What is Atypical Depression?

nci-pensive staring rhoda baer.jpg

Depression is an umbrella term, with two major syndromes: major depressive disorder and persistent depressive disorder (formerly called dysthymia.)

The new DSM-5 names a number of subtypes to major depressive disorder, including postpartum depression, seasonal affective disorder, catatonic depression, melancholic depression and atypical depression.

Symptoms of Atypical Depression

Atypical depression, despite its name, is one of the most common variants of depression, representing nearly a third of depression diagnoses. Experienced by women two to three times more frequently than by men, atypical depression manifests as major depressive disorder or persistent depressive disorder with the ability to briefly experience positive events with an improved mood.

Symptoms of atypical depression include:

  • Increased appetite, with resultant weight gain
  • Hypersomnia (sleeping too much)
  • Feeling symptoms more acutely in the evening than in the morning
  • Experiencing a sensation of being physically “weighed down”, as though there was lead in each limb
  • Having an excessively intense or sensitive reaction to criticism or rejection
  • Having the ability to respond cheerfully to positive events
  • Increased susceptibility to panic attacks and certain phobias

  • Atypical depression generally begins earlier in life than other forms of depression, often in the early teen years. It also tends to last longer and is more frequently misdiagnosed.

    Diagnosing Atypical Depression

    Because many of the symptoms of atypical depression are similar to the symptoms of a variety of physical disorders, like hypothyroidism or chronic fatigue syndrome, diagnosis should begin with a physical exam.

    A careful review of symptoms by a therapist is also important to establish that atypical depression is present. There are a number of other disorders that share some of the symptomology with atypical depression, including bipolar disorder, obsessive-compulsive disorder, panic disorder and bulimia.

    Because atypical depression tends to last longer than other forms of depression, it may occasionally be mistaken for any of several personality disorders, including borderline, histrionic or avoidant personality.

    Treatment of Atypical Depression

    Atypical depression got its name from the fact that it did not respond to tricyclic antidepressants in the same way that other forms of depression did.

    Tricyclics are an older form of depression treatment, and have largely been supplanted with newer therapies. Treatment with MAOIs or SSRI antidepressants and various forms of psychotherapy, especially cognitive therapy, have been found to be effective.

    A small 2011 study published in Journal of Psychiatric Practice discloses that regularly taking chromium supplements may relieve symptoms of atypical depression, especially the craving for carbohydrates.

    Sources: Healthline and Everyday Health

    Photo image courtesy Rhoda Baer / NCI


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