Do you sometimes feel unbearably sad, heavy, and not wanting to do anything? But when a friend calls and tells you good news, or when you watch a favorite movie, does that sadness disappear for a while and a little happiness comes to your mind? And then do you feel the same sadness and weight again? Many people think that depression is a constant, joyless state of mind. But this 'different kind of depression' that we are talking about today is not like that. It is a little different.
What is this 'atypical depression'?
Simply put, atypical depression is a subtype of depression. However, its symptoms are slightly different from the symptoms of the condition we usually call depression.
Now you might think that the word 'atypical' means something that is 'unusual' or 'rarely seen'. But that's not what it means here. It means, "showing symptoms that are different from the symptoms of depression that we usually see."
The main and most distinctive feature of this is that when something pleasant happens to you, the sadness and hopelessness that you feel temporarily disappear. To be precise, your mood 'reacts' to good events. We call this in medicine (mood reactivity) . This is the main factor that distinguishes this condition from other depressive states.
What is the difference between 'normal' depression and this 'different' depression?
Both are mental health conditions. Both involve a long-term feeling of sadness and hopelessness. But there are some clear differences between the two. Let's see what they are. Take a look at this chart.
| Characteristic | Typical Depression | Atypical Depression |
|---|---|---|
| Mood | Even if something good happens, the sadness and emptiness remain. The mood does not change. | When something good happens (e.g. a party, good news), sadness temporarily disappears and happiness is felt. |
| Appetite and weight | Often, appetite decreases, which can lead to weight loss. | Often, appetite increases excessively, which can lead to weight gain. |
| Sleep | Insomnia or excessive waking up. | No matter how much sleep you get, you still feel like you're not getting enough. You have excessive sleepiness (hypersomnia). |
| Starting age | It can occur at any age. | It often begins in the teenage years or early 20s. |
When you see these differences, you probably understand that Atypical Depression is not "less depression," it's "a different kind of depression."
Who is most likely to develop this condition? How common is it?
This condition is twice as common in women as in men. Also, it often begins in adolescence, between the ages of 15-16 and the early 20s.
Despite the name 'Atypical', this is not that unusual. In fact, between 15% and 36% of people diagnosed with depression have this type of depression. This means it's a much more common condition than we think.
What exactly are the symptoms?
In addition to the mood reactivity we talked about earlier, which is when your mood improves when something good happens, you need to have at least two of the following characteristics to recognize this condition.
- Excessive appetite and/or weight gain: You may feel like eating something all the time. You may especially crave foods high in carbohydrates (rice, bread, sweets). This can lead to significant weight gain.
- Hypersomnia: Feeling sleepy even after sleeping 10 or 12 hours a day. Falling asleep frequently during the day is called hypersomnia .
- Leaden Paralysis: The arms and legs feel very heavy and lifeless. They feel as if they are heavy as lead. This can make it difficult to get out of bed or walk. This is called leaden paralysis in medical terms.
- Hypersensitivity to rejection: Even a small criticism or the slightest hint of rejection can be very painful. This can lead to a fear or reluctance to socialize or do work. This can be due to a real rejection or a perceived rejection.
In addition to these specific symptoms, the following symptoms seen in general depression may also occur:
- Feelings of extreme sadness and hopelessness.
- Losing all desire to do things that used to be enjoyable.
- A tendency to get angry quickly and get agitated over small things.
- Difficulty concentrating and remembering things.
Why does this situation occur?
No single cause has been found for this, but researchers believe that a combination of factors may be responsible.
- Changes in brain chemicals: Simply put, this can be due to changes in the functioning of the chemicals in our brain that transmit messages (we call these neurotransmitters ) and the places that receive them ( neuroreceptors) .
- Genetics: If someone in your family has had a mental health condition like depression or bipolar disorder , you are at a higher risk of developing the condition.
- Trauma: Traumatic events, especially those experienced during childhood, such as abuse, can lead to the emergence of such conditions later in life.
- Chronic Stress: Long-term stress at work and in family life can also affect this.
Additional factors that increase risk
In addition to the above reasons, the following may also increase the risk of developing Atypical Depression:
- Having a history of conditions such as bipolar disorder or anxiety .
- Adverse experiences faced in childhood.
- Being emotionally, physically, or sexually abused.
- A serious medical condition, such as an accident or long-term illness.
- A grief as unbearable as the loss of a loved one.
- Having a history of drug or alcohol use.
How does a doctor diagnose this?
When you go to see a doctor, he or she will talk to you carefully about your symptoms, your medical history, and your mental health history.
Remember, it is very important to tell your doctor what you are feeling and the problems you are facing without hiding anything.
Sometimes, blood tests may be done to check for other physical causes of your symptoms. For example, thyroid problems can sometimes cause symptoms of depression, so it's important to rule out those conditions.
Then, if necessary, your doctor can refer you to a specialist, such as a psychiatrist.
What are the treatments for this?
The good news is that atypical depression is a condition that can be treated very well . Treatment options may vary depending on the severity of your condition. There are two main types of treatment that are commonly used.
Psychotherapy
We simply call this counseling. Here, you talk about your problems with a trained mental health counselor (counselor, psychologist).
- Cognitive Behavioral Therapy (CBT): This is a widely used and effective treatment. It helps you identify negative thoughts and feelings that come to your mind and understand how they affect your actions. This helps you change those negative patterns and train you to think in healthier ways.
Medications (Antidepressants)
There are different types of medications used to treat depression. These medications mainly work by balancing the levels of neurotransmitters in the brain.
- In the past, a class of drugs called MAOIs worked very well for people with atypical depression. But there were many things to be careful about when taking them with food and drinks, and there were many side effects. So now doctors don't often recommend that class of drugs.
- Now, there are many safer, less side-effect-prone, and more effective medications available, such as SSRIs .
Your doctor will decide which medication is right for you and how long you should take it. Therefore, never start or stop taking medication without consulting a doctor.
In addition to these treatments, making some changes to your lifestyle (exercise, avoiding alcohol and drug use) can also help control symptoms.
What happens if left untreated?
If left untreated, this can have serious consequences.
- Excessive appetite leading to overeating and weight gain.
- Increased conflicts in relationships.
- Increased risk of drug addiction.
- Reduced efficiency and avoidance of work or educational activities.
- Exacerbation of other physical conditions.
- Increased risk of suicide.
However, with proper treatment, 70% to 80% of people with depression can experience significant improvement in their symptoms. The first treatment you start with may not work for you. But don't give up. Talk to your doctor to find a treatment plan that works for you.
When should I see a doctor?
If you feel like you have the symptoms mentioned in this article, please do not think, "This is just a feeling of sadness, it will get better with time," and please see a doctor without delay. This is a medical condition that requires treatment, just like diabetes and high blood pressure.
Most importantly: If you or someone you know is having suicidal thoughts, please go to your nearest hospital Emergency Department (ETU) immediately or talk to a trusted adult about it. Don't suffer alone.
Take-Home Message
- Atypical Depression is a 'different' type of depression. The main characteristic is that the sadness temporarily disappears when something good happens.
- This is not something that 'occurs rarely', it is much more common than we think.
- The main symptoms are excessive appetite, excessive sleepiness, heaviness in the arms and legs, and extreme sensitivity to rejection.
- This is not a weakness, but a condition that can be best cured with treatment.
- If you have these symptoms, don't be shy or afraid to seek medical advice. The sooner you get help, the sooner you can recover.
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