Introduction
Atypical depression, also known as major depression with atypical features, is a distinct form of depression where the symptoms deviate from the conventional criteria. One distinguishing symptom of atypical depression is a transient improvement in mood when faced with actual or anticipated positive events, known as mood reactivity. Additional notable symptoms include heightened appetite and sensitivity to feelings of rejection. The term 'atypical' does not imply that the condition is strange or uncommon; rather, it indicates a departure from the characteristics associated with 'typical' depression.
How does Typical and Atypical Depression Differ from Each Other?
Both typical and atypical depression are mental health disorders characterized by prolonged feelings of sadness and hopelessness. The primary distinction lies in the temporary brightening of mood in response to positive events, such as an enjoyable birthday party, seen in atypical depression, whereas in typical major depression, the depressive mood typically remains constant.
Typical depression often leads to decreased appetite and insomnia (difficulty in falling asleep), while atypical depression commonly manifests as an increase in appetite and excessive sleepiness despite having sufficient sleep or oversleeping. Furthermore, atypical depression tends to manifest at an earlier age and persist for a longer duration, often becoming a chronic condition, in contrast to typical depression.
Who Is Susceptible to Developing Atypical Depression?
The prevalence of atypical depression is twice as high among women and individuals assigned female at birth compared to men and individuals assigned male at birth. This particular form of depression tends to emerge during adolescence or the early twenties.
What Is the Cause of Atypical Depression?
The exact cause of depression remains unknown. Similar to other mental disorders, there are various factors that may contribute to its development, including:
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Biological Differences: Individuals with depression often exhibit physical changes in their brains. The significance of these changes is still not fully understood, but they may eventually provide insights into the underlying causes of depression.
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Brain Chemistry: Neurotransmitters, which are naturally occurring brain chemicals, are believed to play a role in depression. Recent studies suggest that alterations in the function and impact of these neurotransmitters, as well as their interactions with the neural circuits involved in maintaining mood stability, may significantly contribute to depression and its treatment.
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Hormones: Changes in the body's hormonal balance may be implicated in the onset or triggering of depression. Hormonal shifts can occur during pregnancy, in the postpartum period (weeks or months after delivery), as a result of thyroid problems, menopause, or various other conditions.
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Inherited Traits: Depression tends to be more prevalent in individuals who have blood relatives with the condition. Researchers are actively investigating genes that may be involved in the development of depression.
What Are the Risk Factors of Atypical Depression?
Depression frequently emerges during adolescence, young adulthood (in the 20s), or early adulthood (in the 30s), although it can occur at any stage of life. While the diagnosis of depression is more common among women than men, this disparity may be influenced by the fact that women are more inclined to seek treatment. Several factors appear to heighten the risk of developing or triggering depression, including:
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Having a family history of depression.
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Experiencing a significant loss, such as through death, divorce, or separation, which may trigger an underlying susceptibility to depression beyond normal grief.
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Interpersonal conflicts and associated emotions like guilt.
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Enduring any form of abuse, whether physical, sexual, or emotional.
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Undergoing major life events such as relocating, changing or losing a job, graduating, retiring, or experiencing social isolation, particularly in individuals with a biological predisposition to depression.
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Facing serious illnesses such as cancer, heart disease, stroke, or HIV.
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Engaging in drug or alcohol abuse.
What Are the Symptoms of Atypical Depression?
The primary distinguishing feature of atypical depression, when compared to typical depression, is the temporary improvement of mood in response to positive events. Typically, this improvement is not observed in cases of typical depression. Additionally, individuals with atypical depression experience at least two of the following symptoms:
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Increased appetite and significant weight gain.
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Excessive sleepiness (hypersomnia).
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A heavy sensation in their arms or legs, also known as leaden paralysis.
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Heightened sensitivity to criticism or rejection, leading to significant impairment in social and occupational functioning. These emotional reactions can occur in response to imagined, anticipated, or real rejection.
Furthermore, other depressive symptoms commonly associated with atypical depression include:
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Intense feelings of sadness or hopelessness.
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Loss of interest in activities that were fun previously.
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Easy irritability or frustration.
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Difficulty concentrating or remembering things.
What Is the Treatment for Atypical Depression?
Treatment for atypical depression can be effective and may involve psychotherapy (talk therapy) and/or medication. Making lifestyle changes like regular exercise and avoiding alcohol or drugs can also help improve symptoms.
Psychotherapy involves working with a qualified mental health expert who helps to identify and change unhealthy emotions, thoughts, and behaviors. Cognitive behavioral therapy (CBT) is a common type of psychotherapy used to treat atypical depression. It helps to understand how one’s thoughts influence one’s actions and teaches healthier thinking patterns and habits.
Antidepressant medications are also used to treat atypical depression. Different types of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and noradrenaline reuptake inhibitors (SNRIs), can help balance neurotransmitters in the brain.
In the past, monoamine oxidase inhibitors (MAOIs) were often prescribed for atypical depression, but they have more severe side effects and dietary restrictions. As a result, they are less commonly prescribed nowadays. The choice of medication depends on the specific symptoms and needs.
What Are the Complications of Atypical Depression?
Depression is a severe disorder that can have a devastating impact on both the person and the family. If left untreated, depression often worsens, giving rise to emotional, behavioral, and health complications that permeate every aspect of one’s life. The followings are examples of the complications associated with depression:
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Excessive weight or obesity, which can contribute to the development of heart disease and diabetes.
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Physical pain or illnesses.
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Misuse of alcohol or drugs.
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Anxiety disorders, such as panic disorder.
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Family conflicts, relationship difficulties, and challenges at work or school.
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Social isolation, feeling disconnected from others.
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Suicidal thoughts, suicide attempts, or suicide.
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Self-harm behaviors, such as cutting.
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Premature death resulting from various medical conditions.
Is There Any Way to Prevent Atypical Depression?
While it is not possible to guarantee the prevention of depression, the following strategies may be helpful:
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Implement stress management techniques to enhance one’s resilience, improve self-esteem, and mitigate the impact of stress.
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Seek support from family and friends, particularly during challenging times, as their presence can assist in navigating difficult periods.
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Seek treatment promptly when one notices the initial signs of a problem, as early intervention can aid in preventing the escalation of depression.
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Consider long-term maintenance treatment as a preventive measure against the recurrence of symptoms.
Conclusion
Atypical depression, characterized by mood improvements in response to positive events, can be effectively treated with psychotherapy and medication. Making lifestyle changes and seeking early treatment is important. While the exact cause of depression remains unclear, factors like biological differences, brain chemistry, hormones, and inherited traits may play a role. Depression can lead to various complications, but they can be minimized through proper management. While prevention is not guaranteed, managing stress, seeking support, early intervention, and long-term maintenance treatment can help.
