Overview

Any type of depression can make you feel sad and keep you from enjoying life. However, atypical depression — also called depression with atypical features — means that your depressed mood can brighten in response to positive events. Other key symptoms include increased appetite, sleeping too much, feeling that your arms or legs are heavy, and feeling rejected.

Despite its name, atypical depression is not uncommon or unusual. It can affect how you feel, think and behave, and it can lead to emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

Treatment for atypical depression includes medication, talk therapy (psychotherapy) and lifestyle changes.

Symptoms

Symptoms of depression can vary from person to person. Key signs and symptoms may include:

  • Depression that temporarily lifts in response to good news or positive events
  • Increased appetite that can cause weight gain
  • Increased desire to sleep, usually more than 10 hours a day
  • Heavy, leaden feeling in your arms or legs that lasts an hour or more in a day — a feeling that is different from fatigue
  • Sensitivity to rejection or criticism, which affects your relationships, social life or job

Other symptoms also may be part of atypical depression, such as:

  • Insomnia
  • Disordered eating, such as bulimia, bingeing or extreme food restrictions
  • Poor body image and fear of being fat
  • Headaches and other aches and pains

Some researchers are beginning to think of atypical depression as part of a larger subgroup of reactive depressive disorders — depression caused as a reaction to external events or circumstances.

Atypical depression may occur as a feature of major depression or of mild, long-lasting depression (dysthymia). Symptoms of atypical depression may overlap with other subtypes of depression, such as melancholic or anxious distress depression.

For some people, signs and symptoms of atypical depression can be severe, such as feeling suicidal or not being able to do basic day-to-day activities.

When to see a doctor

If you feel depressed, make an appointment to see your doctor as soon as you can. Atypical depression may get worse if it isn't treated. If you're reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

  • Call your mental health specialist
  • Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255)
  • Seek help from your primary doctor or other health care provider
  • Reach out to a close friend or loved one
  • Contact a minister, spiritual leader or someone else in your faith community

If a loved one or friend is in danger of attempting suicide or has made an attempt:

  • Make sure someone stays with that person
  • Call 911 or your local emergency number immediately
  • Or, if you can do so safely, take the person to the nearest hospital emergency room

Causes

It's not known exactly what causes atypical depression or why some people have different features of depression. Atypical depression often starts in the teenage years, earlier than other types of depression, and can have a more long-term (chronic) course.

As with other types of depression, a combination of factors may be involved. These include:

  • Brain differences. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When these chemicals are abnormal or impaired, the function of nerve receptors and nerve systems change, leading to depression.
  • Inherited traits. Depression is more common in people whose blood relatives also have the condition.

Risk factors

Many factors seem to increase the risk of developing or triggering depression, whether it's atypical or not. Risk factors may include:

  • History of bipolar disorder
  • Abuse of alcohol or recreational drugs
  • Physical or sexual abuse
  • Traumatic childhood experiences
  • Certain personality traits, such as low self-esteem or being overly dependent
  • Serious illness, such as cancer or heart disease
  • Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)
  • Environmental stressors

Your risk of depression may also increase if you have:

  • Blood relatives with a history of depression, bipolar disorder or alcoholism
  • Stressful life events, such as the death of a loved one
  • Depression after giving birth (postpartum depression)
  • Family members who committed suicide
  • Few friends or other personal relationships

Complications

Like other types of depression, atypical depression is a serious illness that can cause major problems. Atypical depression can result in emotional, behavioral and health problems that affect every area of your life.

For example, atypical depression can be associated with:

  • Weight gain due to an increased appetite
  • Personal and work relationship problems due to rejection sensitivity
  • Drug or alcohol use due to trouble coping
  • Other mental health disorders such as anxiety
  • Suicide from feelings of depression

Prevention

There's no sure way to prevent depression. However, these strategies may help.

  • Take steps to control stress, to increase your resilience and to boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis, to help you weather rough spells.
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening.
  • Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.
Sept. 17, 2015
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