What You Should Know About Atypical Depression—And 5 Surprising Signs to Watch For

By Lauren Zielinski, MSN, CNM
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Since we’re all unique individuals, it makes perfect sense that dealing with something as personal as depression might look different for everyone. However, we tend to relate depression to the “classic signs” and often breeze over atypical depression symptoms. But it has to be said: the ways we express mental health conditions like depression is complex.

It’s also human nature to categorize our experiences, things that happen to us, and how we see the world into a more black and white mold. It’s easier for our brains to say: depression looks like X and decide whether or not (or where) we fit into that definition. The reality though, is that the beauty and oftentimes the battles in life come from our nuanced differences. I see this idea play out often in my work in medicine. Each individual body, in their own individual space— physically, mentally, emotionally—their life experiences up to this point influencing everything about them. Even on a genetic level, our experiences impact us.

Featured image by Riley Reed.

Lauren Zielinski
Lauren Zielinski, MSN, CNM

Lauren Zielinski is a certified nurse-midwife with over 11 years of experience in women’s health and birth. She studied medicine at The University of Colorado-Denver with a focus on community health and birth center work.

The Importance of Understanding Atypical Depression

The point I’m making is that it’s important to think outside of the box when it comes to the range of human experiences we may encounter, especially in how we see mental health. As a society, the more comfortable we become talking about mental health, the more we learn. The classic signs of depression are there for a reason—because they’re the most common. However, it’s also important to consider what we call in medicine the “zebras in the room,” or in other words, the presentation of atypical depression symptoms.

According to a 2021 study covered by the National Institute of Health, “nearly half of Americans surveyed reported recent symptoms of an anxiety or depressive disorder.” The data shows that “rates of anxiety, depression, and substance use disorder have increased since the beginning of the pandemic.” With the increase in stress and drastic shifts in how we live our lives, it’s no surprise that perhaps you or someone close to you is suffering from anxiety or depression.

Below, we’re diving into what depression looks like and how atypical depression presents so you can learn what to look out for or maybe even seek treatment.

Camille Styles stretching in meditation space_atypical depression symptoms
Image by Michelle Nash

What is depression?

The signs and symptoms below are what we recognize as the more common and hallmark signs of depression. As a provider, I’ve found that many of my patients in the non-medical community don’t fully understand the breadth of symptoms that depression can incur on someone’s life. It’s more than just sadness or crying. Depression has the potential to impact us not only mentally but physically.

So many of my patients report feeling completely disabled or heavy with dread and sadness. It can envelop your whole being and it’s not something that’s easy to “snap out of.” Below is a list of the most commonly recognized symptoms of “typical” depression:

  • Irritability, impatience, hostility and angry outbursts, even at small things
  • Erratic behavior, such as hanging up on someone or driving aggressively
  • Feelings of emptiness, hopelessness or sadness
  • Loss of motivation or interest
  • Lack of energy and slowed speech, movements or thoughts
  • Back pain, headaches, and other physical ailments without a clear source
  • Impaired thinking, concentration, memory and decision-making
  • Persistent guilt, anxiety and self-blame
  • Insomnia, or oversleeping
  • Significant changes in appetite resulting in weight loss or gain
  • Recurrent thoughts of death, or suicidal ideation or attempts
sweet pea flowers_atypical depression symptoms
Image by Jenn Rose Smith

What is atypical depression?

According to the Cleveland Clinic, “atypical depression is at least twice more likely to affect women than men. In addition, atypical depression tends to begin at an earlier age (teen years and early 20s) and last longer (often becoming a chronic condition) than typical depression. Symptoms of atypical depression can vary from person to person.”

Despite the name, atypical depression is more common than is widely recognized. The Cleveland Clinic also notes that 121 million people globally suffer from depression, while 18 to 36% of that 121 million show atypical symptoms rather than standard signs of depression. Of note: It’s also been found that an increased risk of suicide and anxiety disorders is present with atypical depression, which makes it even more important for this “other” depression to become more widely recognized and understood.

Notable signs and symptoms of atypical depression include:

  • Depression that temporarily lifts in response to good news or positive events
  • Increased appetite or weight gain
  • Sleeping too much but still feeling sleepy in the daytime
  • Heavy, leaden feeling in your arms or legs that lasts an hour or more
  • Sensitivity to rejection or criticism, which affects your relationships, social life, or job
Nitsa Citrine drinking tea at home_atypical depression symptoms
Image by Claire Huntsberger

What should I do if I’m concerned?

When you’re depressed, it can be hard to take steps toward healing, and a challenge to find the energy to call a therapist or even talk to someone about it. There’s good research that for mild to moderate depression, talk therapy may be as effective as medication. I always recommend therapy, a healthy diet, and exercise as the first step in beginning to sift through the muddy waters.

Connect With a Therapist

Psychology Today is a great resource for finding a therapist. By entering your insurance and zip code, you can connect with therapists in your area. Due to the general lack of great mental health support in America, it can be hard to find someone who is taking new patients. But don’t give up! If a therapist is fully booked, ask if they can refer you to other specialists or if they have a wait list.

Remember: Not every therapist will be a good match. Not unlike online dating, it doesn’t always work out! Consider your first appointment a get-to-know-you date. Many therapists will also offer free initial consultations.

Consider Medication

There is nothing wrong with using medications to help lift you out of a slump or for long-term use. Sometimes we need some medication to help us get to the place where we can begin exercising, eating well, and showing up for regular appointments. It’s important to set the expectation up front that not every medication is right for every person. It can take a few tries to find the right medication, which can be difficult when you’re already not feeling well. Most mental health medications take 4-6 weeks until you feel the full effect, so don’t despair if you don’t feel better immediately.

Remember: Life Is Full of Highs and Lows

If you’re low now, you can begin to climb out of where you are to higher ground. Consider telling supportive friends or family what you’re dealing with and ask for support. Sometimes, asking a partner or friend to check in weekly can keep you accountable to your progress. As when we are depressed, our lack of motivation and drive can weigh us down from accomplishing the simplest tasks. But never, ever give up.