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What is Atypical Depression?

This video describes atypical depression. When we talk about the term atypical depression, what we're usually referring to is a specifier referred to as “with atypical features.” This specifier is available for major depressive disorder, persistent depressive disorder, and bipolar disorder. This is not a subtype of these disorders, but rather a specifier, so it adds more information to the diagnosis. In order for the with a typical features specifier to be added to a diagnosis, separate criteria have to be met in addition to the criteria necessary for that primary diagnosis. The symptom criteria for the specifier need to be present the majority of days in the current or most recent major depressive episode, or in the case of persistent depressive disorder, just in the course of persistent depressive disorder. Criterion A is mood reactivity and this is required. This is when someone feels a little bit better when they hear good news. In Criterion B there are four symptom criteria and at least two have to be met: significant weight gain or an increase in appetite, hypersomnia, leaden paralysis, and interpersonal rejection sensitivity. Criterion C is the symptoms for with melancholic features and with catatonia cannot be met. The atypical depression specifier can't exist at the same time as melancholic features or catatonia. Atypical depression is actually not that unusual. It affects about 15 to 40% of individuals with major depressive disorder and about the same percent of individuals with bipolar disorder. There are some characteristics that are associated with atypical depression that we don't see with major depressive disorder with another specifier or without any specifiers. For example, certain personality traits tend to be more common in atypical depression, like the traits seen with borderline, histrionic, and avoidant personality disorders. With atypical depression we also see an increase risk of suicidal behavior and increased comorbidity with other mental disorders.