Atypical depression constitutes a specific variant of major depressive disorder; it is not a separate diagnosis. In addition to the symptoms required for the diagnosis of major depressive disorder, "atypical" symptoms include mood reactivity, excessive sleeping, excessive eating, a feeling of "leaden paralysis" and extreme sensitivity to interpersonal rejection.
Basics
For a diagnosis of depression with "atypical features" to occur, an individual must first meet all the criteria for major depressive disorder. Symptoms include sad or depressed mood and lack of interest or pleasure in activities normally enjoyed, as well as several secondary features, such as sleep problems, eating problems and fatigue, according to the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders."
Individuals with "atypical depression" do not experience unusual symptoms, as the name implies, but experience specific patterns in the depression symptoms listed above, as well as some additional, specific symptoms.
Mood Reactivity
An individual with atypical depression experiences the low, or sad, mood characteristic of major depressive disorder. In a different twist, however, the "atypical" individual responds well to individuals who attempt to cheer him up and feels better, temporarily, when in a situation that is enjoyable and happy. Other individuals with major depressive disorder, especially those designated as "melancholic," do not experience this type of situational reactivity.
Increased Appetite
Individuals with major depressive disorder may experience either a significant increase or decrease in appetite. Some may have to force themselves to eat and lose large amounts of weight. However, individuals with atypical depression characteristically present with the opposite problem--they report a ravenous appetite and find it difficult to stop themselves from eating. These people may experience significant weight gain, states the American Psychiatric Association (APA).
Increased Need for Sleep
A person with depression may sleep a lot less or a lot more than is typical for her. Insomnia is quite common in melancholic depression. However, a person with atypical depression experiences the opposite problem--sleeping significantly more than usual. For example, an individual who usually sleeps eight hours may find herself sleeping 10 to 12 hours when in the depths of atypical depression.
Leaden Paralysis
Most individuals with major depressive disorder report feeling a state of almost constant fatigue. However, the person with atypical depression may experience an additional symptom: a feeling of heaviness in his arms and legs, as if he is filled with lead, explains the APA. He may feel he cannot lift his arms or walk easily due to this subjective experience.
Sensitivity to Rejection
People with atypical depression experience a pattern of being especially sensitive to perceived rejection or criticism by others. The APA says that this long-standing pattern occurs even when the person feels good. These individuals tend to feel very sad or angry about the perceived criticism or rejection, which results in significant social or occupational problems.
References
- "Diagnostic and Statistical Manual of Mental Disorders"; American Psychiatric Association; 2000
- American Medical Network: Major Depressive Disorder
- All About Depression: Specifiers Used to Describe Mood Disorders
