Atypical Depression: Treatment, Symptoms, Tests
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Atypical Depression

Overview

Atypical depression used to be considered a form of depression. The American Psychiatric Association no longer recognizes atypical depression as a separate disorder. Instead, the condition is now called major depression with atypical features.

Major depressive disorder (MDD) is a mental disorder that can affect how people think, feel, and behave. People with MDD often lost interest in doing activities they usually enjoy and have trouble performing everyday tasks. Occasionally, they may also feel as if life isn’t worth living. These symptoms may interfere with daily life and take a toll on physical and emotional health.

The symptoms of MDD with atypical features are similar to those of classic MDD. However, there is a key difference. In people who have MDD with atypical features, mood can improve in response to positive circumstances and events. A positive change is unlikely to boost mood in those with classic MDD.

Atypical Depression Symptoms

Symptoms

The symptoms of MDD with atypical features can vary from person-to-person. In general, however, those with the condition often experience symptoms of MDD. These symptoms include:

  • persistent feelings of sadness or hopelessness
  • anxiety or irritability
  • sleeping too much or too little
  • loss of interest in activities that were once enjoyable
  • difficulty concentrating, making decisions, and remembering things
  • low energy or fatigue
  • thoughts or talk of suicide

They may also experience atypical features of MDD, such as:

  • mood that temporarily lifts or brightens in response to positive events or good news
  • significant weight gain
  • increase in appetite
  • heavy feeling in the arms or legs
  • body aches or headaches
  • sleeping for extended periods of time during the day or night
  • extreme negative response to perceived criticism or rejection

Atypical Depression Causes

Causes

The exact cause of MDD with atypical features isn’t known. However, there are factors that can increase the risk of developing this condition. Common risk factors include:

  • traumatic experiences, such as physical abuse, death of a loved one, or divorce
  • a history of abusing alcohol and drugs
  • being diagnosed with a major illness

Genetics may play a role in the development of MDD as well. People who have a family history of MDD are more likely to develop the condition.

MDD may also be caused by an imbalance in brain chemicals that regulate mood, such as serotonin, norepinephrine, and dopamine.

Atypical Depression Diagnosis

Diagnosis

Schedule an appointment with your doctor if you believe you have MDD with atypical features. Your doctor may complete a physical examination and order lab tests, such as a complete blood count and a thyroid function test. These tests can check for potential health problems that may be triggering your symptoms. Treating an underlying illness may improve your mood and ease other symptoms associated with MDD.

Your doctor may also complete a psychological evaluation to look for signs of MDD with atypical features. They may ask you questions about your:

  • symptoms
  • personal life
  • past experiences
  • current medications
  • personal or family history

Your doctor may diagnose MDD with atypical features if:

  • there is no underlying condition causing your symptoms
  • your symptoms match the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Atypical Depression Treatment

Treatment

Treatment for MDD with atypical features can vary. In most cases, however, treatment includes a combination of medications, talk therapy, and lifestyle changes.

Medications

Your doctor may prescribe antidepressants, such as monoamine oxidase inhibitors (MAOIs) or selective serotonin reuptake inhibitors (SSRIs). Some people who have MDD with atypical features don’t respond well to tricyclic antidepressants. However, numerous MAOIs and SSRIs have proven effective in treating symptoms of the disorder. Your doctor may prescribe one medication or a combination of medications to control your symptoms.

It’s important to note that taking an MAOI may require changing your diet. These antidepressants can interact with certain foods and medications, including birth control pills and decongestants. Make sure to ask your doctor about side effects and food or drug interactions before you begin taking a new medication.

Talk Therapy

Talk therapy involves meeting with a therapist or counselor on a regular basis. This type of treatment allows you to:

  • express your feelings
  • identify unhealthy thoughts
  • learn how to problem solve

This can help you cope with your condition and improve your outlook. Your therapist can also show you how to set realistic life goals so you can regain a sense of satisfaction and control over your life.

Lifestyle and Home Remedies

Aside from medication and therapy, lifestyle changes and home remedies may also help relieve symptoms of MDD with atypical features. These include:

  • avoiding recreational drugs and alcohol
  • exercising at least three times per week
  • getting plenty of sleep
  • implementing relaxation techniques, such as deep breathing and meditation
  • taking certain supplements, such as fish oil and St. John’s wort

Make sure to consult with your doctor before you start taking any supplements. Some natural remedies may interact with certain medications used to treat MDD.

Living with Atypical Depression

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Talk therapy, medication, and lifestyle changes are effective treatments for MDD with atypical features. But there are other ways to cope with symptoms:

  • Write in a journal every day.
  • Plan ahead and manage your time well.
  • Participate in activities that help manage stress, such as yoga, tai chi, or meditation.
  • Surround yourself with family and friends instead of isolating yourself.
  • Confide in a trusted friend.
  • Ask your doctor for information on local support groups for depression.

You Asked, We Answered

  • How can I help someone who has MDD with atypical features?
  • The best way to help somebody who has MDD with atypical features is to be supportive. Acknowledge that their mood is not related to anything you did or said to them. Rather, their mood is related to the symptoms of the disorder. Mood has the potential to brighten when positive news or circumstances occur. So you can help the individual to see positive aspects of things going on in their lives. If they’re taking prescription medications, encourage them to take the medications as directed. You should also encourage them to attend all follow-up appointments with their doctors.

    - Timothy J. Legg, PhD, PMHNP-BC

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