Identification of atypical features is important in the treatment of depression for both treatment selection and prognosis, especially when initial measures prove ineffective. The concept of atypical depression has evolved over many years, and now it appears timely for a further revision.
There are many rapidly effective treatments for mania in bipolar disorder. However, there are relatively few options for bipolar depression, and none that are rapidly effective—even though bipolar depression constitutes between 20% to 50% of all depressive disorders.
There is evidence that the combination of medication and psychotherapy improves outcomes for many psychiatric illnesses. Among the several forms of psychotherapy that might be considered, cognitive-behavioral therapy (CBT) is the most extensively studied.