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Symptoms

By Mayo Clinic staff

Managing Depression

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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

When to see a doctor
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.

When to get emergency help
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.

References
  1. O'Keane V, et al. A review of atypical depression in relation to the course of depression and changes in HPA axis organization. Psychoneuroendocrinology. 2012. In press. Accessed June 19, 2012.
  2. Atypical features specifier. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 19, 2012.
  3. Cizza G, et al. Clinical subtypes of depression are associated with specific metabolic parameters and circadian endocrine profiles in women: The power study. Plos One. 2012. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0028912. Accessed June 19, 2012.
  4. Pae C, et al. Atypical depression: A comprehensive review. CNS Drugs. 2009;2:1023.
  5. Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed June 19, 2012.
  6. McPhee SJ, et al. Current Medical Diagnosis & Treatment. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=13381. Accessed June 20, 2012.
  7. Parker G, et al. Will a new genotyping test help the clinician predict response to antidepressant drugs? Australasian Psychiatry. 2010;18:413.
  8. Deplin (Prescribing information). Covington, La.: Pamlab; 2011. http://www.deplin.com/. Accessed Aug. 27, 2012.
  9. Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 7, 2012.
  10. Understanding major depression. National Alliance on Mental Health. http://www.nami.org/Template.cfm?section=Search&Template=Search/SearchDisplay.cfm. Accessed June 20, 2012.
  11. Indications for electroconvulsive therapy (ECT) in unipolar depression and its efficacy. http://www.uptodate.com/index. Accessed June 20, 2012.
  12. Carpenter DJ. St. John's wort and S-adenosyl amethione as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: What is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16:17.
  13. Lamers F, et al. Stability and transitions of depressive subtypes over a 2-year follow-up. Physiological Medicine. 2012. In press. Accessed June 19, 2012.
  14. Hourani LL, et al. Influence of spirituality on depression, posttraumatic stress disorder, and suicidality in active duty military personnel. Depression Research and Treatment. 2012;2012:1.
  15. Depression and complementary health practices: What the science says. National Center for Complementary and Alternative Medicine. Dec. 2011. http://nccam.nih.gov/health/providers/digest/depression-science.htm. Accessed May 10, 2012.
  16. Viibryd (prescribing information). St. Louis, Mo.: Forest Pharmaceuticals; 2011. http://www.viibryd.com/. Accessed June 20, 2012.
  17. SAMe. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=786&ds=adverse&lang=0. Accessed Aug. 3, 2012.
  18. Papakotas GI, et al. Folates and s-adenosylmethionine for major depressive disorder. Canadian Journal of Psychiatry. 2012;57:406.
  19. Marchand WR. Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression. Journal of Psychiatric Practice. 2012;18:233.
  20. Tanyi RA, et al. The effects of psychoneuroimmunology (PNI) based lifestyle intervention in modifying the progression of depression in clinically depressed adults. International Journal of Psychiatry in Medicine. 2011;42:151.
  21. Wu J, et al. Acupuncture for depression: A review of clinical applications. The Canadian Journal of Psychiatry. 2012;57:397.
  22. Chi J, et al. Tai chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials. Geriatrics & Gerontology International. 2012. In Print. http://www.ncbi.nlm.nih.gov/pubmed/22680972. Accessed Aug. 28, 2012.
  23. Chan MF, et al. The effectiveness of music listening in reducing depressive symptoms in adults: A systemic review. Complementary Therapies in Medicine. 2011;19:332.
  24. McCaffrey R, et al. Garden walking and art therapy for depression in older adults: A pilot study. Research in Gerontological Nursing. 2011;4:237.
DS01181 Sept. 20, 2012

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