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Atypical Depression

Also known as Depression with Atypical Features, this subtype of a Major Depressive Episode has a certain set of symptoms that makes it different from a regular episode. This subtype can also be seen in episodes of Dysthymia.

According to the DSM-IV-TR, the main criterion for Atypical Depression is that the depressed mood brightens, if only temporarily, in response to perceived positive events. This is a phenomenon known as mood reactivity.  These positive events can be things as simple as a kind comment from a friend, or participating in a fun activity.  

In addition, the person will have two or more of the following symptoms:

  • A significant increase in appetite and/or weight
  • Sleeping much more than normally
  • Having a heavy, leaden feeling in the arms and legs, known as leaden paralysis
  • For much of their life the person has tended to be someone who is very sensitive to feelings of rejection, to the point where this sensitivity has caused them difficulties in social or occupational settings

This may seem like an odd and somewhat random collection of symptoms, and we still do not know why they go together. Yet the fact remains that this type of Depressive Episode is very common, occuring in over a third of all cases of Depression, and it seems to reflect a more serious form of the illness [ref]. Compared with non-atypical depression, people with Atypical Depressive Episodes tend to have had an earlier age of onset of their Major Depressive Disorder and are more likely to have suffered from childhood abuse [ref]. Their Depressive Episodes tend to be more severe and they are more at risk for suffering from other psychiatric disorders as well, including Panic Disorder, Social Anxiety Disorder and Substance Abuse [ref]. Many of these individuals also turn out to have an underlying Bipolar Disorder [ref]. Woman tend to suffer from Atypical Depression more frequently than men [ref].

 

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Major Depressive Episode

Melancholic Depression