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What Is Atypical Depression

The number of Americans suffering from depression is significant – about 15 million people every year. But that number will jump in 2020 due to COVID-19 and its effects, driving millions more into its depths as they struggle with illness, death, financial hardships, and other societal changes never imagined.


WebMD defines atypical depression as “a subtype of major depression or dysthymic disorder that involves several specific symptoms, including increased appetite or weight gain, sleepiness or excessive sleep, marked fatigue or weakness, moods that are strongly reactive to environmental circumstances, and feeling extremely sensitive to rejection.”
Major depression or dysthymic disorder have a common “specifier” – atypical depression. People suffering from atypical depression have frequently faced depression first early in their lives, normally in their teens.


Besides mood reactivity, someone suffering from atypical depression may experience two or more of:

  • A bigger eating habit, resulting in significant weight gain
  • Sleeping an excessive amount of hours
  • Feeling as if your arms and legs are very heavy, also known as leaden paralysis
  • You have increased sensitivity and intense reaction to rejection or criticism, resulting in considerable work and social impairment

These symptoms are different than you might experience with typical depression, which includes insomnia and loss of appetite. Unfortunately, the mood of people suffering from atypical depression usually does not get better, even when something good happens.
It is not uncommon for a person with atypical depression to experience other symptoms, such as:

  • Depressed mood or sadness for the entire day or nearly every day
  • Loss of enjoyment in activities that were once enjoyable
  • Major change in appetite or weight
  • Insomnia or too much sleep nearly every day
  • A state of being rundown or physical restlessness that is observable by others
  • Loss of energy or fatigue almost every day
  • Feelings of worthlessness, hopelessness, or excessive guilt nearly every day
  • Problems with making decisions or focusing almost every day
  • Repeated thoughts of suicide or death, suicide planning, or suicide attempts


Over the years, research has begun pinpointing several factors that appear to increase the risk of triggering or developing depression:

  • Personality traits, such as being too dependent and having low self-esteem, being pessimistic or self-critical
  • Stressful or traumatic events, including instances of sexual or physical abuse, the
  • loss or death of a loved one, a bad relationship, or money problems
  • Blood relatives with a history of bipolar disorder, depression, alcoholism, or suicide
  • History of an anxiety disorder, eating disorder, post-traumatic stress disorder, or other mental health ailments
  • Abuse of recreational drugs or alcohol
  • Serious or chronic illness, including stroke, chronic pain, cancer, or heart disease
  • Taking certain medications, like some high blood pressure drugs or sleeping pills – always talk to a doctor before using any medication


While the roots of depression are unknown, there are factors which boost the risk, including:

  • Family history
  • A substantial loss — from divorce, death, or separation — that could trigger an underlying susceptibility to depression as opposed to normal grief
  • Interpersonal disputes and related emotions like guilt
  • Any type of physical, sexual, or emotional abuse
  • Any kind of major life experience such as changing or ending a job, moving, retiring, graduating, or social isolation in people with a biological predisposition to depression
  • Any type of major illness such as COVID-19, heart disease, cancer, stroke, or HIV
  • Drug or alcohol misuse


Diagnosis of atypical depression or any other normally involves:

  • A physical exam to rule out or link depression to an underlying physical health problem.
  • Lab or blood tests to ensure your thyroid or other organs work as expected.
  • A psychiatric evaluation and questionnaire to review your symptoms, thoughts, feelings, behaviors.
  • Consulting with criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Following a medical and psychological evaluation, a positive diagnosis will likely result in your health provider recommending treatment. Options like psychotherapy, self-help, hospitalization, and the use of a newer form of treatment like ketamine infusion therapy to treat mood changes may be discussed. Ketamine and esketamine are administered via infusion therapy or as a nasal spray and are known to help manage your depression symptoms.


Depression and other mental illnesses are treatable with psychotherapy and drugs like ketamine, but the key to managing symptoms is recognizing them and seeking immediate care. If you think you suffer from atypical depression, contact us to get help today.