What distinguishes melancholic features of depression from other depressions?

• A. Nonreactivity to positive events.
• B. Hypersomnia and increased appetite.
• C. Profound anhedonia, early morning awakening, significant weight loss, guilt, and psychomotor changes; nonreactivity to positive events.
• D. Sleep disturbances with normal appetite.

Answer: (C)

Melancholic depression shows a biologically driven pattern with symptoms that are typically more persistent and less responsive to positive events. The hallmark features include profound anhedonia (loss of the ability to feel pleasure), mood that is worse in the morning (early morning awakening), significant weight loss, excessive guilt, and psychomotor changes (either agitation or retardation). Nonreactivity to positive stimuli is also characteristic, meaning that even things that would normally cheer the person do not lift their mood.

This combination distinguishes melancholic features from other depressive patterns. For example, hypersomnia and increased appetite point toward atypical depression, where mood can react to positive events and other biological patterns differ. Sleep disturbance with normal appetite describes a different depressive presentation.

Thus the option that lists all these elements—deep anhedonia, morning worsening with early awakening, weight loss, guilt, psychomotor changes, and nonreactivity to positive events—best captures melancholic features.