Atypical Depression: A Different Kind of Depression May Need a Different Treatment

Don't be fooled by the name: "atypical" depression is actually as common as the "normal" melancholic depression.

In this article I discuss how its symptoms are unique, in whom it most commonly occurs, and treatment options.

What is atypical depression?

Atypical depression shares many features with other forms of depression, such as a persistent low mood, feelings of inadequacy, feeling "slow" and unable to focus, and thoughts of suicide. However, it is distincitve in several key ways.

Atypical depression is marked by "mood reactivity." That is, if you have atypical depression, you may not feel unhappy every minute of the day. Rather, your moods can react to the situation; for example, you could go out and enjoy a dinner with friends, but when home, you would sink back into depression. You can feel better--temporarily--if there is good news.

In addition to mood reactivity, the diagnosis of atypical depression requires two of the following symptoms: excessive sleeping (rather than insomnia), increased appetite or weight gain (rather than decreased appetite and weight loss), sensitivity to rejection, and leaden paralysis. (Leaden paralysis is a term for a heavy, leaden feeling in the arms or legs).

Who gets atypical depression?

Atypical depression is more common among women than men, and it is the form that depression in seasonal affective disorder usually takes. It is also very common in bipolar II disorder.

Patients with atypical depression also have a very high rate of anxiety disorders such as panic disorder, social anxiety disorder, and generalized anxiety disorder.

How does treatment differ for atypical depression?

Although doctors generally first treat atypical depression the same way as other depression, there is strong evidence to suggest that, for some individuals, other treatments may in fact be more effective.