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Atypical Depression: Causes, Signs, and Treatment

Atypical Depression: Causes, Signs, and Treatment - Paradigm Malibu

One of the most common misconceptions about depression is that there are only two kinds of depression – the mild, subclinical depression that almost anyone may experience from time to time, which tends to run its course and pass on its own, and clinical depression, the more serious, long-lasting type of depression that doesn’t pass on its own and needs to be treated with clinical methods like therapy or medication.

What many people don’t realize is that there are a variety of different types of depression with different causes, not all of which are fully understood. Some examples of different types of depression include:

  • Major depressive disorder
  • Seasonal affective disorder
  • Postpartum depression
  • Persistent depressive disorder
  • Premenstrual dysphoric disorder
  • Bipolar disorder
  • Atypical depression

Atypical depression is one of the least well-known and most misunderstood types of depression. Take a look at what you need to know about the causes, signs, and treatments of atypical depression.


Causes of Atypical Depression

It’s often difficult to point to a single cause of any type of depression – it’s often more of a confluence of many factors that lead a person to become depressed.

Generally speaking, depression is thought to be caused by an impairment of the brain circuits that regulate mood and allow communication between different parts of the brain. In that sense, it’s a chemical or physical disorder, and this is true of atypical depression as well as other types of depression.

However, depression is not believed to be entirely chemical. Events or lifestyle factors are thought to trigger depressive episodes. People are more at risk for developing depression if they have certain risk factors such as:

  • Interpersonal conflict
  • Experiencing a significant loss
  • A history of abuse
  • Undergoing a significant life change such as a divorce or long-distance move
  • A serious illness like cancer or heart disease
  • Alcohol or drug use

A family history of depression is also considered to be a risk factor for depression, and people who experience atypical depression are more likely to have had family members who also experienced atypical depression, so there may be some hereditary component to the condition.


Signs of Atypical Depression

The signs of atypical depression are part of what differentiates it from other forms of depression.

People who experience atypical depression differ from those with major depressive disorder in that they tend to have strongly reactive moods, so if something positive happens, their mood will become more positive, at least temporarily.

In other forms of depression, the depressed person tends to remain depressed even when positive things happen. This shouldn’t be confused with outward expressions of contentment or happiness – people with all kinds of depression may appear happy or content even when they’re feeling sad or depressed. But with atypical depression, the underlying mood may actually lift from time to time in response to good news or positive interactions with others.

Other symptoms may include:

  • overeating and weight gain
  • excessive sleeping
  • fatigue
  • the sense that the sufferer’s body is weighed down or that their limbs are especially heavy


People who suffer from atypical depression may be more likely to suffer from certain co-occurring disorders like bulimia, panic disorder, and certain phobias.

People who have atypical features are also unusually sensitive to social rejection and may have difficulty with relationships because of this sensitivity. The breakup of a romantic relationship or a conflict within another type of relationship may precede a depressive episode or inspire the depressed person to seek out treatment.

To diagnose atypical depression, clinicians look for mood reactivity in combination with at least two of the four other most common symptoms of atypical depression: the excessive sleeping, the weight gain or overeating, the feeling of being weighed down, and the rejection sensitivity. Doctors will often do tests to rule out other physical conditions, like thyroid problems, before arriving at a diagnosis.


Treatment Options

One other thing that distinguishes atypical features from other forms of depression is the response to treatment.

Major depression is often treated with tricyclic antidepressants, but these tend not to produce much improvement in people suffering from atypical depression. Although, people who are suffering from the mental illness do respond to monoamine oxidase inhibitor (MAOIs) and, in most cases, to selective serotonin reuptake inhibitors (SSRIs).

Medication is not the only form of treatment. Psychotherapy, sometimes known as talk therapy, is also an effective method of treatment for those with symptoms of atypical depression. In psychotherapy sessions, people who suffer from depression talk about their feelings, relationships, and experiences. They work on identifying and changing unhealthy thoughts and behaviors, setting realistic personal goals, exploring coping strategies and problem-solving techniques, and finding ways to relieve disruptive symptoms of depression.

In many cases, atypical depression symptoms are best treated with a combination of therapy and medication.

There is no one medication or combination of medications that works for every person diagnosed with atypical depression. People who have atypical features may need to try several different medications or combinations of medications before finding the formula that works best for them.

Therapy, in addition to having its own benefits, can also be a helpful way to monitor the effectiveness of medication and how the person taking it is responding to the medication. Antidepressant medications also have potentially negative side effects that affect some people more than others, so those experiencing side effects may need a change in medication or therapeutic strategy even if the medication is working to relieve the symptoms of depression.

It’s important to understand that a person may be suffering from depression even if their moods seem to lift in response to positive events.

There are a number of different types of depression, and atypical depression is as serious as other types of depression like major depressive disorder, postpartum depression, or seasonal affective disorder. People who are experiencing atypical depression are at risk for dangerous behaviors, such as self-harm or even suicidal ideation or attempts.

Atypical depression should be taken seriously and people suffering with atypical features should seek professional treatment from a doctor, therapist, or counselor.


Dr. Nalin is a Licensed Clinical Psychologist, and Founder and Executive Director of Paradigm Treatment Centers, who has been a respected leader in the field of adolescent mental health for more than 20 years. He received his undergraduate degree from the University of Southern California, his Master’s degree from Loyola Marymount University, his Doctoral degree from Pacific University’s APA approved Clinical Psychology program, and completed his training at the University of California, San Diego’s APA approved psychology internship program.

Dr. Nalin has provided training and mentoring to students entering the field of psychology at institutions of learning including Pepperdine University’s Graduate School of Education and Psychology, UCSD, Pacific University, and Santa Monica College. He was also instrumental in the development of the treatment component of Los Angeles County’s first Juvenile Drug Court, which now serves as a national model.

Dr. Nalin has appeared as an expert on shows ranging from CBS News and Larry King, to CNN, The Today Show and MTV. He was also featured in an Anti-Drug Campaign for the Office of National Drug Control Policy (ONDCP).

Dr. Nalin is a Diplomate of the National Institute of Sports Professionals and a Certified Sports Psychologist as well as a Certified Chemical Dependency Intervention Specialist. He lectures and conducts workshops nationally on the issues of teen mental health, substance abuse prevention, and innovative adolescence treatment.

In 2017 Dr. Nalin was awarded The Sigmund Freud Foundation and Sigmund Freud University’s Distinguished Achievement Award in recognition of his work with youth in the field of mental health over the course of his career.

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