Atypical depression
Definition :
Any type of depression can make you feel sad and keep you from enjoying life. However, if you have atypical depression, certain key signs and symptoms tend to occur. These include increased hunger, weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining relationships.
Atypical depression often starts in the teenage years and is more common in women than in men. Despite the name, atypical depression isn't uncommon or unusual. Similar to other forms of depression, treatment for atypical depression includes medications, psychological counseling (psychotherapy) and lifestyle changes.
Symptoms:
Depression of any kind can cause feelings of sadness and a decreased ability to enjoy life. But atypical depression includes these main signs and symptoms:
If you feel depressed, make an appointment to see your doctor as soon as you can. Depression may get worse if it isn't treated. Untreated depression can lead to other mental and physical health problems or problems in other areas of your life. Feelings of depression can also lead to suicide.
If you're reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.
If you have suicidal thoughts
If you or someone you know is having suicidal thoughts, get help right away. Here are some steps you can take:
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
If you have a loved one who is in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Causes:
It's not known exactly what causes atypical depression. As with other types of depression, a combination of factors may be involved. These include:
Complications:
Like other types of depression, atypical depression is a serious illness that can cause major problems. Atypical depression can result in emotional, behavioral and health problems that affect every area of your life. Complications associated with atypical depression may include:
Treatments and drugs:
Treatment for atypical depression is generally the same as for other types of depression. In some cases, a primary care doctor can prescribe medications to relieve symptoms. However, many people with atypical depression need to see a psychiatrist. Most people also benefit from seeing a psychologist or other mental health counselor. Usually the most effective treatment is a combination of medication and psychotherapy.
Atypical depression most often occurs as part of mild, long-lasting depression. However, it can cause more severe symptoms in some people, such as feeling suicidal or not being able to do basic day-to-day activities.
Here's a closer look at your treatment options.
Medications
Many types of medications are available to treat depression. They include:
If a family member has responded well to an antidepressant, it may be one that could help you. You may need to try several medications before you find one that works. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as your body adjusts.
If you're bothered by side effects, don't stop taking an antidepressant without talking to your doctor first. Some antidepressants can cause withdrawal symptoms unless you slowly taper off, and quitting abruptly may cause a sudden worsening of depression. Don't give up until you find a medication that's suitable for you.
If antidepressant treatment doesn't seem to be working, your doctor may recommend a blood test called the cytochrome P450 (CYP450) to check for specific genes that affect how your body processes antidepressants. This may help identify which antidepressant might be a good choice for you, although these genetic tests may not be widely available and they have limitations.
Antidepressants and pregnancy
If you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk to your doctor if you become pregnant or are planning to become pregnant.
Antidepressants and increased suicide risk
Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires that all antidepressants carry "black box" warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. So these age groups need close monitoring by loved ones, caregivers and health care providers. If you — or someone you know — have suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.
Psychotherapy
Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health provider. Psychotherapy is also known as talk therapy, counseling or psychosocial therapy.
Through these talk sessions, you can learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life. Psychotherapy can help you regain a sense of satisfaction and control in your life and help ease depression symptoms such as hopelessness and anger.
Hospitalization and residential treatment programs
In some people, depression is so severe that a hospital stay is needed. Inpatient hospitalization may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves. Partial hospitalization or day treatment programs also are helpful for some people. These programs provide the support and counseling you need while you get symptoms under control.
Other treatments
Other options include:
Definition :
Any type of depression can make you feel sad and keep you from enjoying life. However, if you have atypical depression, certain key signs and symptoms tend to occur. These include increased hunger, weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining relationships.
Atypical depression often starts in the teenage years and is more common in women than in men. Despite the name, atypical depression isn't uncommon or unusual. Similar to other forms of depression, treatment for atypical depression includes medications, psychological counseling (psychotherapy) and lifestyle changes.
Symptoms:
Depression of any kind can cause feelings of sadness and a decreased ability to enjoy life. But atypical depression includes these main signs and symptoms:
- Depression that temporarily lifts when you're cheered up by good news or positive events but returns later
- Increased appetite with unintentional weight gain
- Increased desire to sleep, usually more than 10 hours a day
- Heavy, leaden feeling in your arms and legs that lasts an hour or more in a day
- Trouble maintaining long-lasting relationships because of sensitivity to rejection or criticism, which affects your relationships, social life or job
If you feel depressed, make an appointment to see your doctor as soon as you can. Depression may get worse if it isn't treated. Untreated depression can lead to other mental and physical health problems or problems in other areas of your life. Feelings of depression can also lead to suicide.
If you're reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.
If you have suicidal thoughts
If you or someone you know is having suicidal thoughts, get help right away. Here are some steps you can take:
- Reach out to a close friend or loved one.
- Contact a minister, a spiritual leader or someone in your faith community.
- Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
- Make an appointment with your doctor, mental health provider or other health care provider.
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
If you have a loved one who is in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Causes:
It's not known exactly what causes atypical depression. As with other types of depression, a combination of factors may be involved. These include:
- Brain chemistry. Neurotransmitters are naturally
occurring brain chemicals that likely play a role in depression. When
these chemicals are out of balance, it may lead to depression symptoms.
- Inherited traits. Depression is more common in people whose biological (blood) relatives also have the condition.
- Life events. Events such as the death or loss of a loved one, financial problems, and high stress can trigger depression in some people.
- Early childhood trauma. Traumatic events during childhood, such as abuse or loss of a parent, may cause changes in the brain that make you more susceptible to depression.
Complications:
Like other types of depression, atypical depression is a serious illness that can cause major problems. Atypical depression can result in emotional, behavioral and health problems that affect every area of your life. Complications associated with atypical depression may include:
- Excess weight or obesity, which can lead to heart disease and diabetes
- Alcohol or drug abuse
- Anxiety and panic disorder or social phobia
- Family conflicts, relationship difficulties, and work or school problems
- Social isolation
- Suicidal feelings or suicide
Treatments and drugs:
Treatment for atypical depression is generally the same as for other types of depression. In some cases, a primary care doctor can prescribe medications to relieve symptoms. However, many people with atypical depression need to see a psychiatrist. Most people also benefit from seeing a psychologist or other mental health counselor. Usually the most effective treatment is a combination of medication and psychotherapy.
Atypical depression most often occurs as part of mild, long-lasting depression. However, it can cause more severe symptoms in some people, such as feeling suicidal or not being able to do basic day-to-day activities.
Here's a closer look at your treatment options.
Medications
Many types of medications are available to treat depression. They include:
- Selective serotonin reuptake inhibitors (SSRIs).
Doctors often start treatment by prescribing an SSRI. These medications
are safer and generally cause fewer side effects than do other types of
antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil),
sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). The
most common side effects include decreased sexual desire and delayed
orgasm. Other side effects may go away as your body adjusts to the
medication. They can include digestive problems, jitteriness,
restlessness, headache and insomnia.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs).
These medications include duloxetine (Cymbalta), venlafaxine (Effexor
XR) and desvenlafaxine (Pristiq). Side effects are similar to those
caused by SSRIs. These medications can cause increased sweating, dry
mouth, fast heart rate and constipation.
- Norepinephrine and dopamine reuptake inhibitors (NDRIs).
Bupropion (Wellbutrin) falls into this category. It's one of the few
antidepressants that doesn't cause sexual side effects, and it usually
doesn't cause weight gain. At high doses, bupropion may increase your
risk of having seizures.
- Atypical antidepressants. These medications don't
fit neatly into another antidepressant category. They include trazodone
and mirtazapine (Remeron). Both are sedating and usually taken in the
evening. A newer medication called vilazodone (Viibryd) has a low risk
of sexual side effects. The most common side effects of vilazodone are
diarrhea, nausea, vomiting and insomnia.
- Tricyclic antidepressants. Tricyclic
antidepressants — such as imipramine (Tofranil) and nortriptyline
(Pamelor) — tend to cause more severe side effects than newer
antidepressants. So tricyclics generally aren't prescribed unless you've
tried an SSRI first without improvement. Side effects may include low
blood pressure, dry mouth, blurred vision, constipation, urinary
retention, fast heartbeat, confusion or weight gain, among others.
- Monoamine oxidase inhibitors (MAOIs). MAOIs — such
as tranylcypromine (Parnate) and phenelzine (Nardil) — may be prescribed
as a last resort, when other medications haven't worked, because they
can have serious side effects. Use of MAOIs requires a strict diet
because of dangerous (or even deadly) interactions with foods — such as
certain cheeses, pickles and wines — and some medications including
birth control pills, decongestants and certain herbal supplements.
Selegiline (Emsam), a newer MAOI that you stick on your skin as a patch,
may cause fewer side effects than other MAOIs. These medications can't
be combined with SSRIs.
- Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or medications, such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications might also be added for short-term use. In addition, the FDA approved a medical food — a prescription that provides dietary management for a disease or condition — called Deplin, which contains L-methylfolate, a form of the vitamin folate. Studies have shown that adding Deplin to an antidepressant can be helpful, especially in women and those who can't process (metabolize) folate — a condition identified through a genetic test.
If a family member has responded well to an antidepressant, it may be one that could help you. You may need to try several medications before you find one that works. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as your body adjusts.
If you're bothered by side effects, don't stop taking an antidepressant without talking to your doctor first. Some antidepressants can cause withdrawal symptoms unless you slowly taper off, and quitting abruptly may cause a sudden worsening of depression. Don't give up until you find a medication that's suitable for you.
If antidepressant treatment doesn't seem to be working, your doctor may recommend a blood test called the cytochrome P450 (CYP450) to check for specific genes that affect how your body processes antidepressants. This may help identify which antidepressant might be a good choice for you, although these genetic tests may not be widely available and they have limitations.
Antidepressants and pregnancy
If you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk to your doctor if you become pregnant or are planning to become pregnant.
Antidepressants and increased suicide risk
Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires that all antidepressants carry "black box" warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. So these age groups need close monitoring by loved ones, caregivers and health care providers. If you — or someone you know — have suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.
Psychotherapy
Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health provider. Psychotherapy is also known as talk therapy, counseling or psychosocial therapy.
Through these talk sessions, you can learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life. Psychotherapy can help you regain a sense of satisfaction and control in your life and help ease depression symptoms such as hopelessness and anger.
Hospitalization and residential treatment programs
In some people, depression is so severe that a hospital stay is needed. Inpatient hospitalization may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves. Partial hospitalization or day treatment programs also are helpful for some people. These programs provide the support and counseling you need while you get symptoms under control.
Other treatments
Other options include:
- Electroconvulsive therapy (ECT). In ECT, electrical
currents are passed through the brain. This procedure is thought to
affect levels of neurotransmitters in your brain and typically offers
immediate relief of even severe depression when other treatments don't
work. The most common side effect is confusion, which can last from a
few minutes to several hours. Some people also have memory loss, which
is usually temporary. ECT is usually used for people who don't get
better with medications, can't take antidepressants for health reasons
or are at high risk of suicide.
- Transcranial magnetic stimulation (TMS). TMS may be
an option for those who haven't responded to antidepressants. During
TMS, you sit in a reclining chair with a treatment coil placed against
your scalp. The coil sends brief magnetic pulses to stimulate nerve
cells in your brain that are involved in mood regulation and depression.
Typically, you'll have five treatments each week for up to six weeks.
- Vagus nerve stimulation. This treatment uses electrical impulses with a surgically implanted pulse generator to affect mood centers of the brain. This may be an option if you have long-term, treatment-resistant depression.
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