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What is Melancholic Depression? — Talkspace

July 31, 2022


Types of Treatment for Melancholic Depression

Melancholic depression is widely accepted to be the result of a biological route, not something that’s triggered by outside circumstances. Because of this, medication is most often a big part of a treatment plan. Melancholic depression seems to be largely due to brain function and genetic makeup. This means the medication prescribed needs to be effective at addressing biological causes such as brain function.

Some antidepressant treatments that might be prescribed to treat melancholic depression include:

  • Selective serotonin reuptake inhibitors (SSRIs) — SSRIs change how neurotransmitter serotonin affects the brain, which is how they can help improve your depressed mood. MDD is often treated with SSRIs, but people who have MDD with melancholic features might actually have a better response to first line antidepressant treatment. 
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) — SNRIs can change how norepinephrine and serotonin work in the brain. 
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs) — The only NDRI that works on norepinephrine and dopamine is a medication known as Wellbutrin.
  • Atypical antidepressants — By having an impact on brain chemicals that improve your depressed mood, atypical antidepressants might be prescribed to treat melancholic depression.
  • Tricyclic antidepressants (TCAs) – TCAs are known as the first generation antidepressant treatment. One drawback to using TCAs in general is they tend to have more potential side effects than newer medications might.
  • Monoamine oxidase inhibitors (MAOIs) – MAOIs are also older medications. They have the potential to cause severe side effects, but for a specific type of person, they can still sometimes be a good option.

Medication isn’t the only way to treat melancholic depression. Psychotherapy, also commonly known as talk therapy, is an effective form of treatment, especially when it’s combined with medication. For most people, combining these two treatment options can be an effective way to manage melancholic depression.

Therapy for melancholic depression can be done in person or through online therapy sessions. Therapy can show you how to effectively:

  • Deal with stress in your life
  • Adjust after experiencing a major crisis
  • Identify and then replace negative beliefs or behaviors with positive ones
  • Enhance your communication skills
  • Increase your self-esteem
  • Help you learn how to cope with challenges in your life
  • Teach you how to identify and solve problems
  • Help you create a sense of control in your life

Individual one-on-one therapy is not the only option for someone looking to treat melancholic depression. Group therapy has been found effective as well.

Very extreme and severe cases might benefit from electroconvulsive therapy (ECT). By attaching electrodes that send electrical impulses to the brain, a mild seizure is triggered. Even though ECT has been proven safe and effective, there’s still a pretty negative stigma attached to the idea of using it to treat mental health conditions and mood disorders. For this reason alone, it’s generally not the first line of treatment for melancholic depression. That said, combining therapy, medication, and ECT may be an effective treatment option for melancholic depression symptoms if medication and therapy combined aren’t sufficient.

Therapy through Talkspace can be an affordable, effective, and accessible way for you to treat your melancholic depression. If you’re living with MDD with major depressive disorder with melancholic features, it might be time to consider getting the help you need.



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