Atypical Depression

Atypical Depression

Depression is often thought of as extreme sadness or trouble eating and sleeping. Atypical depression, however, is a form of depression characterized by unusual symptoms. The Mayo Clinic explains:

Any type of depression can make you feel sad and keep you from enjoying life. However, if you have atypical depression, certain key signs and symptoms tend to occur. These include increased hunger, weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining relationships.

This form of depression is often seen beginning in high school students and is most frequent among girls. Despite being called “atypical,” this form of depression is actually very common and not unusual at all. According to the National Center for Biotechnology Information (NCBI), “Atypical depression is the most common form of depression seen in outpatient clinics in psychiatry.”

The odd characteristics that are seen when diagnosing atypical depression are what makes it “atypical.” Most forms of depression include extreme feelings of sadness, lack of sleeping and lack of eating, while atypical depression causes feelings of hypersensitivity and often includes the desire to eat and sleep more than normal.

Atypical Depression Symptoms

In 1994 atypical depression was first formally recognized by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). The DSM-IV specifies atypical depression will manifest with moodiness and at least 2 to 4 of the following symptoms: increased weight gain, overeating, unusual increase in sleep, fatigue, heavy limbs and hypersensitivity to rejection.


A possible symptom could be an increase in appetite and eating. While depression can lead to a lack of appetite, atypical depression may result in the opposite outcome. Overeating may cause a gain of wait, all directly caused by the depression. Gaining five pounds during a depressive episode is enough to count as a possible symptom for atypical depression.


When overeating is experienced, so is tiredness and fatigue. Atypical depression may cause a person to feel tired throughout their day, sleep longer and have trouble waking up. A loss of energy is often experienced and as well as the feelings of happiness that were often felt with certain events or associations.


A person experiencing the fatigue of atypical depression may suddenly start sleeping more than 10 hours a day. Between nighttime sleep and naps, sleep will often be at least two hours more when atypical depression is experienced than when no depression is experienced.

This increase of sleep will not be explained by an increase in activity or growth, but is due to depression and is paired with one or more of the other symptoms related to atypical depression. While many forms of depression may lead to anxiety and a struggle to find sleep, atypical depression may cause a desire for increased sleep—sometimes with feelings of needing to allow time to pass. One might feel as though there isn’t anything else that can be done for the moment but sleep, and this leads to real feelings of fatigue and the ability to sleep.

Heavy Limbs

Feelings of paralyzing heaviness may be felt due to atypical depression and fatigue. The feeling of limbs being weighed down will most often result in a decrease of activity.

Extreme Sensitivity

When something affects a person with atypical depression, the response is often hypersensitive. Rudeness may be one response given by the person with atypical depression when an event happens against their will. Extreme feelings of sensitivity and rejection may be felt when their ideas are turned down. Sensitivity of this kind results in interpersonal rejection and may result in social impairment or an excessive response.

Moodiness Resulting from Specific Events

Those suffering from atypical depression have a tendency to feel better when in a positive setting. This affected change can cause the person to feel liberated from the depression, and the DSM-IV reports that extended positive circumstances can result in extended feelings of positivity. However, these extended positive feelings are not due to an end of the depression, but have been brought about by the change of atmosphere—when events turn negative, the mood will also shift. The positive feelings, though not usually long-lived, may cause the person with atypical depression to not realize they are depressed.

Relationships often become stormy and difficult. A person with atypical depression may have difficulty in sustaining relationships and may avoid relationships altogether to steer clear of rejection or embarrassment. This will hamper the normal functional abilities of the person with atypical depression, most often resulting in unusual social struggles or substance abuse.

Atypical Depression Causes

The Mayo Clinic states, “Despite the name, atypical depression isn’t uncommon or unusual. Similar to other forms of depression, treatment for atypical depression includes medications, psychological counseling (psychotherapy) and lifestyle changes.” The NCBI also notes, “Significantly, depression with atypical feature is a chronic disorder with many subjects describing onset in childhood or adolescences13,15,16 and indicating that they have felt this way all of their lives.”

According to the Mayo Clinic, the exact cause of atypical depression is not known, but possible factors may include: brain chemistry, inherited traits, life events and early childhood trauma. Unbalance chemicals and neurotransmitters in the brain may lead to depression symptoms and may be passed to children. Traumatic events, such as a death of a close friend or family member, high stress or financial concerns may lead to depression. Distressing childhood events may trigger depression with the experience of serious events at a young age, like abuse or the loss of a parent.

Atypical Depression Treatment

A correct diagnosis must be formed before the right treatment will be found. The age of onset, frequency of episodes and other factors may be different among patients and must be considered before a diagnosis is formed. Treatments may require talk therapy or medication, depending on the severity and cause of the atypical depression. A therapist will be able to assess and diagnose the cause of atypical depressive symptoms and recommend a treatment plan accordingly.

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