Young people and women face a higher risk for a form of major depression that often flies under the radar. Their symptoms don’t match what families and friends typically expect to see, making this condition particularly dangerous.
“Atypical depression, more formally known as major depressive disorder with atypical features, is a subtype of depression in which the symptoms are somewhat different from the usual depression criteria,” explains Siphesihle Metuge, a clinical psychologist practising at Netcare Akeso Gqeberha.
“In contrast with the usual pattern of constant depressive symptoms, individuals with atypical depression can have temporary boosts in their mood in response to happy events, such as a birthday party, and this is known as mood reactivity. These fleeting periods of uplifted mood can be falsely reassuring to those around the person, creating the mistaken impression that they are ‘okay’ at times when the person’s state of mental health may be particularly vulnerable,” she explains.
“What is especially concerning about atypical depression is that it normally has an earlier age of onset, lasts longer, and is more likely to become chronic than typical depression. It is also linked to a higher risk of suicidal behaviour.”
Spot the unexpected signs
She explains that both typical and atypical depression involve a prolonged low mood or feelings of sadness and hopelessness, and loss of interest in activities the person usually enjoys. Overlapping symptoms can include irritability or agitation, body aches, a feeling of heaviness in the arms and legs, difficulty concentrating, and poor memory.
“There are also key differences. Apart from the characteristic brighter moods associated with atypical depression, there can also be an increase in the person’s appetite, whereas depression usually involves loss of appetite as a symptom,” Metuge says.
“Atypical depression also presents with an increased need for sleep, even when the person has slept enough or too much. This contrasts with symptoms of insomnia, such as difficulty falling or staying asleep, which are most often reported during depressive episodes.”
These factors make atypical depression harder to recognise and may prevent people from accessing support when they need it.
Metuge points out that another troubling symptom of depression with atypical features is heightened sensitivity to rejection or criticism, whether real or perceived. “In this state of mind, the person often feels less confident in their relationships and in their educational or work capabilities, further impairing their ability to cope with daily life,” she says.
Who is at risk?
“Studies suggest that women are more likely to be affected by atypical depression than men. Depressive symptoms normally start in the teenage years or in the person’s early 20s, although the condition may remain undiagnosed and untreated for many years. Fortunately, with professional support, the condition can be successfully managed once identified.”
She explains that, like most mental health conditions, it’s not fully understood why some people experience atypical depression and others do not. “Certain factors that may contribute include individual brain chemistry, genetic predisposition or family history of a mood disorder such as depression or bipolar mood disorder, and trauma or adverse childhood experiences,” Metuge says.
“People experiencing grief, chronic stress or physical illness may also be at higher risk of developing depression, including atypical depression. A history of drug or alcohol use is known to exacerbate the risk of depression, among other mental health conditions.”
Regaining control of your life
If you are concerned that you or a loved one may be struggling with their mental health, professional support is available to help manage the condition so that it does not control the person’s life.
“Treatment for atypical depression may include psychotherapy, antidepressant medication, or a combination of both. Lifestyle changes are often recommended as an important part of the treatment plan, including regular exercise and a healthy diet. Limiting alcohol use and quitting any recreational drug use are also needed, as some people try to self-medicate for the emotional pain that comes with depression, leading to further difficulties.”
Psychologists use different talk therapy techniques, such as cognitive behavioural therapy and psychoanalytic therapy, to help identify and change unhealthy thought patterns, emotions and behaviours that may be contributing to the person’s state of mind.
“Medication also plays an important role in managing atypical depression. Antidepressants help balance neurotransmitters, or chemicals in the brain, which are closely linked to symptoms of depression, such as serotonin, dopamine and norepinephrine, according to the person’s individual needs.
“Atypical depression is a serious medical condition requiring rigorous treatment, and with the right combination of psychotherapy, medication and lifestyle changes, the prognosis is very good, and symptoms usually improve significantly. It’s crucial to keep taking medication prescribed for atypical depression even when you are feeling better. Never stop taking your medication without consulting your doctor or psychiatrist,” she emphasises.
Tips for managing atypical depression
- Be prepared: Develop healthy coping mechanisms for managing life stressors
- Build a strong support system: Trusted family and friends are invaluable
- Are you OK? Check in with yourself regularly
- Keep active: Exercise is very effective for mood regulation
- Contact your doctor or mental health team if you notice any signs of depression returning
To make an appointment with a psychologist, psychiatrist, or occupational therapist, please contact your nearest Netcare Akeso facility or download the Netcare app. In the event of a psychological crisis, call Netcare Akeso’s 24-hour crisis line on 0861 435 787, where experienced counsellors are available to listen and offer support options at any time of day or night.
Ends.
References and further reading:
- Łojko D, Rybakowski JK (2017). "Atypical depression: current perspectives". Neuropsychiatric Disease and Treatment. 13: 2447–2456. doi:10.2147/NDT.S147317. PMC 5614762. PMID 29033570.
- Singh T, Williams K (April 2006). "Atypical depression". Psychiatry. 3 (4): 33–39. PMC 2990566. PMID 21103169.
About Netcare Akeso
Netcare Akeso operates a network of private inpatient mental health facilities and is part of the Netcare Group. Netcare Akeso provides individual, integrated and family-oriented treatment in specialised inpatient treatment facilities, as well as certain outpatient services, for a range of psychiatric, psychological and substance use conditions. Please visit www.akeso.co.za or contact [email protected] for further information.
In the event of a psychological crisis, call 0861 435 787, 24 hours a day for emergency support. Psychiatrist consultations can be made through Netcare appointmed™, online at www.netcareappointmed.co.za or by calling 0860 555 565.
For media enquiries, please contact MNA at the contact details listed below:
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