ATYPICAL DEPRESSION: SYMPTOMS, COMPLICATIONS AND TREATMENTS - ARTE - 2026

The atypical depression is a disorder of mood characterized by symptoms possess and specific manifestations. This psychopathological alteration is classified as a type of depression, since the symptoms it presents are mainly depressive. In fact, atypical depression meets the diagnostic criteria for the establishment of major depressive disorder.

However, the particular nomenclature of atypical depression responds to the fact that this disorder is characterized by presenting a series of symptoms that are "atypical" and not very prevalent in most cases of depression.

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

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

Symptoms

The general symptoms of atypical depression are the same as for other depressions. That is, the person has a depressed mood most of the day, as well as 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 the experience of sadness and the decrease in interest and / or gratification.

However, apart from these two core manifestations, atypical depression stands out due to the incorporation of manifestations that are not very prevalent or not very important in the rest of the depressive typologies.

This mood alteration is notable 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, asthenia and fatiguebildiad stand out 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, this disorder usually presents headaches of atypical characteristics, digestive disorders, loss of appetite, dry mouth, dyspepsia, gastralgia, constipation, diarrhea, loss of libido, impotence or balance disorder.

Finally, in some cases of atypical depression, the person may present a disorder that resembles vertigo, which is characterized by the feeling of insecurity while walking, without actually falling.

Anxiety and phobias

Anxious alterations are another of the predominant symptoms in cases of atypical depression. People with this pathology tend to have states of high anxiety for most of the day.

In this sense, it is usually common for anxiety to appear continuously with the decrease in mood. The person may be anxious about being depressed and the main discomfort lies in their altered mood.

Night worsening

Another typical sign of atypical depressions is a worsening of the condition and symptoms at night.

People with this type of mood disturbance may "feel better" during the day and experience an accentuation of 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 great deal of difficulty sleeping, and may sleep up nights due to difficulties in closing their eyes.

Daytime hypersomnia

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

The fact of experiencing an accentuation of depressive symptoms during the night and difficulties in falling asleep often lead to extreme tiredness and drowsiness during the day.

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

Hyperphagia

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

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

Reactivity

Atypical depression also stands out for preserving a certain reactivity of the mood. That is, people with this type of condition are capable of experiencing a slight increase in mood when faced with positive events.

This factor is important when differentiating it from other depressive modalities, where the interest and the experimentation of pleasure is highly diminished.

However, in contrast, atypical depression also tends to show high reactivity towards negative events. People with this alteration tend to collapse at the slightest adversity, falling into a paralyzing position.

Heavy dejection or paralysis

Finally, atypical depression is highlighted by the experience of a feeling of heaviness in the arms and legs.

This factor was one of the most important at the time of initiating the investigation on this type of depression, since the subjects with other depressive modalities do not usually experience specific symptoms in the extremities.

However, this is not the main symptom of atypical depression since other mood alterations can also lead to elevated feelings of fatigue and physical fatigue.

Complications

Atypical depression is usually related to different situations or problematic elements that can derive from the disorder itself. In this sense, special caution must be taken in the following aspects:

Increased weight

The appetite alteration that causes atypical depression is well documented and demonstrated, which is why this alteration constitutes a high risk factor for obesity.

Trying to balance intake and diet is a secondary therapeutic goal but one that can be highly important in different cases.

Anxiety disorders

Although anxiety symptoms are not the main manifestation of atypical depression, it can be important within the clinical picture.

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

Suicide

As with the vast majority of mood disorders, suicide is the main risk factor for the disease.

The evaluation of both death ideas and self-lytic thoughts and suicidal planning should be paramount in the treatment of atypical depression.

Treatment

At present, there are specific treatments to intervene in atypical depression. In general, people who suffer from this disorder have serious clinical conditions that require medication.

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

Pharmacotherapy

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

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

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

References

1. Akiskal H. Towards a new classification of bipolar disorders. In: Vieta E. Bipolar disorders. Clinical and therapeutic advances. Médica Panamericana SA. Madrid, 2001.
2. C. Melancolía spent. In: Vallejo J, Gastó C. Affective disorders: anxiety and depression. 2nd Edition. Masson. Barcelona, ​​2000.
3. Menchón JM, Vallejo J. Dysthymia. In: Roca M. Mood disorders. Médica Panamericana, SA. Madrid, 1999.
4. Navarro V, Gastó C. Neurochemistry of depressions. In: Vallejo J, Leal C. Treaty of Psychiatry. Volume II. Ars Medica. Barcelona, ​​2010.
5. Parker G, Hadzi-Pavlovic D. A disorder of movement and mood. Cambridge University Press. USA, 1996.
6. Paykel IS. Psychopathology of affective disorders. Ed. Pirámide SA. Madrid, 1985.
7. Retterstol N. An European perspective. Cambridge University Press. UK, 1993.
8. Vallejo J. Classification of affective disorders. In: Vallejo J, Gastó C. Affective disorders: anxiety and depression. 2nd Edition. Masson. Barcelona, ​​2000.