What Is Melancholia? (2024)

What Is Melancholia? (1)Melancholia is a subtype of depression. People with melancholic depression often feel extreme despair and guilt. They may struggle to feel any happiness, even when good things happen in their lives.

Although melancholia can be difficult to treat, recovery is possible. A trained mental health professional can help people with melancholia cope with their symptoms.

  • Historyof Melancholia
  • What Is Melancholia?
  • Melancholia and Other Types of Depression
  • What Causes Melancholia?
  • Effects of Melancholia


In 400 B.C., the Greek philosopher Hippocrates theorized that the human body contained four major fluids: blood, black bile, yellow bile, and phlegm. A human grew sick when these fluids were out of balance in their body. An excess of black bile would cause someone to become despondent and fearful. The Greeks call this condition melancholia. It became the first term used for depression and the first way depression was ever studied.

During the Renaissance, Europeans considered melancholia to be a sign of creative genius. They glorified it through art, fashion, and written works. But by the 18th century, the term returned to its clinical roots.

Around the 19th century, people used the term depression synonymously with melancholia. Sigmund Freud’s writings in On Murder, Mourning and Melancholia helped modernize the concept of melancholia into its current definition.


Today, melancholia is no longer listed as a standalone mental health issue. Instead, the Diagnostic and Statistical Manual (DSM) lists it as a specifier for depressive disorders. Rather than receiving a diagnosis for melancholia, a person is more likely to receive a diagnosis of major depression (MDD) with melancholic features. (Melancholia can also occur during the depressive phase of bipolar.)

To be diagnosed with melancholic depression, a person must present at least one of these symptoms:

  1. Loss of enjoyment from all (or nearly all) activities.
  2. Lack of positive response to objectively pleasurable events.

And at least three of the following:

  1. Despair that is not linked to loss or grief.
  2. Loss of appetite or significant weight loss.
  3. Psychom*otor changes: Either physical restlessness or slowed movement.
  4. Diurnal mood variation: Low mood that is worse in the morning.
  5. Waking at least two hours earlier than normal.
  6. Excessive guilt.


Melancholia can look very different from non-melancholic depression. Compared to an individual with another type of depression, someone with melancholia typically:

  • Develops symptoms at a later age.
  • Has more severe symptoms. Instead of having fatigue, the person may have no energy at all. Instead of having a dampened mood, they may be unable to feel any happiness.
  • Is more likely to have psychom*otor symptoms.
  • Is more likely to have anxiety or suicidal thoughts.

Melancholic depression can also occur alongside other specifiers. For example, someone with melancholia may have a seasonal pattern to their symptoms. Research shows melancholia is more prevalent when sunlight and temperature levels are low. Melancholia might also co-occur with postpartum depression and depression with psychotic features.


Melancholia is sometimes called “endogenous depression,” meaning “depression that comes from within. The condition is highly heritable. People with melancholia are likely to have a family history of mood issues or suicide. Social and psychological factors rarely contribute to melancholia the way they might with other depression subtypes.

Research suggests differences in the brain may be responsible for melancholia. Someone with melancholia may have less neurons connecting to their insula (the part of the brain responsible for attention). They may also have an altered hypothalamus, pituitary gland, or adrenal glands. These changes may affect a person’s appetite, stress levels, and more.


Melancholia can prompt various biological changes in the body. People with melancholic depression spend more time in the REM phase and less time in the deep sleep phase. Thus, they may get less quality rest.

People with melancholia often have elevated cortisol levels, which increase one’s stress. They may also experience weight loss and chronic inflammation.

The condition can also affect cognitive processing and performance. Research suggests it impedes working memory, visual learning, verbal learning, and problem solving. These symptoms are specific to the melancholic subtype of depression.

Overall, melancholia can impact a person’s relationships, occupation, and health. In severe cases, it may prompt an individual to attempt suicide. Melancholia tends to cause longer periods of suicidal thinking than other types of depression.

If you or a loved one has melancholia, know that there is hope. A licensed therapist can help you on the journey to recovery. You can find a therapist here.


  1. Brown, W. A. (2007, January 15). Treatment response in melancholia. Acta Psychiatrica Scandinavica, 115(s433), 125-129. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.2007.00970.x/full
  2. Carroll, B. J., Feinberg, M., Greden, J. F., Tarika, J., Albala, A. A., Haskett, R. F., … & Young, E.. (1981). A specific laboratory test for the diagnosis of melancholia: Standardization, validation, and clinical utility. Archives of General Psychiatry, 38(1), 15-22. Retrieved from http://jamanetwork.com/journals/jamapsychiatry/article-abstract/492458
  3. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
  4. Freud, S. (1917). On murder, mourning and melancholia. London: Penguin Group.
  5. Jackson S.W. (2008) History of psychiatry and medical psychology. Boston: Springer.
  6. Javier, H. (2014). The four humors theory. ESSAI, 12(1). Retrieved from http://dc.cod.edu/cgi/viewcontent.cgi?article=1497&context=essai
  7. Lamers, F., Beekman, A. T. F., van Hemert, A. M., Schoevers, R. A., & Penninx, B. W. J. H. (2016). Six-year longitudinal course and outcomes of subtypes of depression. The British Journal of Psychiatry, 208(1), 62-68. Retrieved from https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/sixyear-longitudinal-course-and-outcomes-of-subtypes-of-depression/3F3CC68201884E067284379B05F49697
  8. Melancholic depression: Symptoms, treatment, tests, and more. (2016, March 10). HealthLine. Retrieved from https://www.healthline.com/health/depression/melancholic-depression#Overview1
  9. Parker, G., Fink, M., Shorter, E., Taylor, M. A., Akiskal, H., Berrios, G., … & Swartz, C. (2010. January 1). Issues for DSM-5: Whither melancholia? The case for its classification as a distinct mood disorder. The American Journal of Psychiatry. Retrieved from http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2010.09101525
  10. Parker, G., Roy, K. Hadzi-Pavlovic, D., Wilhelm, K., & Mitchell, P. (2001). The differential impact of age on the phenomenology of melancholia. Psychological Medicine, 31(7), 1231-1236. Retrieved from https://www.cambridge.org/core/journals/psychological-medicine/article/differential-impact-of-age-on-the-phenomenology-of-melancholia/296E27B2F54AD6B3C03A963CCDB7E975
  11. Radua, J., Pertusa, A., & Cardoner, N. (2010, February 28). Climatic relationships with specific clinical subtypes of depression. Psychiatry Research, 175(3), 217-220. Retrieved from http://www.sciencedirect.com/science/article/pii/S0165178108003946
  12. Rush, G., O’Donovan, A., Nagle, L., Conway, C., McCrohan, A., O’Farrelly, C., ... & Malone, K. M. (2016, November 15). Alteration of immune markers in a group of melancholic depressed patients and their response to electroconvulsive therapy. Journal of Affective Disorders, 205(1), 60-68. Retrieved from http://www.sciencedirect.com/science/article/pii/S0165032716302762
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What Is Melancholia? (2024)


What is the meaning behind melancholia? ›

Put in non-symbolic terms, Melancholia seems to suggest that our state of despair is grounded in the knowledge of our death, but that the premonitory knowledge of our impending death is itself grounded in despair.

What is the concept of melancholia? ›

Melancholia or melancholy (from Greek: µέλαινα χολή melaina chole, meaning black bile) is a concept found throughout ancient, medieval, and premodern medicine in Europe that describes a condition characterized by markedly depressed mood, bodily complaints, and sometimes hallucinations and delusions.

What is known as melancholia? ›

Melancholic depression , also called melancholia, is a serious type of depression. Researchers think this type of depression mainly affects your central nervous system.

What does it mean if someone is melancholy? ›

: depressed in spirits : dejected, sad. b. : pensive.

What are the three stages of melancholia? ›

Agrippa classified melancholic inspiration into three ascending levels: imagination, reason, and intellect. He linked imagination (the first and lowest level) to artistic genius; this may account for the numeral “1” in the title and provide a key for explaining the frustration of the winged figure-cum-artist.

Is melancholia worse than depression? ›

The symptoms of melancholia are similar to the general symptoms of depression but are usually more severe. Most people with melancholia slow right down. Their movements, thoughts and speech can be very slow. Less commonly, people with melancholia can experience agitation and restlessness.

What triggers melancholia? ›

Trauma, family history, and brain chemistry can contribute to its onset, but melancholic depression is strongly tied to genetic causes. Antidepressant medications are the first-line treatment for melancholic depression.

Is melancholia an emotion? ›

As an emotion, melancholy's most distinctive aspect is that it involves reflection. Rather than being an immediate response to some object that is present to perception, melancholy most often involves reflection on or contemplation of a memory of a person, place, event, or state of affairs.

What is the organ source of melancholy? ›

Black bile was associated most closely with a melancholy temperament, causing pensive sadness and feelings of fear if imbalanced in quantity. The least desirable of the four humours, black bile was seated in the spleen and associated with the element of earth and season of autumn.

What is the extreme of melancholy? ›

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.

Is melancholy a madness? ›

Non-technical uses of the term 'melancholic' included a whole range of conditions, from unexplained fear and sadness to extreme irrationality, often linked to physical symptoms. But physicians used the term 'melancolia' to explain signs and symptoms of incipient madness, or 'locura no confirmada', which could be cured.

Where does melancholia come from? ›

Drawing back thousands of years, the very word “melancholia” (transliterated from the ancient Greek µέλαινα χολή, literally “black bile”) has its roots in Hippocratic medicine. This term originates from humoral theory, the predominant medical ideology from antiquity through the 19th century.

How do melancholy people behave? ›

Melancholic people are often deep in thought. They tend to be serious individuals who aren't known for telling jokes. They also tend to dwell on events and interactions from the past. Melancholics may be prone to holding grudges, as they can have difficulty letting go of others' wrongdoings.

How to fix melancholy? ›

Quick fixes for a Melancholy Mood
  1. Call a friend. ...
  2. Talk about your feelings. ...
  3. Ask yourself, “Why do I feel this way?” Once you determine the trigger for your blue mood, you might be able to do something about it. ...
  4. Notice what makes you feel better. ...
  5. Consider taking a walk. ...
  6. Eat right. ...
  7. Write it down.
Feb 19, 2019

What is the life of a melancholy person? ›

The Melancholy personality can experience moodiness, be depression prone, and struggle with negative self-talk. They may think too much about the wrong things and have unrealistic expectations. Other potential weaknesses that the Melancholy temperament may exhibit include a critical attitude and being overly sensitive.

What mental illness is portrayed in melancholia? ›

In the final estimation, what is so remarkable about Melancholia's portrayal of depression is not only the details but its entire worldview.

Why did she cheat in melancholia? ›

Therefore, she becomes melancholic, and as a way to get back at her husband's pretensions, she cheats on him while he watches.

Why did Justine sleep with Tim in melancholia? ›

There she knocks down Tim, a man she has just met, squats over him, and furiously humps him in a sand trap. This is the first suggestion of her erotic relationship with the planet Melancholia. The stranger Tim is merely an object; she is turned on not by him but by the presence above her of this new planet.

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