Psychiatric specifier

With atypical features

Mood reactivity occurs with a characteristic reversed-vegetative or interpersonal sensitivity pattern.

Episode features

Depressive disordersBipolar depressive episodes

At a glance

Applies to: Depressive disorders · Bipolar depressive episodes
Deciding signal: Mood can brighten in response to positive events despite a clinically significant depressive episode.
Ask this: Does mood reactivity sit alongside a coherent atypical depressive pattern rather than an isolated symptom?
Wording outcome: Major depressive disorder, current episode, with atypical features

There is no meaningful mood reactivity.
Sleep or appetite change is better explained by medication, shift work, endocrine illness, or another condition.

Fit and exclusions

Start with the deciding signal, then test chronology, competing explanations, and the effect on diagnostic wording.

Mood shows genuine reactivity to positive events.
The episode includes a compatible pattern such as increased sleep, increased appetite, leaden heaviness, or rejection sensitivity.
The pattern is clinically meaningful and not simply a preference or coping style.

Capture the reactive and reversed-vegetative pattern without using “atypical” to mean unusual or mild.

Focus: Reactive mood with a characteristic symptom pattern
Time course: Present through much of the depressive episode
Look for: Mood reactivity, hypersomnia, increased appetite, leaden feeling, rejection sensitivity
Avoid: The label does not simply mean an unusual presentation

Major depressive disorder, current episode, with atypical features

At a glance

Applies to

Depressive disorders · Bipolar depressive episodes

Deciding signal

Mood can brighten in response to positive events despite a clinically significant depressive episode.

Ask this

Does mood reactivity sit alongside a coherent atypical depressive pattern rather than an isolated symptom?

Wording outcome

Major depressive disorder, current episode, with atypical features