Do I Have Atypical Depression?

November 11, 2020

Too often, people who are experiencing atypical depression begin to think that it is just a part of their lives that they will need to learn to deal with. They may even internalize features of the disorder such as fear of rejection as personality traits rather than characteristics of a mental health condition. 

However, you can get help for your atypical depression, and that help can really make a positive impacts in your overall quality of life. Here’s what atypical depression looks like, and how you can take steps toward a happier, healthier you. 

What is atypical depression?

In the 1950s, psychiatrists observed that some depressed patients seemed to fit a different profile than others. Some patients responded better to MAOIs than tricyclic antidepressants. They also had some symptoms in common which were not necessarily present in other depressed patients including:

  • Heaviness of the arms and legs and other physical symptoms.
  • A tendency to overeat and oversleep, even sleeping through repeated alarms in some cases.
  • Symptoms tend to be worse in the evening.
  • Sadness that is not persistent all the time. Visits from loved ones or other happy events only bring momentary cheer.
  • Highly sensitive to perceived rejection.
  • Panic attacks, severe phobias, and unusually intense premenstrual symptoms.

These symptoms were in stark contrast to the majority of depressed patients. Most depressed patients are sad constantly regardless of external stimuli, they wake up early and rarely oversleep, and feel worse in the morning, not the evening. Most depressed patients also lose interest in food and tend to lose weight rather than overeating.

Is Atypical Depression Unusual?

The name atypical may lead you to believe that this type of depression is unusual, but in fact atypical depression is very common. Mild symptoms are especially common, although severe symptoms that can lead to suicidal feelings or the inability to do basic activities can occur as well. 

Epidemiological studies suggest that as many as 15% to 29% of patients may meet the profile for atypical depression while clinical studies show as many as 18% to 36% of depressed patients showing the symptoms. 

What Causes Atypical Depression? 

Like most other forms of depression, we aren’t sure exactly what causes atypical depression. We also don’t know why some people express some symptoms of the illness and not others, or why symptoms vary so drastically between individuals. 

We do know that atypical depression often starts during teenage years. Here are a few of the factors that may contribute to the development of atypical depression:

  • Chemical imbalances in the brain. If the neurotransmitter levels in your brain are impaired or abnormal, the nervous system may change and lead to various types of depression including atypical depression.
  • Genetic factors. If you have a blood relative with atypical depression, you are more likely to suffer from it as well.
  • Bipolar disorder. People who also suffer from bipolar disorder seem more likely to struggle with atypical depression either concurrently with their bipolar disorder or at another time in their life. 
  • Misuse of recreational drugs and alcohol. A history of recreational drug and alcohol abuse makes it more likely that someone will be diagnosed with atypical depression.
  • Trauma in childhood. Traumatic childhood experiences seem to have a strong connection to developing atypical depression.
  • Environmental stress. People who live in environments that are chronically stressful, either because of their home situation or working conditions, may have a higher likelihood of developing the disorder. 
  • Intensely stressful episode. Sudden stressful events like the death of a loved one or a breakup are big contributors to the onset of atypical depression.

What are the Effects of Atypical Depression?

People who are experiencing atypical depression suffer a range of consequences in their life, and a reduction in quality-of-life overall. Here are a few of the effects that atypical depression can have:

  • Weight gain. Atypical depression generally results in increased hunger and indulgence in unhealthy foods, which often results in weight gain. Weight gain can compound feelings of inadequacy and hopelessness in the individual. 
  • Relationship struggles. People suffering from atypical depression have a tendency to respond very negatively to rejection, which can make relationships of all types challenging for people who are experiencing this condition. Minor disagreements may result in arguments and extensive stress. Rejection from even a casual romantic partner can cause tremendous pain.
  • Drug and alcohol use. It is unclear whether atypical depression is secondary to drug and alcohol use or whether people who suffer from atypical depression are more likely to seek out drugs and alcohol in order to relieve their symptoms.
  • Chronic anxiety. Individuals who have atypical depression often have anxiety related to feelings of rejection and inadequacy.
  • Possibility of suicide. Like other people who experience severe depression, people who have atypical depression may be at an increased risk of suicide and may struggle with suicidal thoughts.

Confusion Around Atypical Depression

Atypical depression has proven difficult to diagnose. When studies look into the demographic information as well as symptoms, results have tended to be conflicting. One study looked at the five symptoms associated with atypical depression:

  1. Rejection sensitivity (extreme sensitivity to being criticized or rejected)
  2. Mood reactivity, which means that these patients can cheer up briefly, plus experience one of the following:
  • Eating more and/or weight gain
  • Excessive sleeping
  • A sense of heavy limbs
  • Extreme sensitivity to rejection
  1. Overeating
  2. Oversleeping
  3. Leaden paralysis (heaviness of the arms and legs)

When they looked at 661 psychiatric outpatients, they found a few interesting data points about this disorder:

  • Younger patients were more likely to oversleep and less likely to experience leaden paralysis 
  • Middle-aged patients both overslept and experienced strong rejection sensitivity
  • Female patients generally experienced all of the atypical symptoms except for rejection sensitivity
  • Symptoms were often more severe in those who suffered from rejection sensitivity and paralysis but less likely to have strong mood reactivity
  • Longer illnesses, those lasting over three months, were more likely to experience leaden paralysis, overeating, and sensitivity to rejection.

It was concluded that the features of atypical depression do not line up with the expected clinical profiles. This may imply that more clarifications need to be established to correctly diagnose patients suffering from symptoms associated with atypical depression.

At this time, atypical depression diagnosis is often not reliable. It is not considered a distinct psychiatric disorder for this reason. However, it has not been abandoned by the American Psychiatric Association, because the symptoms are completely distinct from other disorders. 

At this time, someone is considered to have atypical depression in association with their bipolar disorder, major depression, or chronic moderate to mild depression, rather than as a separate disorder. 

How Atypical Depression is Associated with Other Mood Disorders

There appears to be an association between atypical depression and bipolar disorder as well as seasonal mood disorder. In fact, it may help to shed light on how depression and other disorders are connected. 

There may be a biological difference between typical depression and atypical depression. 

Atypical depression may be affected by the hypothalamus, which can also result in chronic fatigue syndrome, postpartum depression, and winter depression. It is also associated with Cushing’s disease. 

All of these issues can result in atypical depressive symptoms. Furthermore, atypical depression has links to personality disorders. Aspects of the disorder like rejection sensitivity appear to be more like personality disorders than mood disorders. 

There seems to be an association between atypical depression and the disorders that result in emotional instability because of an inability to effectively regulate mood. 

How to Treat Atypical Depression

Monoamine oxidase inhibitors (MAOIs) 

The drugs that helped define atypical depression as something different than standard depression are still very good at treating it. MAOIs are the oldest antidepressant medications and can have negative side effects, but in people who tolerate them well, they are extremely effective at controlling the symptoms of atypical depression. 

Only consider this treatment if you are ready to commit to being under the guided care of your health care professional. These drugs can have severe interactions with various foods so a restricted diet is required to use them safely. Managing the side effects also requires constant communication between you and your dedicated mental health care professional. Be sure that you have a health professional who is readily available and who you can maintain good communication with if you are considering using this class of drugs. 

SSRIs

This class of drug is usually not quite as effective for the treatment of atypical depression, but it may be a good option in terms of depression medication, especially for individuals that do not tolerate MAOIs well or don’t want to maintain the diet required in order to be on MAOIs.

Therapy

Various types of psychological therapy can be very effective for helping people deal with atypical depression because aspects of this disease are very likely to affect individual thought processes. 

Talk therapy or psychotherapy are great ways to deal with symptoms. Cognitive behavioral therapy can also be very helpful. These types of therapy are usually most effective when paired with medication.

Treating Your Atypical Depression

If you suspect that you are suffering from the symptoms of atypical depression, don’t be afraid to seek out help. Atypical depression can be very serious, and it has severe consequences on your quality of life. 

Even if you’ve never sought help for something like this before, don’t worry–online mental health clinics like YANA are easy to work with so you can get the expert mental health consultation you need to get started on a treatment that works for you. Even better, YANA is more affordable, more discreet, more convenient, and overall better equipped to be able to provide expert mental healthcare even if you’re brand new to the process.  

There are very effective treatments for atypical depression, it’s just a matter of exploring your options and making a plan to get better. Talk to a dedicated mental health care professional who can prescribe you the medication that you need and be with you every step of the way as you work through your atypical depression. Explore what makes YANA different today and see how easy it can be to get on the path to getting back to normal.

Sources:

https://www.health.harvard.edu/newsletter_article/Atypical_depression

https://www.nchmd.org/education/mayo-health-library/details/CON-20369727

https://pubmed.ncbi.nlm.nih.gov/11711170/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614762/