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Atypical Depression

Considered a subtype of major depression and called atypical depression because many of the symptoms are the opposite of those found in classical depression, this type of depression is anything but uncommon and can linger for years when left untreated.

Having an earlier onset than other forms of depression and more common in women than men, those with this disorder are also at a greater risk of social phobia and other personality disorders.  Because of overlapping features some researches have suggested that this depression is a type of dysthymia or even a variant of cyclothymia, a mild form of bipolar disorder.


The cause as with other forms of depression is unknown but a number of factors such as brain chemistry, genetics, adverse life events and even thyroid dysregulation have been suggested to play a role in this mood disorder.


The Main Features of Atypical Depression:


Hyperphagia - The clinical term hyperphagia refers to excessive hunger and the ingestion of food and whilst those with typical depression will often skip meals, eat less than usual and lose weight; those with atypical depression eat more than usual with intense cravings for carbohydrates, sweets and chocolate resulting in weight gain.


Hypersomnia - Symptoms of insomnia are common in classical depression and include difficulty getting to sleep, early morning waking and then problems getting back to sleep but for those with atypical depression it is hypersomnia and excessive sleeping, difficulty waking up and still feeling un-refreshed and wanting more sleep even after 10-12 hours of sleep.


Leaden Paralysis - Psychomotor slowing, feeling unmotivated, worn out and physically apathetic are general features of depression but with leaden paralysis the arms and legs feel like lead balloons.  With leaden paralysis you may actually want to do something but you're body just won't let you and sometimes mass willpower is required even to just get out of bed, a chair or even walk across a room.


Mood Reactivity - Considered a defining symptom of this depression, mood reactivity involves an elevated mood resulting from positive circumstances, situations and life events, (albeit temporary before the elevated mood reverts back to one of depression) and is one feature that separates this depression from mood non-reactive depression such as major/melancholic depression.


Rejection Sensitivity - Another feature of this depression is sensitivity to criticism and rejection and this can result in difficulty developing and maintaining personal relationships and cause relationship problems and occupational impairment.  As already mentioned those with this depressive disorder are also more inclined to experience additional problems such as social phobia, avoidant personality disorder as well as other psychiatric disorders such as body dysmorphic disorder.


Treatment for Atypical Depression:


Atypical depression is considered one of the most debilitating and functional impairing forms of depression and often goes undiagnosed or misdiagnosed and when left untreated can linger for years and not just impact the suffer but also affect friends, family and co-workers.


This depression is however one of the most difficult to treat as many antidepressants that are 'effective' for other type of depression are ineffective for this type so finding a treatment can involve trial and error and experimenting with a number of different types of antidepressants before finding one that works.


Of the major antidepressants available the older tricyclic antidepressants (TCAs) have little if any impact whilst the monoamine oxidase inhibitors (MAOIs) although effective have a long list of side effects and those prescribed these antidepressants also have to stick to strict dietary restrictions and so these antidepressants are generally only prescribed as a second form of defence.


The selective serotonin re-uptake inhibitors (SSRIs) work for some but not for others but the SNRIs (serotonin-norepinephrine reuptake inhibitors) and NDRI's (norepinephrine and dopamine reuptake inhibitors) do seem to have an antidepressant effect in treating atypical depression.


Finally one alternative treatment option for those that find prescription antidepressants of no value in treating the symptom of this depressive illness or cannot tolerate the antidepressant side-effects there is chromium picolinate supplementation.  According to the Journal of Psychiatric Practice this supplement has an antidepressant effect and also helps relieve the intense cravings for carbohydrates which are a symptom of atypical depression.



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