Living with Atypical Depression

What is atypical depression?

Despite its name, atypical depression isn’t some rare or bizarre condition. According to research data compiled by the Depression and Bipolar Support Alliance (DBSA), atypical depression is the most commonly diagnosed subcategory of major depression. What we’ve come to think of as “typical” depression more closely resembles the subcategory known as melancholic depression.

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, or DSM-IV, makes a distinction between atypical and melancholic depression. The defining feature of melancholic depression is a loss of pleasure in normally enjoyable activities: the patient can’t be cheered up by good news or positive attention from loved ones. Someone suffering from melancholic depression often experiences a significant weight loss or decrease in appetite and may wake up too early in the morning.

By contrast, atypical depression is characterized by “mood reactivity”: the depression lifts when good things happen and deepens in response to negative events. In addition to mood reactivity, a diagnosis of atypical depression requires the presence of at least two of the following symptoms: an increase in appetite or significant weight gain; sleeping for at least 10 hours per day (hypersomnia); a feeling of extreme lethargy or heaviness (leaden paralysis); and a history of extreme reactions to perceived rejection (rejection sensitivity).