What is Atypical depression symptoms complications treatments

Atypical depression is a mood disorder that is characterized by specific symptoms and manifestations. This psychopathological alteration is cataloged as a type of depression, since the symptoms it presents are mainly depressive. Indeed, atypical depression meets the diagnostic criteria for the establishment of major depressive disorder.

However, the specific nomenclature of atypical depression responds to the fact that this disorder is characterized by presenting a series of “atypical” symptoms that are not prevalent in most cases of depression.

In addition to typical depressive symptoms such as sadness or an inability to experience gratification, atypical depression is usually characterized by manifestations such as reactive mood, tiredness in arms and legs, increased appetite, hypersomnia, and hypersensitivity to personal rejection.

Similarly, it stands out for requiring different interventions than other types of depression. In general, people with this type and condition do not respond well to treatment with tricyclic antidepressants and respond to MAOIs.


The general symptoms of atypical depression are the same as those of other depressions. That is, the person is depressed most of the day, in addition to a significant decrease in interest or pleasure in all or almost all activities.

These two main symptoms are essential for the diagnosis of any type of depressive disorder. As atypical depression constitutes a type of depression, its two core manifestations are experiencing sadness and diminished interest and/or gratification.

However, in addition to these two core manifestations, atypical depression stands out due to the incorporation of less prevalent or unimportant manifestations in the rest of the depressive typologies.

This mood change stands out for presenting the following symptoms classified as “atypical”

vegetative signs

Vegetative manifestations that may be more or less prevalent in cases of depression are one of the predominant symptoms of atypical depression.

Among these types of signs are asthenia and fatigue in the context of a global lack of vitality. These manifestations are more marked during the first hours of the day in many patients.

Likewise, in this disorder, headaches with atypical characteristics, digestive disorders, loss of appetite, dry mouth, dyspepsia, gastralgias, constipation, diarrhea, loss of libido, impotence or balance disorder usually occur.

Finally, in some cases of atypical depression, the person may have a vertigo-like disorder characterized by a feeling of insecurity when walking without falling.

Anxiety and phobias

Anxious changes are other predominant symptoms in cases of atypical depression. People with this pathology usually have states of high anxiety during most of the day.

In this sense, it is generally common for anxiety to appear continuously to lower the mood. The person may be concerned that they are depressed and the main discomfort is their mood swings.

Worse at night

Another typical sign of atypical depression is worsening mood and symptoms at night.

People with this type of mood disorder may “feel better” during the day and experience an increase in their depressive symptoms at night.

initial insomnia

Difficulties falling asleep are also important and recurrent manifestations of this psychopathology.

People with this type of disorder tend to have a lot of difficulty sleeping and may experience sleepless nights due to difficulty closing their eyes.

daytime hypersomnia

As a consequence and as a cause of the previous manifestation, it is common for individuals with this type of depression to have high hours of sleep during the day.

Experiencing an accentuation of depressive symptoms at night and difficulties falling asleep often result in extreme tiredness and daytime sleepiness.

Likewise, high hours of rest during the day tend to further increase difficulties in falling asleep at night. People with atypical depression often sleep during the day and are awake and anxious at night.


Unlike most cases of depressive disorders, where symptoms are usually accompanied by a decrease in appetite and weight loss, hyperphagia is usually seen in atypical depression.

Subjects with this psychopathological alteration generally experience an excessive increase in the sensation of appetite, a fact that can lead to uncontrolled consumption and a notable weight gain.


It also stands out for preserving a certain mood reactivity. That is, people with this type of condition are able to experience a slight increase in mood in the face of positive events.

This factor is important in differentiating it from other depressive modalities, in which the experience of interest and pleasure is greatly reduced.

However, and in return, atypical depression usually also shows high reactivity to negative events. People with this disorder often break down in the face of minor adversity, falling into a paralyzing position.

Dejection or heavy paralysis

Finally, it is noted for experiencing a feeling of heaviness in the arms and legs.

This factor was one of the most important at the time of initiating the investigation into this type of depression, since individuals with other depressive modalities generally do not present specific symptoms in the extremities.

However, this is not the main symptom of atypical depression, as other mood swings can also occur with high feelings of fatigue and physical fatigue.

Complications of Atypical depression

It is usually related to different problematic situations or elements that may arise from the disorder itself. In this sense, special care must be taken in the following aspects:

Weight gain

The change in appetite that causes atypical depression is well documented and demonstrated, therefore, this change is a high risk factor for obesity.

Trying to balance intake and diet is a secondary therapeutic objective, but it can be highly important in different cases.

anxiety disorders

Although anxious symptomatology is not the main manifestation of atypical depression, it can be important in the clinical picture.

People with this type of depression may be at greater risk of developing an anxiety disorder, such as social phobia or panic attacks.


As in the vast majority of mood disorders, suicide is the main risk factor for the pathology.

Assessment of ideas about death, autolytic thoughts and suicidal planning should be paramount in the treatment of atypical depression.


Currently, there are specific treatments to intervene in atypical depression. In general, people suffering from this disorder have serious medical conditions that require medication.

Likewise, psychotherapy is a highly recommended tool to accompany pharmacological treatment.


Unlike most types of depression, people with atypical depression often do not respond adequately to treatment with tricyclic antidepressants.

The first choice drugs to treat this psychopathology are monoamine oxidase inhibitors (MAOIs). However, these medications should be used with caution as they can cause significant side effects.

Another type of psychoactive drug used in the treatment of atypical depression is selective serotonin reuptake inhibitors (SSRIs). These medications have fewer side effects than MAOIs and are effective medications for atypical depression.

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