Depression doesn’t have a stereotypical look, and you can’t necessarily tell if someone is struggling based on how they outwardly behave. However, atypical depression has different symptoms from the conventional presentation of depression. Because of this, the condition may be overlooked, and people experiencing these symptoms might not know what's going on.
People with atypical depression often have features similar to conventional depression. However, their mood tends to brighten in response to positive events. They also tend to experience higher levels of interpersonal rejection sensitivity.
Although atypical sometimes means unusual or rare, research shows that is relatively common, impacting anywhere from 15-36% of people with a depressive disorder.
Let's get into what you need to know.
Symptoms of Atypical Depression
There is a significant overlap between atypical depression and conventional major depressive disorder symptoms. The main difference lies in mood reactivity. People with atypical depression tend to feel happiness or excitement when positive events occur. This doesn't generally happen in classic cases of major depression.
That doesn't mean the atypical depression is any less serious. All types of depression lie on a continuum- symptoms may vary from mild to severe and can ebb and flow throughout the lifetime.
Research shows that atypical depression is about four times more common in women than in men. The average age of symptom onset is around adolescence, and people with atypical depression often experience symptoms at an earlier age.
Atypical depression also has high rates of comorbidity with anxiety disorders, bipolar disorder, and seasonal affective disorder.
Here are some of the main atypical depression symptoms:
Increased mood reactivity: This means that you experience happiness and/or excitement in response to positive events. This contrasts with melancholic depression, where people generally don't experience a boost in mood based on external circumstances. Because of this symptom, some people doubt that they actually have depression or they don’t believe their depression is “serious” enough.
Increased appetite/significant weight gain: People with atypical depression may feel hungrier than normal when they feel depressed. This symptom can coincide with disordered eating habits, including binge eating, compulsive overeating, and using compensatory measures (such as purging). People with typical depression also tend to experience appetite shifts, but they're more likely to lose their appetite and/or lose weight.
Hypersomnia: Hypersomnia refers to sleeping too much and feeling like you need more sleep than usual. Hypersomnia usually means sleeping more than 10 hours per day (or 2 hours more than usual). Despite the additional sleep, you don't feel adequately rested, and you may feel sluggish throughout the day.
Heavy sensations in the arms and legs: Also known as leaden paralysis, this symptom refers to feeling like your limbs are being weighed down. You might also experience excessive fatigue due to this sensation. It's common for people to categorize this depressive symptom for other health conditions like chronic fatigue syndrome or chronic pain.
Difficulty accepting feedback/sensitivity to criticism: While nobody likes feeling rejected, a heightened sensitivity to feeling judged is one of the major components of atypical depression. This pattern tends to be long-term, and it often impacts relationships and other areas of functioning.
Suicidal thoughts: Anyone with depression is at a higher risk of suicidal thoughts and suicidal behavior. However, atypical features can mask a typical depressed mood. Other people may not be as aware of this potential risk factor.
Increased irritability: Like with classic major depressive disorder, people with atypical depression may experience more irritation during the day. You may feel like you're always snapping or upset with something, and this frustration can cause you to lash out at others.
Anhedonia: In all types of depression, it's common for people to lose interest in relationships or activities that once felt pleasurable. Sometimes this anhedonia is so strong that you feel a persistent sense of numbness throughout the day.
How Is Atypical Depression Diagnosed?
Like with most mental disorders, it's important to rule out medical concerns to obtain an accurate diagnosis. Many health conditions, such as fibromyalgia, hypothyroidism, or vitamin deficiencies have symptoms that mimic depression. A thorough physical exam and lab tests help screen for these other conditions.
Major depressive disorder is generally diagnosed when symptoms cannot be better explained by another condition and when they match the criteria listed within the Diagnostic and Statistical Manual (DSM).
Keep in mind that you don't need to fully meet the criteria for major depressive disorder to benefit from seeking support. Even if you have just a few atypical symptoms- or you're worried about other mental health issues- it's worth addressing your concerns with a therapist.
How Does Therapy Treat Atypical Depression?
Mood disorders can be frustrating and challenging, but it is possible to overcome your depressive symptoms and live a meaningful life. Looking after your mental health is one of the most valuable decisions you can make for your emotional well-being.
People with atypical depression tend to respond well to therapy. Your treatment will vary based on your specific symptoms, goals, and prognosis, but we may focus on the following goals:
Understanding and challenging unhealthy thoughts: Depressive symptoms often pair with negative beliefs like, I'm worthless, or, Life is always unfair. Therapy can help you untangle the subjectivity behind these thoughts to make them into more rational mindsets.
Treating underlying trauma perpetuating depression: is a significant risk factor for depression. Trauma-informed therapy, including EMDR, offers a safe environment to heal from trauma symptoms. This work can help you feel better about yourself and decrease your depressive symptoms.
Engaging in positive lifestyle changes: Therapy can help you identify healthy lifestyle changes, such as mindfulness, building a positive support system, and practicing more self-compassion. While these skills do not inherently cure a mood disorder, they can help reduce the intensity and frequency of certain symptoms.
Expressing your feelings in a supportive environment: Therapy offers a supportive space to share your true feelings and be your authentic self. This time is entirely dedicated to you.
I am here to support you on your journey to wellness. I would be honored to provide you with compassion and guidance during this time.
Contact me today to schedule an initial consultation.
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