Study of 15,000 people with depression: 1 in 5 experience ‘atypical’ type characterised by excessive sleep and weight gain, poorer response to common antidepressants (SSRIs), and genetic risk for metabolic, inflammatory, and circadian (body clock) disturbances
https://www.abc.net.au/news/2026-01-16/antidepressants-less-effective-atypical-depression/106231014
19 Comments
POV you ar depressed with ADHD
This article reinforces something a lot of us feel anecdotally, depression isn’t one monolithic thing, and the standard “SSRI first” approach just doesn’t fit everyone, especially subgroups with different symptom profiles like atypical depression (e.g., oversleeping, weight gain, etc.).
There is research suggesting neurodivergent burnout and major depression can get confused in clinical settings because of overlapping symptoms. That makes it easy for someone with chronic exhaustion from masking and sensory overload to be diagnosed with depression and steered toward medications that aren’t a good match.
Depression is often treated as one-size-fits-all, so ppl w atypical traits get meds that don’t match their biology, delaying real improvement
Cool. Cool. Now how do you fix it?
Of course I know him, *he’s me*
Man I really wish I could try psilocybin or ketamine treatments instead of taking SSRIs and mood stabilizers.
definitely me. Now I want to know what can be done!
I’ve never tried any medication for my depression. About 5 years ago my psychiatrist at the time said I wasn’t a good candidate for medication. It’s possible that’s changed since.
I’ve gained a lot of weight and have struggled immensely with maintaining a healthy sleep schedule since as well. Though I’m fairly certain I’m not on the spectrum nor do I have ADHD. I need to see a doctor again to see if the way mental health is diagnosed has changed at all. I really need some help.
“They also had a higher genetic risk for other conditions such as ADHD and bipolar disorder, as well as metabolic and inflammatory dysfunctions, which could lead to diabetes or high blood pressure.”
If the symptoms don’t match, and the treatments don’t match- are we sure we should be labeling this depression? Or are we diagnosing depression when someone’s other medical complaints aren’t falling neatly in another diagnosis?
Literally going through medication options to help w my severe anxiety / depression and adhd. SSRI/SNRIs haven’t helped at all.
I did not know I was being studied.
In all seriousness they mention a higher incidence of ADHD as a comorbidity, but circadian rhythm disorders are a very common symptom of ADHD and often result in excessive sleep because we feel like we’re in a permanent state of jet lag. I’m not clear as to whether they were able to differentiate the sleep disturbances from the increased prevalence of ADHD.
I do know that the worse my circadian rhythm disorder gets, the more weight I tend to gain because it disrupts my metabolism and I end up eating late into the night. This in turn makes me depressed.
I think it’s harder than it might seem to disentangle all of these issues or say definitively what causes what. The treatment resistant aspect is an interesting one though. I was prescribed l-methylfolate to help with my treatment resistant depression, and switching to Viibryd seemed to help as well. So it might be the case that people with ADHD and depression respond differently to treatment.
I wonder how many of them are actually bipolar? I was diagnosed as one of these atypical depression cases. In my case, there were mixed episodes that were super hard to recognize because the hypomania was the dysphoric type.
Edit: Then again, maybe it’s an ADHD/depression thing. I do have ADHD too.
Ahh yes found this out In 1997 in college
The first question is what is atypical about excessive sleep and weight gain, those are considered common symptoms.
Secondly, only about half of those respond
to SSRIs with typical depression in studies, and this is only marginally better than response to a placebo, which has about a 40% response rate itself
That sounds a lot like burnout to be honest. The whole lot from the sleep disturbances to metabolic disorders.
This was me before we discovered that I had undoagnosed ADHD. Once my ADHD was treated, the depression vanished.
That’s me. I have all those characteristics. Meds work for a few months and then I’m right back where I started. It’s been that way since puberty. It gets worse in the Winter.
Sounds like MTHFR leading insulin resistance and other stuff.
Oh hi! This is me. Then I found out i have double homozygous positive mthfr mutations. So I treated for that with methyl b vitamins and it worked. I tried so many meds, for so many years. And a 10 dollar supplement was the answer. Blows my mind sometimes