Atypical Depression

Medically Reviewed by Shruthi N, MD on September 08, 2024
Written by Alyson Powell Key
4 min read

Atypical depression (also called atypical depressive disorder) can be an additional feature or type of major depression or dysthymic disorder (a mild, long-lasting form of depression). People with atypical depression often have their first symptoms at an early age, during their teenage years.

Someone with classic major depression has at least five of the following nine symptoms:

  • Feeling sad or down most of the day, nearly every day
  • Not enjoying things you used to like
  • A big change in weight or how much you eat (gaining or losing more than 5% of your weight in a month)
  • Having trouble sleeping or sleeping too much nearly every day
  • Feeling fidgety or unusually tired, which other people can notice
  • Feeling worn out or low on energy almost every day
  • Feeling hopeless, worthless, or overly guilty almost every day
  • Trouble focusing or making decisions nearly every day
  • Frequent thoughts about dying or suicide, making a plan, or attempting suicide

Dysthymic disorder (also called persistent depressive disorder) involves feeling depressed most days for at least 2 years in adults (one year in children and teens) and having at least two of the symptoms listed above but fewer than the five needed to diagnose major depression.

Atypical depression is common despite its name (in this case, "atypical" means different from "typical" depression). It's different from another type of depression called melancholic depression. In melancholic depression, you often:

  • Have trouble sleeping (instead of sleeping too much)
  • Lose your appetite (instead of eating more)
  • Don't have mood changes based on what’s happening around you
  • Have a much harder time feeling pleasure

One of the main differences between atypical depression and melancholic depression is how your mood reacts to good things. With atypical depression, your mood often gets better when something positive happens. In melancholic depression, good events usually don’t improve your mood. To diagnose atypical depression, a person must also have at least two of these symptoms along with mood reactivity:

  • Sleeping too much
  • Eating more or gaining weight
  • Being extra sensitive to rejection, which can cause problems in relationships and work
  • A mental feeling of heaviness or being weighed down

Your doctor will check for physical reasons behind these symptoms. This usually involves a physical exam and tests to find issues such as hypothyroidism. With this condition, low levels of thyroid hormone can cause symptoms such as depression and weight gain.

Doctors believe depression happens when brain circuits that control mood don’t work properly, affecting how different parts of the brain communicate. Nerve cells in these circuits send signals using brain chemicals called neurotransmitters, such as dopamine, serotonin, and norepinephrine. Antidepressants may adjust these chemicals to help mood-related brain circuits work better.

Although doctors don't know the exact cause of depression, certain things can raise your chances of getting it, such as:

  • A family history of depression
  • A major loss, such as death, divorce, or separation
  • Conflicts with others and feelings of guilt
  • Physical, sexual, or emotional abuse
  • Major life changes such as moving, losing or changing jobs, or being socially isolated if someone is already vulnerable to depression
  • Serious illnesses
  • Drug or alcohol abuse

Your doctor is likely to suggest psychotherapy (talk therapy) and medication for atypical depression, depending on how serious your symptoms are. There are different types of psychotherapy and medications available for treatment. Your doctor may refer you to a specialist such as a psychiatrist, psychologist, or other licensed mental health professional for care.

It can be challenging to live with depression, but there are ways to care for yourself, such as:

  • Talk to someone you trust, such as a friend, family member, or mental health professional.
  • Get peer support through groups specializing in mental health.
  • Try mindfulness, which involves being aware and present in the moment.
  • Take care of yourself by eating nutritious food and getting enough sleep and physical activity.
  • Get some sunlight and fresh air, which research shows can improve your mood.
  • Try a new or creative activity.
  • Keep a mood diary or journal to track how you're feeling day to day and express your thoughts.

Here are some ways that you can support a loved one who's dealing with atypical depression:

  • Encourage them to get help, including finding services or going to appointments.
  • Talk openly about depression and listen to them without judgment.
  • Keep in touch through texts, emails, or phone calls.
  • Don't blame them for their depression.
  • Offer practical help, such as cooking or cleaning, but encourage them to do some things themselves.
  • Continue with usual activities and conversation to maintain normalcy in your relationship.

Atypical depression is a type of depression where you might have a temporary boost in mood in response to something positive happening. Other symptoms include feeling hungrier than normal, sleeping too much, and being sensitive to rejection. Treatments for atypical depression include talk therapy and medication.