Atypical depression shares many symptoms with other forms of depression. It’s characterized by persistent sadness, irritability, fatigue, and social withdrawal.
However, atypical depression involves mood reactivity. This means that if something good happens, a person's depression will lift. While temporary, this doesn't occur with other types of depression.
Atypical depression is treated in much the same way as other depressive disorders. This can include therapy, self-care, and medication.
As its name suggests, atypical depression doesn’t look exactly like other types of depression. It shares some features with major depressive disorder (MDD), like prolonged periods of sadness and hopelessness. But atypical depression also has some distinct symptoms.
Namely, when something positive happens, a person with atypical depression may experience an improvement in mood [1]. This doesn’t usually happen with other forms of depression.
Depression is one of the most common mental health conditions. It affects about 5% of the world’s population [2]. Among that group, about 15%–30% have atypical depression [2]. Despite how common it is, atypical depression isn’t widely understood. Learning more about this form of depression can help you identify the signs and know when to ask for help.
Symptoms of atypical depression
To be diagnosed with atypical depression — also referred to as major depression with atypical features — a person must experience something that clinicians call “mood reactivity.” This is the ability to feel better temporarily in response to a positive life event.
In addition, they must also have at least two of the following symptoms [1]:
Hyperphagia: Increased appetite and unintended weight gain
Hypersomnia: Sleeping much more than usual
Leaden paralysis: Feeling like your limbs are heavy or weighed down
Rejection sensitivity: Responding to rejection so intensely that it impacts relationships or functioning
These symptoms may accompany other depressive symptoms, including:
Sadness
Hopelessness
Irritability
Social isolation
Loss of interest in activities
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Atypical depression vs. other conditions
Atypical depression shares some symptoms with other mental health conditions. So, sometimes, this can make it challenging to get a correct diagnosis.
Here’s what sets atypical depression apart from some other common mental health concerns:
“Typical” depression (or MDD): MDD is a mood disorder that’s characterized by periods of sadness, loss of motivation, and fatigue. It doesn’t normally lift when positive events occur. But this does happen for people with atypical depression.
Bipolar disorder: Bipolar disorder is characterized by manic episodes, which can create a burst of euphoric energy. This isn’t the same as the mood reactivity that occurs with atypical depression.
Attention-deficit hyperactivity disorder (ADHD): The main symptoms of ADHD are inattentiveness and hyperactivity. It’s not a mood disorder like atypical depression.
Dysthymia: This is a form of constant, low-level depression. Like MDD, people with dysthymia typically don’t experience mood reactivity.
Melancholic depression: As a subtype of MDD [3], this condition can lead to a total or near-total loss of interest in activities. It’s also characterized by periods of severe depression that don’t lift with positive life events (as is the case with atypical depression).
Who’s most likely to have atypical depression
We don’t yet fully understand what causes atypical depression.
But experts have identified a few factors that may increase your risk [4]:
Being young (atypical depression has an earlier onset than other forms of depression)
Identifying as a woman
Having a family history of depression or other mental health concerns
Differences in brain structure and functioning
Experiencing trauma, especially during childhood
Navigating grief and loss
Having other mental health concerns
Being exposed to chronic stress
How atypical depression affects daily life
Atypical depression can negatively affect your mental and physical well-being in many ways. It can make it more difficult to function at home, work, and school, and take a toll on your relationships. People with atypical depression may stop spending time with loved ones or doing things they used to enjoy. They may have a harder time taking care of themselves or others.
The mood reactivity caused by atypical depression can be especially difficult to manage. A person living with depression may welcome a temporary improvement in mood. But for some people, these mood changes can represent a loss of control. Feeling better can be bittersweet when, inevitably, the person returns to a depressive state.
Fortunately, like other forms of depression, atypical depression is treatable. Early detection and intervention can help prevent your symptoms from worsening. With early and ongoing care, you can learn valuable coping skills to maintain your mental health.
How to manage atypical depression
Atypical depression is a serious condition that typically requires professional help. While there’s no cure for any form of depression, you can live a full, balanced life with the right support.
Treatment for atypical depression usually involves:
Therapy: Talk therapies like cognitive behavioral therapy (CBT) or interpersonal therapy have been shown to be effective in treating depression. These approaches help you identify and replace unhelpful thought or behavior patterns that may contribute to your symptoms. They can also help you identify triggers and learn healthy ways to manage depressive episodes when they occur.
Psychiatric care: Certain medications [5] can be effective in treating atypical depression. A psychiatric care provider can help you understand the pros and cons of different medications and determine which one (if any) might be right for you.
Self-care: In addition to working with a therapist or psychiatrist, self-care can be an important part of the healing process [5]. For example, practicing mindfulness, spending time with friends, joining a support group, and taking good care of your physical health can help you manage depression.
A commonly overlooked emotional pattern in atypical depression is mood reactivity — meaning someone may feel noticeably better when something positive happens, then crash again afterward. Because they can still laugh, have good moments, or enjoy certain things, many people tell themselves they ‘can’t really be depressed,’ even while they’re still struggling deeply.
Brandy Chalmers, LPC
Clinical reviewer
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Unlike other forms of depression, atypical depression includes mood reactivity. This means that when something positive happens, a person with atypical depression will feel better. Atypical depression is a serious mental health condition that can impact your well-being, so it's important to seek care as soon as possible. Recovery is possible with professional support.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Atypical Depression https://pmc.ncbi.nlm.nih.gov/articles/PMC2990566/
- Manifestation and Measurement of Atypical Depression: A Scoping Review https://onlinelibrary.wiley.com/doi/full/10.1002/cpp.70123
- Melancholic Depression https://www.sciencedirect.com/topics/neuroscience/melancholic-depression
- Atypical Depression https://my.clevelandclinic.org/health/diseases/21131-atypical-depression
- Pharmacological treatments for atypical depression: A systematic review and network meta-analysis of randomized controlled trials https://www.sciencedirect.com/science/article/abs/pii/S0924977X25000823
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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