Depression is a huge mental health problem in the United States. Clinical depression affects nearly 19 million Americans and it is the number one source of disability.
There are a number of different types of depression however, there is dysthymia (a milder longer lasting form of depression), psychotic depression, (a severe form characterized by delusions) and the most common on all types of depression, atypical depression.
Atypical depression is believed to account for approximately 40% of all cases of depression. Perhaps the hallmark symptom of atypical depression is something called “mood reactivity” wherein patients are able to experience improved mood in response to positive events.
This is generally not the case with standard or melancholic depression, where patients cannot experience positive moods regardless of the situation.
“Patients with this variety of depression, about 10 million Americans, have what physicians label mood reactivity: they can be cheered up at least 50% in response to positive events in their life, albeit temporarily.” – J. W. Stewart. M.D.
Also in contrast to standard or melancholic depression, those suffering with atypical depression tend to sleep more, rather than less, and eat more rather than less (sometimes gaining a significant amount of weight).
According to the psychiatric DSM in order to be diagnosed with atypical depression in addition to suffering from low mood with mood reactivity, two of the following criteria must be met.
- Weight gain or increase in appetite
- Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)
- Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)
- Long-standing pattern of interpersonal rejection sensitivity that results in significant social or occupational impairment.
Unlike other types of depression, atypical depression tends to begin earlier in life (average age of onset being 17). It affects women more often than men with 70% of sufferers being female.
In addition if someone suffers with atypical depression they are also more likely to suffer with other conditions such as social phobia, avoidant personality disorder, body dysmorphic disorder, or panic disorder. They are also more likely to abuse drugs and are more of a suicide risk.
Another feature of atypical depression is a longstanding pattern of extreme sensitivity to perceived interpersonal rejection that affects functioning at work, in love, and with friends. Given their fear of rejection, many withdraw from relationships entirely and refuse to go on job interviews.
Certain risk factors may increase one’s chances of developing atypical depression. Interestingly, if one was depressed as a child, it’s more likely that they will suffer from atypical depression as an adult. A family history of alcoholism and taking certain types of medications may also play a role.
Other factors that can lead to an increased risk of atypical depression include having very little social contact, having a family member who committed suicide, being seriously ill, experiencing financial problems, abusing drugs, and possessing specific personality traits such as pessimism.
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 one’s life. Complications associated with atypical depression can include:
- Substance abuse, many people with depression drink too much or abuse drugs
- Family conflicts
- Relationship difficulties
- Work or school problems
- Social isolation
- Suicidal feelings
Those suffering from atypical depression seem to respond better to an older class of antidepressant drugs known as MAOI antidepressants. (Parnate, Nardil, Marplan). However because of their sometimes dangerous side effects, MAOIs are no longer considered a first line treatment. Most doctors prefer to treat Atypical depression with the safer SSRI antidepressants.
Some studies indicate that talk therapy is just as effective in treating atypical depression as medication. A study conducted in 1999 found that patients receiving cognitive behavioral therapy responded just as well as patients receiving the MAOI drug, Nardil, where 58% of patients in both groups improved.
For more information on atypical depression, including treatment information and self-help strategies visit All About Depression.
Source material: NIMH.gov, Webmd, APA DSM-IV, Wikipedia