Atypical Depression Linked to Risk of Inflammation, Heart Disease

If further research supports these findings, “it would establish increased systemic inflammation as another feature that distinguishes atypical from non-atypical depression, and it would indicate that atypical depression may be partially driving the overall depression-inflammation relationship,” Stewart and colleagues wrote.1

Because of the increased inflammation seen in patients with atypical depression, they may be at an especially high risk of developing heart disease and warrant early intervention. Other findings reported in a study co-authored by Stewart and published in Psychosomatic Medicine  in 20145 offer promising results in this very area. Results of the randomized controlled trial show that patients who received antidepressants and psychotherapy cut their subsequent risk of heart attack and stroke nearly in half compared with patients who received standard care.

A 2015 study from BMC Psychiatry6 investigated dietary differences among 1,660 participants that included healthy controls and patients with different subtypes of depression. The researchers found that patients with atypical depression had the lowest diet quality scores of all participants, suggesting that therapists might consider including referral to a nutritionist as part of the treatment plans for such patients, if appropriate. By providing relevant and timely intervention to patients with atypical depression, mental health clinicians can play a critical role in helping them prevent a multitude of health problems.

Tori Rodriguez, MA, LPC, is a psychotherapist and freelancer writer based in Atlanta.


  1. Hickman RJ, Khambaty T, Stewart JC. C-reactive protein is elevated in atypical but not nonatypical depression: data from the National Health and Nutrition Examination Survey (NHANES) 1999– 2004. J Behav Med. 2014; 37(4):621-629.
  2. Schuch JJ, Roest AM, Nolen WA, et al. Gender differences in major depressive disorder: results from the Netherlands study of depression and anxiety. J Affect Dis. 2014; 156:156-163.
  3. Coryell W. Depressive Disorders. Merck Manual: Professional Version; 2013. Available at: Accessed July 8, 2015.
  4. Rudolf S, Greggersen W, Kahl KG, et al. Elevated IL-6 levels in patients with atypical depression but not in patients with typical depression. Psychiatry Res. 2014; 217(1-2):34-38.
  5. Stewart JC, Perkins AJ, Callahan CM. Effect of collaborative care for depression on risk of cardiovascular events: data from the IMPACT randomized controlled trial. Psychosom Med. 2014; 76(1):29-37.
  6. Rahe C, Baune BT, Unrath M, et al. Associations between depression subtypes, depression severity and diet quality: cross-sectional findings from the BiDirect Study. BMC Psychiatry. 2015; 15:38.