Now we recognize that atypical depression appears in younger age groups. At any given time 3 percent of children and teens in the United States are depressed. Of those 3 percent, two thirds do not get the help they need (Kramlinger, 2001). Family and relationships suffer, social development is affected, and the risk of drug or alcohol abuse rises. Atypical depression in preschoolers results in a loss of interest in playing, and frequent crying. For an elementary student, irritability, easy discouragement, "sad appearance", complaints of boredom, difficulty with school work, and talk of death are major signs. Symptoms for a teenager include constant fatigue, arguments with parents and teachers, loss of interests in favorite activities, refusal to do chores and homework, suicidal thoughts, or engagement in harmful behavior to themselves (cutting, etc.). Teenagers and children are more susceptible to any type of depression if they experience a lot of stress, experience the death of a loved one, a breakup in a relationship, are a victim of neglect or abuse, or have a chronic disease such as diabetes. Studies show that younger patients who are depressed experience more hypersomnia, or excessive sleeping, while middle aged patients who are depressed experience more hyperphagia, or excessive eating, and rejection sensitivity (Posternak, 2001).
Atypical depression is a controversial category of depression. Those psychiatrists and doctors that support it say it describes a very unique form of depression. It is not included in the Standard Medical Manual (the Diagnostic and Statistical Manual of Mental Disorders) due to criticism saying that there are no studies that substantiate a reliable and valid diagnosis (Cousens, 2000). Atypical depression does not follow "rules" and is very difficult to diagnose. Elizabeth Wurtzel, author of Prozac Nation, states, "The atypically depressed are more likely to be walking wounded, people like me who are quite functional whose lives proceed almost as usual, except that they"re depressed all the time, almost constantly embroiled in thoughts of suicide even as they go through their paces.