Atypical depression
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226178562
2008-07-17T04:52:06Z
BrainMagMo
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very POV, limited studies and claims about controversial claims.
{{POV}}
'''Atypical Depression (AD)''' is a subtype of [[dysthymia]] and Major Depression characterized by mood reactivity — being able to experience improved mood in response to positive events. In contrast, sufferers of [[Melancholic depression|"melancholic" depression]] generally cannot experience positive moods, even when good things happen. Additionally, atypical depression is characterized by ''[[reversed vegetative symptoms]]'', namely over-eating and over-sleeping.
Despite its name, "atypical" depression is actually the most common subtype of depression<ref>http://www.biopsychiatry.com/atypical.htm Course and treatment of atypical depression</ref><ref>http://www.mcmanweb.com/article-200.htm Atypical Depression</ref> — up to 40% of the depressed population may be classified as having atypical depression.
==Diagnostic criteria (DSM-IV-TR)==
The [[DSM-IV-TR]], a widely used manual for diagnosing [[mental disorder]]s, defines Atypical Depression as a subtype of depression or [[dysthymia]], characterized by Atypical Features:
:A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events)
:B. At least two of the following:
:# Significant weight gain or increase in appetite ("[[eating disorder|comfort eating]]")<ref>http://www.depnet.com.au/universe1/depression/other_types_of_depression/ Other types of depression</ref>
:# Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)
:# Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)
:# Long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment
:C. Criteria are not met for [[Melancholic depression|Melancholic Depression]] or [[Catatonia|Catatonic Depression]] during the same episode.
By the [[ICD|ICD-10]] classification, it will fall in the category of F32 or F39.
==Research==
In general, atypical depression tends to cause greater functional impairment than other forms of depression. Atypical depression is a chronic syndrome that tends to begin earlier in life than other forms of depression — usually beginning in teenage years. Similarly, patients with atypical depression are more likely to suffer from other psychiatric syndromes such as [[panic disorder]], [[social phobia]], [[avoidant personality disorder]], or [[body dysmorphic disorder]].
Medication response differs between chronic atypical depression and acute melancholic depression. While some studies<ref>http://www.mayoclinic.com/health/atypical-depression/AN01363 Atypical depression: How is it different from 'regular' depression?</ref> suggest that an older class of drugs, [[MAOI]]s, may be more effective at treating atypical depression, the modern [[SSRI]]s are usually quite effective, while the [[tricyclic antidepressant]]s are not. In addition, [[SSRI]] response can often be enhanced with "booster" medications. And, medication treatment works best when combined with appropriate psychotherapy.<ref>http://www.workpsychcorp.com/newsweek2.html Depression Update: Atypical Depression</ref> It is important to remember that such co-morbid syndromes as [[panic disorder]] may not be fully treated without additional medication.
It has been noted that patients with atypical depression often suffer from intense cravings for [[carbohydrate]]s. A mineral supplement, [[chromium picolinate]], was found to assuage these cravings.<ref>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16184071&query_hl=5&itool=pubmed_DocSum A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving</ref><ref>http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=12559660&dopt=Citation Effectiveness of chromium in atypical depression: a placebo-controlled trial</ref>
Some hypothesize that atypical depression may be related to thyroid dysregulation. Some studies have found subtle [[thyroid]] abnormalities in people with atypical depression.<ref>http://www.webmd.com/depression/news/20040315/atypical-depression-thyroid-link-still-alive Atypical Depression: Thyroid Link Still Alive</ref> Another study suggests that patients may benefit from [[triiodothyronine]], a medication used to treat [[hypothyroidism]].<ref>http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&dopt=AbstractPlus&list_uids=16086620 Atypical Depression and Triiodothyronine</ref>
==References==
{{Reflist|1}}
==Additional Resources==
#[http://depression.about.com/cs/diagnosis/a/atypicaldepress.htm Atypical Depression Actually Very Typical ]
#[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15935235&query_hl=3 Atypical Depression and Hypothalamic-Pituitary-Adrenal function]
*Also see [[Clinical depression]].
[[Category:Mood disorders]]
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