Atypical Depression

 $ Atypical depression $
Atypical depression, or depression with atypical features as it has been known in the DSM, is depression that shares many of the typical symptoms of the psychiatric syndromes major depression or dysthymia but is characterized by improved mood in response to positive events. In contrast, people with melancholic depression generally do not experience an improved mood in response to normally pleasurable events. Atypical depression also features significant weight gain or an increased appetite, hypersomnia, a heavy sensation in the limbs and interpersonal rejection sensitivity that results in significant social or occupational impairment.[1]

Despite its name, "atypical" depression does not mean it is uncommon or unusual.[2] The reason for its name is twofold: (1) it was identified with its "unique" symptoms subsequent to the identification of melancholic depression and (2) its responses to the two different classes of antidepressants that were available at the time were different from melancholic depression (i.e., MAOIs had clinically significant benefits for atypical depression, while tricyclics did not).[3]

Atypical depression is two to three times more common in women than in men.[1] Individuals with atypical features tend to report an earlier age of onset (e.g. while in high school) in their depressive episode, which also tend to be more chronic[4] and only have partial remission between episodes. Younger individuals may be more likely to have atypical features, whereas older individuals may more often have episodes with melancholic features.[1] Atypical depression has high comorbidity of anxiety disorders, carries more risk of suicidal behavior, and has distinct personality psychopathology and biological traits.[4] Atypical depression is more common in individuals with bipolar I,[4] bipolar II,[4][5] cyclothymia[4] and seasonal affective disorder.[1] Depressive episodes in bipolar disorder tend to have...