Major depressive disorder with atypical features is a subtype of major depression.
Diagnostic criteria for atypical depression
“To be diagnosed with atypical depression, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.
For a diagnosis of atypical depression, you must first meet the general DSM criteria for major depression — such as feeling down most of the day and losing interest or pleasure in activities you once enjoyed. You’ll also need to meet other specific criteria for atypical depression.
For a diagnosis of atypical depression you must have this symptom:
- Depression that temporarily lifts when you’re cheered up by positive events (the presence of marked mood reactivity i.e., improvement in mood in response to actual or potential positive events)
In addition, you must have at least two of these symptoms for diagnosis:
Gaining weight or having a noticeable increase in appetite (Significant weight gain or increase in appetite)
Sleeping too much (Hypersomnia)
Being sensitive to rejection by others so that it affects your work or relationships (i.e. a long-standing pattern of interpersonal rejection sensitivity–not limited to episodes of mood disturbance–that results in significant social or occupational impairment )
Having a heavy feeling in your arms and legs (leaden paralysis–a heavy, leaden feeling in the arms or legs)
In major depressive disorder with atypical features, MAO inhibitors have greater efficacy than tricyclic antidepressants. Other options include SSRIs, bupropion, cognitive-behavioral therapy, and electroconvulsive therapy.
References:
Work Group on Major Depressive Disorder Independent Review Panel: Practice Guideline for the Treatment of Patients With Major Depressive Disorder, ed 3. American Psychiatric Association, 2010.