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What is Atypical Depression?

Atypical depression is a subtype of depression that is extremely common, contrary to what one might expect from the name. More than 40% of people with major depression experience atypical depression, and the age of onset is often young, usually in the teens. There are a variety of treatment options available for this mental health condition. Patients are generally advised to see a therapist because each case is different and treatment needs to be tailored to the needs of the patient.

People with atypical depression have many of the hallmark symptoms of depression, paired with what is known as mood reactivity: they can experience isolated mood improvements. People with major depression usually do not respond to happy events and don't experience mood elevation, while people with atypical depression may periodically feel good in response to events around them. Symptoms like anxiety, suicidal thoughts, feeling down, and lethargy can all be noted in patients with atypical depression.

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In addition, patients develop some combination of excessive sleeping, rejection sensitivity, overeating, and a leaden feeling in the limbs. Some patients may have all four, but others have at least two. This can cause impairments for the patient, particularly in the case of rejection sensitivity, where patients are extremely reactive when they sense rejection, even if it is not intended. This can contribute to social anxiety and may make it difficult to maintain interpersonal relationships, in addition to making it hard to function at work, where forms of rejection can be encountered on a regular basis.

Treatment for this mood disorder can include prescription medications to improve the patient's brain chemistry, with the goal of addressing an imbalance of neurotransmitters. Some patients also experience benefits from talk therapy. Addressing the medication initially with medication may allow patients to reach a state where they can benefit from therapy, and it may be possible to wean off antidepressants later, depending on the specifics of a patient's case.

The young onset of this disorder can be a problem for patients. A teen who is sleeping a lot, consuming copious amounts of food, and feeling generally down and unmotivated may have these signs attributed to laziness without any further clinical investigation. This can result in untreated depression, potentially exposing the patient to more serious risks, like suicide. It is important for teens and young adults to be evaluated if they experience symptoms like anxiety, lack of motivation, and feelings of depression or hopelessness.

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