Atypical depression is a type of depression that accounts for the complexity of this group of mental disorders. It shows that what we popularly call “being depressed” is a complex psychological phenomenon that can be expressed under a variety of symptoms that can be classified in different ways.

Next we will see what the symptoms of atypical depression are, what characteristics differentiate it from other types of depression and what kind of treatments have been shown to be effective in intervening in these cases.

What is atypical depression?

Atypical depression is a depressive disorder that, despite presenting many of the characteristics of major depression, also expresses other atypical symptoms that are rare in this kind of psychopathological disorder .

For example, while the main symptoms of this group of disorders, such as sadness or anhedonia and abulia, are present in atypical depression, other signs and symptoms also appear, such as an overreaction to events perceived as negative, an extreme increase in sleep and the need for sleep, etc.

In general terms, atypical depression is considered to be low prevalence, i.e. rare and rarely diagnosed . Most cases of depression receive another diagnosis.

Symptoms of Atypical Depression

The symptoms of atypical depression can be very varied, especially considering how rarely it is diagnosed. The signs and symptoms most often associated with this type of depression include the following.

1. Hypersomnia

The person feels a deep need for sleep, which causes him/her psychosocial and work problems , as it interferes with his/her work. This also produces a greater isolation, and has a negative impact on the possibility of developing motivational projects.

In the end, the problems in organizing a schedule, as well as the lack of social life that is a consequence of hypersomnia, make the day-to-day life of the person with atypical depression increasingly monotonous, lacking in novel stimuli.

2. Hypersensitivity

Many people with atypical depression feel that any sign means that there is a negative situation for them . For example, an ambiguous reaction from another person is interpreted as a sign of rejection or mockery, or a relative failure, such as not arriving on time at a bus that has already started, is seen as a sign that the day will be catastrophic.

However, this reactivity usually also appears in the face of positive events , although to a lesser degree than that expressed in the face of unpleasant situations. This ability to react relatively happily to positive situations is something that does not occur in most cases of depression, and is one of the distinguishing features of atypical depression.

3. Extreme increase in appetite

In major depression it is typical that patients experience a significant decrease in the feeling of hunger, added to a general attitude of passivity and lack of initiative.

In atypical depression, however, hyperphagia is relatively frequent, and is very associated with psychological states marked by excessive anxiety. For this reason, binge eating and frequent visits to the refrigerator may occur, which appear as a form of compensatory behaviour, to distract oneself from those thoughts that generate anxiety.

4. Extreme tiredness

Many patients with this type of depression feel a sense of dejection that leads them to spend a lot of time resting on a bed or couch. This, in turn, contributes to them feeling more isolated and alone , which feeds the vicious circle of depression. The lack of energy is expressed in all facets of life, from work to social life and the attention to the basic needs of food, hygiene and care of the home.

5. Anxious states

This is a group of symptoms related to the states of anxiety typical of other mental disorders and which, in the case of depressive disorders, are much less common. For example, the person with atypical depression may feel anxious about being aware of his or her condition, or may be very worried about the image he or she is giving in front of others. This feeling of discomfort adds to the damage to the quality of life caused by the symptoms typically associated with depression.

Its causes

As with most mental disorders, the reason for the appearance of atypical depression has to do with multi-causal phenomena . This means that biological and genetic elements, but also cultural ones, participate in its existence, as well as factors associated with the learned dynamics of interaction with the environment and with other people.

For example, a traumatic event can trigger genetically latent biological processes, and the way in which this experience is lived will be influenced by the culture that has been internalized and by learning and customs. Neither the environment nor genetics are solely responsible for atypical depression.

Treatments

The psychotherapeutic intervention is very relevant in the treatment of atypical depression, as it allows patients to be trained in a large number of habits and social skills that will allow them to improve their quality of life (without making the symptoms disappear completely).

Specifically, cognitive-behavioral therapies allow us to act both on our daily behavioral habits and on our ideas, beliefs and thinking styles, in order to achieve effects both on the actions linked to movement and interaction with the environment and on the mind and the way in which what is happening is perceived and interpreted.

As for treatment with psychotropic drugs, this is also frequent in medical intervention in cases of atypical depression, especially considering the seriousness of this disorder and the way it affects practically all areas of personal and working life.

The most commonly used medications are antidepressants , such as selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). Both are drugs whose use can only be initiated by a doctor’s prescription, and their use must be monitored by expert mental health and psychiatric personnel.