ICD-11 Criteria for Current Depressive Episode With Melancholia 6A80.3 Description In the context of a current Depressive Episode, several of the following symptoms have been present during the worst period of the current episode: loss of interest or pleasure in most activities that are normally enjoyable to the individual (i.e., pervasive anhedonia); lack of emotional reactivity to normally pleasurable stimuli or circumstances (i.e., mood does not lift even transiently with exposure); terminal insomnia (i.e., waking in the morning two hours or more before the usual time); depressive symptoms are worse in the morning; marked psychomotor retardation or agitation; marked loss of appetite or loss of weight. Diagnostic Requirements This specifier can be applied if, in the context of a current Depressive Episode, several of the following symptoms have been present during the worst period of the current episode: Loss of interest or pleasure in most activities that are normally enjoyable to t