Pathological sadness

What it means

A negative emotional state characterized by sadness, unhappiness, or sorrow that is excessive in intensity, duration, or resistance to self-regulation compared with culturally appropriate norms or the individual's usual emotional range. It may arise spontaneously or in response to significant life events, but when reactive, it is disproportionate to or persists beyond what is typically expected for the context. Pathological sadness can be associated with feelings of hopelessness, helplessness, anhedonia, and a pessimistic outlook, but these features are not invariably present. It may also be accompanied by increased tearfulness, low energy, cognitive difficulties such as impaired concentration, and somatic changes including disrupted sleep or appetite.

Sadness, per se, is a basic emotion with negative valence and low arousal. Sadness has significant evolutionary implications from behavioral, cognitive, social and health perspectives. As sadness persists, physical and cognitive symptoms including fatigue, difficulty concentrating, disrupted sleep, and loss of interest or pleasure in activities may become present, when dominant, interfere with personal, social, or occupational functioning. This state is distinct from normative sadness or grief and should be differentiated from the syndromic presentation of Major Depressive Disorder.

Rare diseases that can present with this1

The range is how often this sign appears among people diagnosed with each disease — it is not a probability of having any of them. Many of these signs also occur in common, non-rare conditions. A sign on this page is a conversation to have with a clinician, not a conclusion.

Part of the broader category

Also called: Abnormal grief response · Depressed mood · Dysthymia · Emotional pain · Feeling hopeless all the time · Has the blues · Melancholy · Morbid sadness