Can a Depressed Person Have Good Days? - Atypical Depression

Usually we think of someone who is moderately to severely depressed as being very sad and unresponsive to things. Maybe even zombie like. But that isn’t always how it looks. But when it does look like this, we call it having melancholic features or a melancholic depression.
When someone is able to have good days or still enjoy some things, we call it having atypical features or an atypical depression. Atypical depression is the most common way depression looks.
Here’s a comparison of the two types:
Atypical
Mood lifts
More appetite
Leaden paralysis
Rejection sensitive
Worse in afternoon
Melancholic
Always sad
Less appetite
Slowed or agitated
Guilt focused
Worse in morning
Atypical depression has been shown to respond better to a different kind of antidepressant called monoamine oxidase inhibitors or MAOI’s. These drugs aren’t used as much as they once were 20-30 years ago before the selective serotonin reuptake inhibitors or SSRI’s came out. Those would be medications like Prozac, Zoloft and Lexapro. These medications have less side effects overall, so they are better tolerated. But they are not as good for atypical depression.
The MAOI’s fell out of favor because they have a lot of drug interactions and a serious interaction with foods high in tyramine. If you consume those foods while taking one of these drugs you could have a hypertensive crisis where your blood pressure shoots up very high. And This could be fatal. So people taking the medication were given a list of foods that you couldn’t eat while you were on the medicine. Some of these foods were aged cheeses and wine. You also have to be very careful taking certain prescription and non-prescription medications including some allergy medications. Those interactions could cause serotonin syndrome which could also make you very sick to where you need to go to the hospital.
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