• Atypical Depression

    (Depression with Atypical Features)

    Definition

    Depression is a mental illness marked by feelings of profound sadness and lack of interest in activities. It is a persistent low mood that interferes with the ability to function and appreciate things in life.
    Atypical depression is depression with periods of mood brightening in response to positive events. Atypical depression will also have some symptoms that are not often found with depression.

    Causes

    The exact cause of atypical depression is not known but probably due to changes in brain chemistry. It is likely from a combination of genetic and environmental factors.
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    Risk Factors

    While the exact cause of depression is not clearly established, there are several factors that are associated with atypical depression such as:
    • Having a family history of depression
    • Having a personal history of mental illness
    • Chronic illness, such as cancer
    • Stressful or traumatic life events
    • History of physical or sexual abuse
    • History of drug or alcohol use disorder
    • Certain medications
    • Lack of a support system

    Symptoms

    People with atypical depression have depression with periods of mood brightening, known as mood reactivity. Other symptoms that may occur include:
    • Overeating
    • Oversleeping
    • Heavy feeling in the arms or legs
    • Feeling rejected

    Diagnosis

    There is no blood test or diagnostic test for atypical depression. You will be asked about your symptoms and medical history. The doctor may also ask about depression symptoms and behaviors as well as any family history of mental health issues.
    Specific mental health questionnaires may be done. This will help the doctor get detailed information about your speech, thoughts, memory, and mood. A physical exam and other tests can help rule out other causes.

    Treatment

    Combination treatment of medication and psychotherapy is often the most effective.

    Antidepressant Medications

    Antidepressant medications may be most effective in people with atypical depression. These medications can take 2-6 weeks to reach their maximum effectiveness. There are many different types of medications to treat atypical depression. You will work with your doctor to find the medication that benefits you the most and has the fewest side effects.

    Therapy

    Psychotherapy for atypical depression consists of various types of counseling. These include cognitive behavior therapy (CBT), interpersonal therapy, psychodynamic therapy, or a combination of these. Therapy is designed to help you cope with difficulties in relationships, change negative thinking and behavior patterns, and resolve difficult feelings.

    Exercise

    A regular exercise program has been shown to relieve some of the symptoms. It should play a large role in the overall management of atypical depression.

    Prevention

    Whether or not depression develops is part of genetic makeup that cannot be prevented. However, certain habits may help decrease the risk of depressive episodes:
    • Being aware of your personal risk factors
    • Having a psychiatric evaluation and psychotherapy if needed
    • Developing social supports
    • Learning stress management techniques
    • Exercising regularly
    • Not abusing alcohol or drugs
    • Getting adequate sleep, rest, and recreation
    • Eating healthful foods, including fruits, vegetables, and whole grains

    RESOURCES

    Depression and Bipolar Support Alliance http://www.dbsalliance.org

    Mental Health America http://www.mentalhealthamerica.net

    CANADIAN RESOURCES

    Canadian Mental Health Association https://cmha.ca

    Canadian Psychiatric Association http://www.cpa-apc.org

    References

    Atypical depression. Mayo Clinic website. Available at: http://www.mayoclinic.org/diseases-conditions/atypical-depression/basics/definition/con-20035114. Accessed October 3, 2017.

    Major depressive disorder (MDD). EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T116638/Major-depressive-disorder-MDD. Updated July 19, 2017. Accessed October 3, 2017.

    Quitkin F. Depression with atypical features: diagnostic validity, prevalence, and treatment. Primary Care Companion J Clin Psychiatry. 2002;4(3):94-99.

    Singh T, Williams K. Atypical depression. Psychiatry (Edgmont). 2006;3(4):33-39.

    Revision Information

    • Reviewer: EBSCO Medical Review Board Adrian Preda, MD
    • Review Date: 09/2017
    • Update Date: 00/30/2016
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