The condition of melancholia could be about to make a comeback.
A Sydney psychiatrist is leading a global push to have melancholia listed as a mental illness.
Professor Gordon Parker from the Black Dog Institute says patients suffering the symptoms of melancholia should be given special status instead of being diagnosed with depression.
“We believe that melancholia is a separate diagnosis, a separate condition that requires quite different treatment to most of the other depressive conditions that are able to be diagnosed,” he said.
Professor Parker says melancholy is a very physical state, with many sufferers at risk of suicide.
“The person’s signs of concentration [are] quite distinct and impaired, so that they can’t read something or concentrate on it,” he said.
“Secondly they can have what we called retardation.
“Where they feel very slowed down, a lack of energy. It’s almost impossible to get out of bed and have a bath or shower.
“They find their mood is lacking in any pleasure. They can’t be cheered up, they can’t look forward to anything.”
Professor Parker says there is overwhelming evidence that the condition does not respond to certain treatments that are held to be effective for major depression.
The Black Dog Institute is about to embark on a study of three treatments that will take three years.
“At the moment we feel that many treatments are just being given in a universal, non-specific way,” Professor Parker said.
“We need a more rational model. What that will actually do to the sales of anti-depressants is, I think, predictable, but not likely to be an expansion.”
But not everyone agrees that melancholia should be recognised as a separate condition.
Ian Hickie, the executive director of the Brain and Mind Institute, says there is not enough evidence to support the idea.
“It’s an old idea that at the end of the day hasn’t really stood up against other biological markers to show us different causes of depression and the ability of providing different treatments,” he said.
“So while it’s been a very popular idea, historically it has very old origins.
“It hasn’t really stood the scientific test of time to take the field forward.”