(2000). Younger individuals may be more likely to have atypical features, whereas older individuals may more often have episodes with melancholic features. [8] Atypical depression is more common in individuals with bipolar I,[8] bipolar II,[8][9] cyclothymia[8] and seasonal affective disorder. Psychotherapy, whether alone or in combination with medication, is also an effective treatment. There is also a newer, selective and reversible MAOI Moclobemide, which doesn't require tyramine diet and has less side effects. Overall, rejection sensitivity is the most common symptom, and due to some studies forgoing this criterion, there is concern for underestimation of prevalence. [18], True prevalence of atypical depression is difficult to determine. [4], Despite its name, "atypical" depression does not mean it is uncommon or unusual. [3], Other studies have examined the symptoms associated with hysteroid dysphoria and found that while the symptoms are observable, they are not unique or distinct enough to be considered their own condition. while in high school) of their depressive episodes, which also tend to be more chronic[8] and only have partial remission between episodes. Wikipedia mentions it only briefly as "rejection sensitivity". Rejection Sensitive Dysphoria Q: Bipolar Meltdown? "Atypical Depression in the 21st Century: Diagnostic and Treatment Issues", "Atypical depression: current perspectives, "Superposição entre depressão atípica, doença afetiva sazonal e síndrome da fadiga crônica", "Atypical depression: current perspectives", "Clinical Practice Review for Major Depressive Disorder | Anxiety and Depression Association of America, ADAA", "Depression With Atypical Features: Diagnostic Validity, Prevalence, and Treatment", "Atypical depression - Symptoms and Causes", Atypical Depression - Depression Central Mood Disorders & Treatment, Satish Reddy, MD., Editor (Formerly Dr. Ivan Goldberg's Depression Central), Other specified feeding or eating disorder, https://en.wikipedia.org/w/index.php?title=Atypical_depression&oldid=987874607, Wikipedia articles needing page number citations from November 2015, Articles with unsourced statements from November 2015, Creative Commons Attribution-ShareAlike License, Low mood, mood reactivity, hyperphagia, hypersomnia, leaden paralysis, interpersonal rejection sensitivity, Bipolar disorder, anxiety disorder, female sex, Melancholic depression, anxiety disorder, bipolar disorder, Mood reactivity (i.e., mood brightens in response to actual or potential positive events). American Psychiatric Association. Tricyclic antidepressants (TCAs) were also used prior to the year 2000 for atypical depression, but were not as efficacious as MAOIs, and have fallen out of favor with prescribers due to the less tolerable side effects of TCAs and more adequate therapies being available. They tend to respond dramatically to any hint that someone doesn’t want to be with them. [13], Some evidence supports that psychotherapy such as cognitive behavioral therapy (CBT) has equal efficacy to MAOI. [citation needed], Depression characterized by improved mood in response to positive events. Several studies conducted in patients diagnosed with a depressive disorder show that about 40% exhibit atypical symptoms, with four times more instances found in female patients. [5] The reason for its name is twofold: it was identified with its "unique" symptoms subsequent to the identification of melancholic depression and its responses to the two different classes of antidepressants that were available at the time were different from melancholic depression (i.e., MAOIs had clinically significant benefits for atypical depression, while tricyclics did not). In contrast to atypical depression, people with melancholic depression generally do not experience an improved mood in response to normally pleasurable events. [11] Overall, rejection sensitivity is the most common symptom, and due to some studies forgoing this criterion, there is concern for underestimation of prevalence. [1], Hysteroid dysphoria has been described in outpatient populations and is thought to be a subtype of atypical depression involving rejection sensitivity and therapeutic response to monoamine oxidase inhibitors.
[19] Research also supports that atypical depression tends to have an earlier onset, with teenagers and young adults more likely to exhibit atypical depression than older patients.
[23] While the more modern SSRIs and SNRIs are usually quite effective in this illness, the tricyclic antidepressants typically are not. Atypical depression also features significant weight gain or an increased appetite, hypersomnia, a heavy sensation in the limbs, and interpersonal rejection sensitivity that results in significant social or occupational impairment. [4], Recent research suggests that young people are more likely to suffer from hypersomnia while older people are more likely to suffer from polyphagia. [13] Currently, antidepressants such as SSRIs, SNRIs, NRIs, and mirtazapine are considered the best medications to treat atypical depression due to efficacy and fewer side effects than previous treatments. [17], No robust guidelines for the treatment of atypical depression currently exist. Similarly, patients with atypical depression are more likely to suffer from personality disorders and anxiety disorders such as borderline personality disorder, avoidant personality disorder, generalized anxiety disorder, obsessive-compulsive disorder, and bipolar disorder.
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