To receive a diagnosis of major depressive episode, melancholic, an individual must display:

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Melancholic depression is characterized by a loss of pleasure in most or all activities, a failure of reactivity to pleasurable stimuli, a quality of depressed mood more pronounced than that of grief or loss, a worsening of symptoms in the morning hours, early-morning waking, psychomotor retardation, excessive weight loss (not due to dieting), or excessive guilt. The key feature of melancholic depression that distinguishes it from other forms is the lack of response to what used to be pleasurable activities or events.

To Receive a Diagnosis of Major Depressive Episode, Melancholic, an Individual