Agitated depression

"Classification of Endogenous Psychoses and Their Differentiated Etiology"
Karl Leonhard
Springer Verlag, 2nd Revised edition, 1999
p. 24-30

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Agitated depression is characterized by a tortured-depressive state accompanied by continuous restlessness and fearful agitation. Anxious obsessions generally occur, often with ideas of sin and hypochondriacal fears. At the onset, restlessness and pathological ideation may vary, but if the suffering lasts a long time, this becomes more constant. Complaining then often occurs stereotypically with the same content. In any case the restlessness tends to become tenacious and cannot be overcome. Nor do the patients let themselves be distracted from their complaints. Often it is even impossible to receive answers to simple questions. The inability to influence patients with agitated depression may create a false impression of obstinacy. As the anxiety recedes, the lamenting often becomes oppressive, almost querulous, although an anxious tortured undertone remains recognizable. Agitated depressions may run their course quickly, but tend to be protracted. This is particularly true in milder forms in which the oppression outweighs the lamenting; it may extend to several years. Apart from their psychosis patients may show traits of anxious restlessness in their temperaments. My investigations are not sufficient, however, to make a clear statement in this regard. I have also not collected enough information about the physique. Pyknic constitution seems to be common, even though loss of weight often accompanies the condition.

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