Psycho-Babble Medication Thread 582

Shown: posts 1 to 13 of 13. This is the beginning of the thread.

 

Atypical depression

Posted by Tanya on September 9, 1998, at 17:50:58

Can anyone give me some information on atypical depression? And what is it sucessfully treated with?
Thanks in advance.

 

Re: Atypical depression

Posted by Elizabeth on December 14, 1998, at 3:29:21

In reply to Atypical depression, posted by Tanya on September 9, 1998, at 17:50:58

> Can anyone give me some information on atypical depression? And what is it sucessfully treated with?
> Thanks in advance.

Atypical depression is characterized by reactive mood (ability to be cheered up temporarily when good things happen, but also lability that may lead to irritability and "overreacting" to losses and disappointments) and retained ability to enjoy simple pleasures such as food and sex. Atypical depressives may have periodic cravings for food, especially sweets, and may also have cravings for other pleasant experiences such as shopping, sex, and alcohol and may be quite impulsive about indulging these cravings, bingeing on the things that give them pleasure. They tend to gain weight when depressed, as a result. They also may use excessive sleeping as an escape. They often will feel extremely lethargic, heavy, as though they cannot move at all. Frequently the depression seems to occur in response to some kind of loss (such as romantic rejection) but often far out of proportion to this loss.

Traditionally, MAO inhibitors (Nardil, Parnate) have been the treatment of choice. Lately it appears that SSRIs are also effective. It remains to be seen whether Wellbutrin, Effexor, Serzone, Remeron, and the like will work as well. The SSRIs, Effexor, and especially Wellbutrin have the nice effect that they tend to be less sedating than other antidepressants.

Many people with atypical depression also experience significant anxiety, mood swings, and chronic course of illness. For these, a mood stabilizer may be in order (these can help to decrease the number of episodes - you need to take them for a longer time, like a year, before the benefits become apparent). Topamax, in particular, is a newer anticonvulsant that helps promote weight gain, although it may lack the antidepressant effects of lithium. Benzodiazepines may also help with anxiety and interpersonal sensitivity.

Don't bother with tricyclics until you've tried pretty much everything else. They are not very effective in this type of depression.

 

Re: Atypical depression

Posted by Nancy on April 8, 1999, at 13:03:35

In reply to Re: Atypical depression, posted by Elizabeth on December 14, 1998, at 3:29:21

> > Can anyone give me some information on atypical depression? And what is it sucessfully treated with?
> > Thanks in advance.
> Atypical depression is characterized by reactive mood (ability to be cheered up temporarily when good things happen, but also lability that may lead to irritability and "overreacting" to losses and disappointments) and retained ability to enjoy simple pleasures such as food and sex. Atypical depressives may have periodic cravings for food, especially sweets, and may also have cravings for other pleasant experiences such as shopping, sex, and alcohol and may be quite impulsive about indulging these cravings, bingeing on the things that give them pleasure. They tend to gain weight when depressed, as a result. They also may use excessive sleeping as an escape. They often will feel extremely lethargic, heavy, as though they cannot move at all. Frequently the depression seems to occur in response to some kind of loss (such as romantic rejection) but often far out of proportion to this loss.
> Traditionally, MAO inhibitors (Nardil, Parnate) have been the treatment of choice. Lately it appears that SSRIs are also effective. It remains to be seen whether Wellbutrin, Effexor, Serzone, Remeron, and the like will work as well. The SSRIs, Effexor, and especially Wellbutrin have the nice effect that they tend to be less sedating than other antidepressants.
> Many people with atypical depression also experience significant anxiety, mood swings, and chronic course of illness. For these, a mood stabilizer may be in order (these can help to decrease the number of episodes - you need to take them for a longer time, like a year, before the benefits become apparent). Topamax, in particular, is a newer anticonvulsant that helps promote weight gain, although it may lack the antidepressant effects of lithium. Benzodiazepines may also help with anxiety and interpersonal sensitivity.
> Don't bother with tricyclics until you've tried pretty much everything else. They are not very effective in this type of depression.


E, it sounds like you're describing bipolar-2 disorder. BTW, Topomax is known for inducing weight loss. It is also beneficially used in hard to treat bipolar-1 patients (treatment refractive, rapid cycling).

 

Re: Atypical depression

Posted by Elizabeth on April 9, 1999, at 6:08:49

In reply to Re: Atypical depression, posted by Nancy on April 8, 1999, at 13:03:35

> E, it sounds like you're describing bipolar-2 disorder. BTW, Topomax is known for inducing weight loss. It is also beneficially used in hard to treat bipolar-1 patients (treatment refractive, rapid cycling).

Individuals with Bipolar II disorders have had at least one hypomanic episode and at least one major depressive episode. The depressive episode may have had atypical features, but it doesn't have to.

Being capable of being cheered up temporarily (by good things happening) while depressed - and even, as a result, pleasure-seeking in hopes of relief - is not equivalent to being hypomanic, if that's what you're thinking.

(Atypical depression is sometimes confused with borderline personality disorder, though. Then again, so is everything else.)

 

Re: Atypical depression

Posted by Nancy on April 9, 1999, at 19:10:26

In reply to Re: Atypical depression, posted by Elizabeth on April 9, 1999, at 6:08:49

Hi Elizabeth, Nancy again. That's very helpful. But, is it true that both unipolar and bipolar individuals can be highly labile? I assumed that the increased lability was associated with rapid cycling (something I'm personally familiar with) :) Nancy

> > E, it sounds like you're describing bipolar-2 disorder. BTW, Topomax is known for inducing weight loss. It is also beneficially used in hard to treat bipolar-1 patients (treatment refractive, rapid cycling).
>
> Individuals with Bipolar II disorders have had at least one hypomanic episode and at least one major depressive episode. The depressive episode may have had atypical features, but it doesn't have to.
>
> Being capable of being cheered up temporarily (by good things happening) while depressed - and even, as a result, pleasure-seeking in hopes of relief - is not equivalent to being hypomanic, if that's what you're thinking.
>
> (Atypical depression is sometimes confused with borderline personality disorder, though. Then again, so is everything else.)

 

Re: Atypical depression

Posted by Elizabeth on April 12, 1999, at 4:16:30

In reply to Re: Atypical depression, posted by Nancy on April 9, 1999, at 19:10:26

> Hi Elizabeth, Nancy again. That's very helpful. But, is it true that both unipolar and bipolar individuals can be highly labile? I assumed that the increased lability was associated with rapid cycling (something I'm personally familiar with) :) Nancy

Yes, it's true. That's not the only distinctive feature of atypical depression, though. (Actually I'd say the overeating is the most obvious thing.) Also, it's not just labile mood, it's *reactive* mood.

I've seen people who have this, and that has convinced me that it's quite real and that it's not "just" a form of something else (such as bipolar II).

 

Re: Atypical depression

Posted by carol on April 16, 1999, at 13:23:37

In reply to Re: Atypical depression, posted by Elizabeth on April 12, 1999, at 4:16:30

i have been reading your posts w/nancy ,i find them very interesting & informative, this is my first visit to the site, very enlightening

 

Re: Atypical depression

Posted by Albert on April 19, 1999, at 19:19:30

In reply to Re: Atypical depression, posted by Elizabeth on December 14, 1998, at 3:29:21

Hello anyone. I'm currently taking Zoloft for depression, but now I'm concerned about what it could do to me since I've been reading some scary stories. A few years ago a doctor treated me with what he diagnosed as Bipolar 2, using Lithium.
I stopped when he retired. Are drugs really effective in this area, or is it better to look into natural, non-side-effect alternatives? I don't want to become a loony when my body starts to get tired of Zoloft. Any comments?

 

bipolar II - Albert

Posted by Elizabeth on April 20, 1999, at 3:22:52

In reply to Re: Atypical depression, posted by Albert on April 19, 1999, at 19:19:30

Hi there Albert. You are right to be concerned: if you do have bipolar disorder - get the records from your old doc, the one who diagnosed you as bipolar II, and give them to your current one - there's a good chance that an antidepressant by itself will cause switching (into hypomania) or rapid-cycling.

The way to prevent this is, of course, with mood stabilizers. I know many people with bipolar II disorder who are functioning successfully on these combinations of meds - an antidepressant and a mood stabilizer, sometimes two mood stabilizers are needed, sometimes they can get by without an antidepressant (or using lithium as the antidepressant).

Good luck to you.

 

Re: Atypical depression

Posted by levi on April 21, 1999, at 0:46:04

In reply to Re: Atypical depression, posted by Elizabeth on December 14, 1998, at 3:29:21

> > Can anyone give me some information on atypical depression? And what is it sucessfully treated with?
> > Thanks in advance.
> While there are numerous differences between 'typical' and atypical depressions, it should not be forgotten that a depressed mood is a hallmark of both. additionally, there seems to be some connection between atypical depression and Seasonal affective disorder, both in epidemiology and symptomatology

 

Re: Atypical depression

Posted by Kathy on April 21, 1999, at 15:31:33

In reply to Re: Atypical depression, posted by levi on April 21, 1999, at 0:46:04

This thread has been really informative. I did not
even know that there was such a thing as Atypical depression.
I've been seeing a therapist for a few months now and we have been
trying to determine what it is that I have. I am depressed,
yes but I just got out of a really trying relationship with a man
that I was very much in love with, but he was having major guilt issues
about leaving his former partner - he left her and she of course played
up the total victim and he is a co-dependent/rescuer and well anyway it
was really messed up but it has sent me into a depression that I can only
find very temporary relieve from - mainly from the bottle, but sometimes
from other sources like family/friends etc. Anyway, after reading so much
on the websites about all kinds of disorders, I've decided that I have them
all - Adult ADD, OCD, depresssion, anxiety attacks,perhaps maybe even bipolar
and now Atypical depression, which I think of the above describes me the best -
that and the ADD. And, I'm just kidding about thinking that I have them all
but I do think that I have stumbled across something on this website with the
atypical depression. It describes me rather well and my ex too, believe it or
not. Anyway, I have tried with little success, buspar, paxil (did try long
enough), xanax, and zoloft (only a few days). I took it for two days and felt
really anxious or something - it was just uncomfortable and at the time I think
I was suffering more from anxiety and fear of the unknown (of how my relatioship
was going to go) so I decided to quit, but now that I'm more depressed than
anything else and just a little bit anxious I'm wondering if I should try the zoloft
again. Also, is it good for atypical D and if so, is a rush characteristic of zoloft
in the first week. I really want a cure for this illness whatever it is and I have
pretty much been living with it my whole life.

Thanks


 

Re: Atypical depression

Posted by katie on April 22, 1999, at 15:41:08

In reply to Re: Atypical depression, posted by Albert on April 19, 1999, at 19:19:30

> Hello anyone. I'm currently taking Zoloft for depression, but now I'm concerned about what it could do to me since I've been reading some scary stories. A few years ago a doctor treated me with what he diagnosed as Bipolar 2, using Lithium.
> I stopped when he retired. Are drugs really effective in this area, or is it better to look into natural, non-side-effect alternatives? I don't want to become a loony when my body starts to get tired of Zoloft. Any comments?

I was also taking zoloft for depression, but it made me a little too euphoric (manic) and I was put back on lithium which was exactly what I needed. During most of my battles with my mood disorder I've come to the realization that the meds keep my mind at bay. It's kind of like my mind is full of zoo animals and the drugs are the keys to the cages that keep them safely locked away. So, most of the time I don't worry because I have a real good security system...at least so far, anyway.

 

Re: Atypical depression

Posted by Victoria on April 22, 1999, at 21:04:36

In reply to Re: Atypical depression, posted by Kathy on April 21, 1999, at 15:31:33

It can take a few weeks for zoloft or any SSRI to take effect, so you won't know what works until you've given it a long enough trial. Many side effects diminish after the first few days or weeks; if they are intolerable, some people (I"m one) do better on smaller doses or starting out with a small dose and working up. Do you have a good doctor who knows a lot about these meds who can help you figure out what works for you?


> This thread has been really informative. I did not
> even know that there was such a thing as Atypical depression.
> I've been seeing a therapist for a few months now and we have been
> trying to determine what it is that I have. I am depressed,
> yes but I just got out of a really trying relationship with a man
> that I was very much in love with, but he was having major guilt issues
> about leaving his former partner - he left her and she of course played
> up the total victim and he is a co-dependent/rescuer and well anyway it
> was really messed up but it has sent me into a depression that I can only
> find very temporary relieve from - mainly from the bottle, but sometimes
> from other sources like family/friends etc. Anyway, after reading so much
> on the websites about all kinds of disorders, I've decided that I have them
> all - Adult ADD, OCD, depresssion, anxiety attacks,perhaps maybe even bipolar
> and now Atypical depression, which I think of the above describes me the best -
> that and the ADD. And, I'm just kidding about thinking that I have them all
> but I do think that I have stumbled across something on this website with the
> atypical depression. It describes me rather well and my ex too, believe it or
> not. Anyway, I have tried with little success, buspar, paxil (did try long
> enough), xanax, and zoloft (only a few days). I took it for two days and felt
> really anxious or something - it was just uncomfortable and at the time I think
> I was suffering more from anxiety and fear of the unknown (of how my relatioship
> was going to go) so I decided to quit, but now that I'm more depressed than
> anything else and just a little bit anxious I'm wondering if I should try the zoloft
> again. Also, is it good for atypical D and if so, is a rush characteristic of zoloft
> in the first week. I really want a cure for this illness whatever it is and I have
> pretty much been living with it my whole life.
>
> Thanks


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.