The Ups and Downs of Atypical Depression

Atypical depression, a sub-type of major depression, is the most common form of depression today. People who suffer atypical depression exhibit all the normal symptoms of depression but they also react to external positive experiences in a positive way. Atypical depression sufferers respond to their environment, enjoying the company of friends but slipping back into deep depression when alone or faced with a stressful situation. It is this aspect of atypical depression that differentiates it from melancholic depression in which external positive experiences still result in depressed feelings.

People who suffer from atypical depression also exhibit other symptoms that aren’t normally associated with “normal” depression including:

• Increase in appetite with a weight gain of ten or more pounds.
• Hypersomnia over sleeping of more than 10 hours per day.
• Leaden paralysis of the arms and legs
• Long-term pattern of sensitivity to rejection in personal situations that causes social or work related withdrawal.

In 1998 Dr. Andrew A. Nierenberg, associate director of the depression clinical and research program at Massachusetts General Hospital, published a study that found 42% of participants suffered from atypical depression, 12% had melancholic depression, 14% had both depression subtypes and the remaining did not suffer from depression.

Studies have also found that atypical depression begins earlier in a person’s life than other forms of depression with most sufferers beginning to show symptoms in their teenage years. Those who suffer from atypical depression are also at greater risk of suffering from other mental disorders such as social phobias, avoidant personality disorder or body dysmorphic disorder. Atypical depression is more prevalent in females than males as well, with nearly 70% of it’s sufferers being women.

Treating atypical depression is an ongoing process. Research has shown that MAOIs such as Nardil or Parnate work reasonably well as do the newer SSRI medications (Lexapro, Prozac, Zoloft). Most patients prefer the SSRIs because they do not exhibit the unpleasant side effects of the MAOIs.

It is also important that if you or someone you know suffers from atypical depression that you or they seek psychiatric help. Atypical depression is not easy to diagnose the treatment choices can vary from patient to patient. A general care practitioner does not have the expertise to differentiate between the subtypes of depression and may not know the best course of treatment for their patient.

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