Synonym: melanocholia agitata, depression with psychomotor agitation
Patient selection: depression
Features of agitated depression:
(1) agitation and restlessness
(2) emotional lability
(3) thoughts that race, that are "crowded" or that vanish too quickly
(4) insomnia or frequent night awakenings
(5) suicidal thoughts or attempts
(6) expressive and talkative
(7) purposeless and stereotyped movements (fidgeting, hand-wringing, etc)
(8) anxiety
(9) variable delusions
The risk of suicide makes management of this form of depression crucial.
Agitated depression may be associated with:
(1) substance abuse, especially opiate addiction
(2) bipolar disorder (some want to define agitated depressin as a bipolar mixed state)
Differential diagnosis:
(1) hyperthyroidism
(2) akathisia
(3) stimulant drug intoxication
