonium

Young people who are sometimes hysterical, praying and singing devoutly, beseeching, entreating, & c. Young women with suppressed menses may be affected in this manner, patients can’t bear solitude or darkness, if they are left alone or are in a dark room, the mental affections are very much by any sort of drink.

Paralysis of pharynx and oesophagus. Contracting, tearing in throat; sensation as if a ball were lodged in throat. Twitching of pomum Adami, up and down movement as in swallowing. Spasm of oesophagus. night terrors, nightmares, or dark thoughts while awake. People with this type of anxiety are often scared of the dark or being alone and are especially scared by thoughts of monsters or mysterious figures. Their imaginations tend to worsen their anxiety.

Lilium Tigrinum

Tormented about her/his salvation. Consolation aggravates. Profound depression of spirits. Constant inclination to weep. Anxious; fears some organic and incurable disease. Disposed to curse, strike, think obscene things. Aimless, hurried manner; must keep busy. Head hot, dull, heavy. Faint in warm room. Wild feeling in head.

Aurum Metalicum

Feeling of self-condemnation and utter worthlessness. Profound despondency, with increased blood pressure, with thorough disgust of life, and thoughts of suicide. Talks of committing suicide. Great fear of death. Peevish and vehement at least contradiction. Anthropophobia. Mental derangements. Constant rapid questioning without waiting for reply. Cannot do things fast enough. Over Sensitiveness to noise, excitement, confusion.

Violent pain in head; worse at night, outward pressure. Roaring in head. Vertigo. Tearing through brain to forehead. Pain in bones extending to face. Congestion to head. Boils on scalp.

Staphysagria

Impetuous, violent outbursts of passion, hypochondriacal, sad. Very sensitive as to what others say about her/him. Dwells on sexual matters; prefers solitude. Peevish. Child cries for many things, and refuses them when offered.

Stupefying headache; passes off with yawning. Brain feels squeezed. Sensation of a ball of lead in forehead. Itching eruption above and behind ears.

Oleander

Memory weak; slow perception. Melancholy, with obstinate constipation. Vertigo and diplopia, when looking down. Vertigo, when looking fixedly at an object, and on rising in bed. Pain in brain, as if head would burst. Numb feeling. Dull, unable to think. Indolence. Eruption on scalp. Humid, fetid spots behind ears and occiput, with red, rough, herpetic spots in front. Corrosive itching on forehead and edge of hair; worse, heat.

Coffea Cruda

Gaiety, easy comprehension, irritability, excited; senses acute. Impressionable, especially to pleasurable impressions. Full of ideas, quick to act. Tossing about in anguish.

Tight pain, worse from noise, smell, narcotics. Seems as if brain were torn to pieces, as if nail were driven in head. Worse in open air. Sensitive hearing.

Nux Vomica

Very irritable, sensitive to all impressions. Ugly, malicious. Cannot bear noises, odors, light, etc. Does not want to be touched. Time passes too slowly. Even the least ailment affects her greatly. Disposed to reproach others. Sullen, fault-finding.

Headache in occiput or over eyes, with vertigo; brain feels turning in a circle. Over sensitiveness. Vertigo, with momentary loss of consciousness. Intoxicated feeling; worse, morning, mental exertion, tobacco, alcohol, coffee, open air. Pressing pain on vertex, as if a nail driven in. Vertigo in morning and after dinner. Scalp sensitive. Frontal headache, with desire to press the head against something. Congestive headache, associated with haemorrhoids. Headache in the sunshine. Feels distended and sore within, after a debauch.

Natrum Muriaticum for Melancholia

Psychic causes of disease; ill effects of grief, fright, anger, etc. Depressed, particularly in chronic diseases. Consolation aggravates. Irritable; gets into a passion about trifles. Awkward, hasty. Wants to be alone to cry. Tears with laughter.

Throbs. Blinding headache. Aches as if a thousand little hammers were knocking on the brain, in the morning on awakening, after menstruation, from sunrise to sunset. Feels too large; cold. Anaemic headache of school-girls; nervous, discouraged, broken down. Chronic headache, semi-lateral, congestive, from sunrise to sunset, with pale face, nausea, vomiting; periodical; from eye strain; menstrual. Before attack, numbness and tingling in lips, tongue and nose, relieved by sleep. Frontal sinus inflammation.

Ambra Gresia

Dread of people, and desire to be alone. Cannot do anything in presence of others. Intensely shy, blushes easily. Music causes weeping. Despair, loathing of life. Fantastic illusions. Bashful. Loss of love of life. Restless, excited, very loquacious. Time passes slowly. Thinking, difficult in the morning with old people. Dwells upon unpleasant things.

Slow comprehension. Vertigo, with weakness in head and stomach. Pressure on front part of head with mental depression. Tearing pain in upper half of brain. Senile dizziness. Rush of blood to head, when listening to music. Hearing impaired. Epistaxis, especially in the morning. Profuse bleeding from teeth. Hair falls out.

Natrum Carbonicum

Unable to think; difficult, slow comprehension. Mental weakness and depression; worries; very sensitive to noise; colds, change of weather. Anxious and restless during thunderstorm; worse from music. Marked gayety. Sensitive to presence of certain individuals.

Aches from slightest mental exertion, worse from sun or working under gas-light, Feels too large. Oversensitive of hearing. Headaches with return of hot weather. Vertigo from exposure to sun.

Sepia Officinalis and feminine Melancholia

Indifferent to those loved best. Averse to occupation, to family. Irritable; easily offended. Dreads to be alone. Very sad. Weeps when telling symptoms. Miserly. Anxious toward evening; indolent.

Vertigo, with sensation of something rolling rounds in head. Prodromal symptoms of apoplexy. Stinging pain from within outward and upward mostly left, or in forehead, with nausea, vomiting; worse indoors and when lying on painful side.

Jerking of head backwards and forwards. Coldness of vertex. Headache in terrible shocks at menstrual nisus, with scanty flow. Hair falls out. Open fontanelles. Roots of hair sensitive. Pimples on forehead near hair.

Glonoinum

Recent German provings of Glonoine: very marked nerve disturbances. Great lassitude, no inclination to work; extreme irritability, easily excited by the slightest opposition, ending in congestive head symptoms, congestive headaches.

Cannabis Indica and Melancholia

Exaltation of spirit, with excessive loquacity. Full of fun and mischief, and laughs immoderately. Hallucinations and imaginations innumerable. Anguish, accompanied by great oppression: worse in the open air. Constant fear of becoming insane. Exaggeration of duration of time and extent of space; seconds seem ages, a few rods an immense distance.

Horror of darkness. Fear of approaching death. Inability to recall any thought or event, on account of different thoughts crowding on his brain. Sudden loss of speech; begins a sentence but cannot finish it. Stammering and stuttering. Exaltation of spirits, with excessive loquacity. Very absent minded. Every few minutes he/she would lose him/herself, and then wake up, as it were, to those around him. Constantly theorising. Clairvoyance. Delirium tremens; trembling; hallucinations; tendency to become furious; nausea; unquenchable thirst. Laughs at merest trifle. Sudden loss of memory.

For consultation about Melancholia, Depression Stress and Anxiety, visit our clinic.

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  Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS) ;  senior research officer Dnepropetrovsk state medical academy Ukraine; is a leading Homeopathic physician practicing in Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.

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