Melancholia: It's not simple loneliness or grief

CEBU, Philippines - There is a serious health condition that most people take lightly, mistaking it as simply being lonely. Seeking diversion is the usual reaction of the person who has it. He or she seeks out some friends, go online, and see a movie, catch pokemons etc.

It is good if the person still seeks diversions from his or her damp feelings. But diversions only go so far. And it can only allow the brewing melancholia to go on, even get worse, underneath.

A full-blown melancholic depression is a very distressing condition.  It may strike in episodes or it seizes the person completely.  It manifests itself by a distinct loss of pleasure in usual interests and activities and being in a non-reactive mood.

Another symptom is bad mood and lack of energy, especially in the morning. It's usually worse in the mornings and tends to fluctuate during the course of the day. The change in behavior may be more readily noticed by family and friends.

A certain sense of 'emptiness and inactivity' may also be noticed. The affected person may want to linger in bed and delay personal morning routine, like taking a shower and getting ready for the day ahead. There may also be a problem in focusing or keeping one's attention.

Melancholic depression is a biologically-based condition, but its manifestations may vary with different age groups.  It can afflict people who are into their 60s or younger. Its cause may be genetic or a result of physical wearing away.

The condition may be hard to detect in persons with good social skills whose outward vivacity may cover inner distress and despair. With the rest, slight signs like a dispirited voice tone and loss of the 'light in their eyes' may seep through.

The website www.blackdoginstitute.org.au suggests useful questions which can help determine whether a person is suffering from melancholic depression:

• Do you still read the newspaper… watch TV?

• What do you do all day - what would you normally do?

• What do you still enjoy - hobbies… the company of children or grandchildren or the sunrise?

• Do you feel worse in the morning or in the evening?

• How do you sleep?  Do you wake early in the morning?

• Can you be cheered up? What lifts your mood?

Melancholic depression is not a new condition. In 1917, celebrated psychoanalyst Sigmund Freud compared the phenomenon of mourning after the loss and death of a close loved one to the condition of melancholia or depression. Freud explained that both conditions shared a similar outward affect on the affected person and were both due to similar environmental influences. The inhibition, "absorbedness" of the ego, and the disinterest in the external world was equally evident in both mourning and melancholia.

Freud, however, pointed out that despite the similarities, there were some fundamental differences. Mourning was recognized as a healthy and normal process that is necessary for the recovery from the loss and would not be seen neither as a pathology nor a need for medical intervention. Melancholia, for its part, was an abnormal pathology, and a dangerous illness due to its suicidal tendency.

On closer observation, there are certain features in melancholia that are not present in mourning. In melancholia, there is neither feeling of loss in the subject nor any actual loss to justify such feeling. And even if the affected person may be able to point to a "cause" of his down feeling, he may not be able to explain why the cause has to make him feel down.

Instead, a loss of self-regard is observable in melancholia. The affected person feels himself worthless and despicable. There is a diminished sense of self. The person is often unaware of the condition creeping in, unlike in mourning where the grieving person is very much aware of the emergence of the feeling.

Melancholic depression often goes with a difficulty with nourishment, digesting etc., as well as insomnia. The gravity of these symptoms depends on the depth of the melancholic condition. If the condition is suspected of a loved one, the case shall be referred to a doctor immediately.

The condition is not as simple as it may seem. It is not simple loneliness or grief. And it can grow into something really bad.