Depression doesn’t look the same for everyone. Some people might experience symptoms that never quite go away. Others may feel their mood improve after something positive; however, their depressive symptoms return soon after. The latter is a subtype of major depressive order (MDD) called atypical depression, and it accounts for 15-36% of all depression cases.
If you’re wondering, “What is atypical depression,” this article will break down what sets atypical depression apart, what the symptoms look like, and how it’s treated.
Feeling sad is a normal part of life that everyone experiences from time to time. However, if your sadness doesn’t go away or gets worse over time, it may be a sign of something more serious.
Depression is a mental health disorder that can not only affect how you feel, but also how you think and function. This may look like having a negative predisposition toward life, withdrawing from hobbies, or having low energy. It can even cause physical symptoms like eating too much or too little.
Like many mental health conditions, depression exists on a spectrum. Some people have persistent symptoms, while others may have episodes that come and go (e.g., bipolar disorder).
There are also several subtypes of depression, each with their own patterns and causes. These subtypes include:
Both atypical and clinical depression fall under the umbrella of MDD, and while they have some overlap in symptoms, they still have their differences. In clinical depression, symptoms are consistent. A person may feel down with little to no change in their mood, even when something good happens.
On the other hand, atypical depression is defined by mood reactivity, which means a person may feel better temporarily in response to positive events. Someone might smile or laugh, but still struggle with ongoing symptoms beneath the surface.
Additionally, people with atypical depression have greater impairments in attention, alertness, and social cognition compared to those with clinical depression. These cognitive issues, plus the mood instability, can significantly affect one’s quality of life.
As mentioned previously, the main factor that defines atypical depression is that your mood can improve in response to something good, but then fall back down into depression just as quickly. In addition to mood reactivity, other symptoms may include:
Studies show that those with atypical depression report longer episodes, more hospitalizations, and poorer quality of life. They’re also more likely to engage in unhealthy coping behaviors like smoking or drinking.
Atypical depression frequently overlaps with other mental health conditions, especially anxiety (e.g., social anxiety and generalized anxiety disorder). When mood reactivity combines with heightened fear or worry, emotional regulation becomes an uphill battle.
Atypical symptoms can also resemble features of bipolar disorder. Both conditions feature mood swings and changes in energy, which sometimes leads to misdiagnosis. However, unlike bipolar disorder, atypical depression doesn’t include manic or hypomanic episodes.
Furthermore, some people with ADHD report depressive episodes that align with atypical features, including oversleeping, emotional sensitivity, and seasonal mood changes. Research suggests that symptom severity in ADHD may fluctuate throughout the year with some overlap seen in those who exhibit season and atypical depression patterns.
Atypical depression has patterns that are seen across genetics, brain function, life experience, and behavior. While the causes may vary from person to person, research has found several common factors:
When treating atypical depression, doctors may use one or a combination of treatments that are best suited for you. This could include medications, psychotherapy, or a different method.
Some people with atypical depression don’t respond well to first-line antidepressants. In fact, medications like monoamine oxidase inhibitors (MAOIs) have been found to be the most effective.
A series of six studies conducted at Columbia University found that phenelzine, a type of MAOI, was more effective in treating atypical depression than imipramine (tricyclic antidepressant) and placebo. Response rates were 26% for placebo, 44% for imipramine, and 72% for phenelzine.
That said, medication response isn’t guaranteed. Your doctor can work with you to find a medication that’s effective for your specific symptoms.
Cognitive behavioral therapy (CBT) is commonly used to treat many forms of depression. It helps patients challenge unhelpful beliefs and improve their communication in their interpersonal relationships. Therapy may also look at past experiences, like rejection or neglect, as these may be influencing your current behaviors.
When traditional treatments aren’t enough, it may be time to explore alternative options.
Research into transcranial magnetic stimulation (TMS) has found a different brain target for atypical depression compared to other types of MDD. While traditional TMS focuses on the dorsolateral prefrontal cortex, one study found that low-frequency TMS applied to occipital cortex (visual processing and emotional perception) led to better outcomes for people with atypical symptoms. The study reported a 70.73% response rate and a 46.34% remission rate.
Other treatment options may include acupuncture or light therapy. Keep in mind, these two options aren’t replacements for clinical care, but they can be useful add-ons to help ease depression symptoms.
Professional treatment is important, but how you take care of yourself day to day can also affect how you feel. Here are some helpful strategies:
Atypical depression can be hard to recognize, especially when your mood improves around others or during positive moments. However, temporary relief doesn’t mean you’re fine, and it doesn’t mean that you have to keep pushing through on your own.
At Cura Behavioral Health, we offer personalized therapy and medication management for people living with atypical depression. Whether you’ve tried treatment before or you’re just starting to consider it, our team is here to help you find a plan that works.
Contact us today to schedule an appointment and get back to feeling like you again.
Social Anxiety Disorder: a General Overview – SHS Web of Conferences
The repressed life of adult female patients with mild ADHD – Frontiers in Psychiatry
A neuroimaging-based precision medicine framework for depression – Asian Journal of Psychiatry
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
