Dr. Ananya Mandal, MD
Melancholia was first identified by the Greek physician Hippocrates, who described sufferers as being plagued with ''fears and despondencies''. But due to lack of exact biochemical and clinical features this condition has been struck off the Diagnostic and Statistical Manual of Mental Disorders used worldwide to diagnose mental illnesses.
Gordon Parker, a professor of psychiatry at the University of NSW and director of the Black Dog Institute, is heading a team of 17 international psychiatrists who want the 2500-year-old condition, melancholia, listed as an illness in its own right in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, due in 2013.
In the current edition, the DSM-IV-TR, psychiatrists must choose between diagnosing major or minor depression for patients with the usual treatments including antidepressants, and psychotherapy or counseling.
Impact
Australia alone is estimated to have over 600,000 melancholic patients. Treating melancholic patients with counseling has been found to be ineffective leading to a rise in suicides in this population of patients.
''I see about three people a week who have had meandering psychotherapy for years with no real outcome,'' said Dr. Parker.
''Major depression seems to have gravitas and meaning but the treatment is very open-ended. If you see a psychiatrist, you will get drugs and cognitive behavioural therapy. If you see a counselor, you will get counseling. But if you see someone in a kaftan, you will get crystal therapy … That's why I'm against it being used as a diagnosis,'' Professor Parker said.
Clinical features