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Atypical Depression

Mood reactivity, hyperphagia, hypersomnia, leaden paralysis, rejection sensitivity

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Psikiyatri department. Book Appointment →

What is Atypical Depression?

Atypical depression is a DSM-5 specifier of major depressive disorder requiring mood reactivity (mood brightens with positive events) plus at least two of: significant weight gain or appetite increase, hypersomnia, leaden paralysis (heavy feeling in limbs), and long-standing interpersonal rejection sensitivity causing functional impairment.

It tends to begin earlier in life (adolescence to young adulthood), is more common in women, has a chronic course, and often shows seasonal variation. Comorbidity with social anxiety, panic disorder, body dysmorphic disorder, and substance use is high.

Monoamine oxidase inhibitors (phenelzine) historically showed superior efficacy for atypical features. Modern first-line treatment includes SSRIs (sertraline, fluoxetine), with bupropion useful for hypersomnia and weight concerns. Cognitive behavioral therapy and interpersonal psychotherapy address rejection sensitivity. Light therapy benefits seasonal cases.

Symptoms

Mood improves with good news
Increased appetite and weight gain
Sleeping more than 10 hours
Heavy feeling in arms and legs
Extreme sensitivity to criticism

Risk Factors

Female sex
Early life stress and trauma
Family history of depression
Bipolar II disorder
Comorbid anxiety disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When sleep exceeds 10 hours daily
  • For unexplained weight gain with low mood
  • For severe rejection sensitivity
  • For chronic low energy
  • For seasonal mood pattern

Treatment Methods

01
SSRI first-line therapy
02
MAOI for refractory cases
03
Bupropion for hypersomnia and weight
04
Cognitive behavioral therapy
05
Interpersonal psychotherapy
06
Light therapy for seasonal pattern

Which Department to Visit?

You can visit our Psikiyatri department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.