All About Atypical Depression

Atypical depression is difficult to diagnose. Many people who suffer from atypical depression do not know they are suffering from it because they feel positive sometimes. However, it does not take long before the dark clouds overshadow again and the anxiety, the bad mood and the lack of motivation return.

Despite the name, atypical depression is actually quite common. It is similar to clinical depression, but patients suffering from this particular disorder have uncommon symptoms. They may, for example, respond positively to their surroundings and have a good appetite, but feel heavy in their arms and legs.

Psychologists used the clinical term for the first time in the 50s. They use it casually to begin with, to describe patients with depression who did not respond to regular antidepressant medication. It required further analysis and study to find common factors between these patients and understand what exactly they were facing.

Observations in atypical depression

The first thing they observed was that these patients  expressed pain in their arms and legs. They reported that it was difficult to move because their extremities felt heavy. Psychologists also noted that they showed atypical signs and symptoms of clinical depression, such as hypersomnia or hyperphagia (overeating).

They also observed that their patients’ symptoms worsened during the day. In the morning, they could respond to compliments, enjoy other people’s company, and respond positively to certain stimuli.

In the afternoon, things changed. After collecting data and finding these common symptoms, researchers named this particular condition “atypical depression”.

From here, it became much easier to create new medicine, especially for this disorder. In addition, there are many mental health professionals who believe that atypical depression accounts for about 20% of all cases of depression. 

It is therefore important to develop a psychological and pharmacological approach tailored to this disorder. Let’s dive a little deeper into it.

Atypical depression: Characteristics and symptoms

A study by Jonathan RT Davidson, of the University of California, shows that the most common symptoms of atypical depression are biological or vegetative. Other studies came to similar findings. Patients with atypical depression complain of physical pain more than anything else. They are often exhausted and feel that their bodies are failing them.

This is one of the reasons why this condition is so difficult to diagnose. You might just think that you have worked too much, are overtired, do not eat well enough, or exercise too much. However, the DSM-5 atypically describes depression as persistent. This means that if you do not get help, your mental health will suffer from it.

What are the most common characteristics of this psychological condition? Let’s take a look at it.

Your mood responds to positive stimuli

One of the characteristics of clinical depression (or dysthymia) is the inability to respond to positive situations or stimuli. An individual with clinical depression has severe difficulty experiencing any kind of enjoyment or pleasure.

Individuals with atypical depression experience moments of positivity when they see someone they love or hear words of praise or encouragement.  

Anxiety, nervousness, restlessness and mistrust

Atypical depression also has high comorbidity with other disorders, as is the case with anxiety or even bipolar disorder. As a result, the most common symptoms are nervousness, hypersensitivity, a constant feeling that something will go wrong, and so on.

Likewise, patients with atypical depression have difficulty maintaining happy, stable relationships. They have a hard time trusting people. They are sensitive to criticism and they have a fear of being betrayed or rejected.

Heavy paralysis

Heavy paralysis refers to the heavy feeling in the extremities that we mentioned at the beginning of the article. Patients with heavy paralysis feel an intense exhaustion or even pain in their arms and legs that limits their mobility.

Hypersomnia

Sleeping too much is also another sign of atypical depression. You sleep extremely much, take long naps, get up late in the morning and have a hard time getting your things done at work. It does not matter how much sleep you get. You feel permanently tired. Rest does not give you energy, or make you feel stronger.

A big appetite

Anxiety and nervousness often lead to an almost constant hyperphagia. This means that you are hungry all the time and that you eat compulsively. 

What treatments are available for atypical depression?

According to Cristancho, O’Reardon, and Thase (2012), atypical depression tends to be chronic and more common in women and young people. At the same time, it is the most common form of depression that healthcare professionals treat outside of the hospital.

If you suffer from atypical depression and you do not receive treatment, the consequences can be quite serious. This is true if there is comorbidity with other disorders, such as anxiety or bipolar disorder.

The best approach to treatment really depends on each patient’s situation. Many women with atypical depression, for example, also need help with eating disorders, such as bulimia. However, with good, psychological therapy and appropriate medication, patients can see significant improvements.

• Cognitive behavioral therapy enables patients to work with thought patterns and behaviors, to improve their daily, social skills.
• Likewise,  treatment with a form of antidepressant medication, called MAOIs (monoamine oxidase inhibitors), has been shown to be very effective in patients with atypical depression.

In conclusion, it is important to mention an additional detail about atypical depression. This disorder is much more common than you might think and people are having it in their 20s.

Early detection enables healthcare professionals to give patients better control over their lives and provide them with tools and strategies so that they can become happy and confident individuals.