lack of reactivity of mood is that even highly desired events are not associated with
marked brightening of mood. Either mood does not brighten at all, or it brightens
only partially (e.g., up to 20%–40% of normal for only minutes at a time). The “dis-
tinct quality” of mood that is characteristic of the “with melancholic features” speci-
fier is experienced as qualitatively different from that during a nonmelancholic
depressive episode. A depressed mood that is described as merely more severe,
longer lasting, or present without a reason is  not considered distinct in quality. Psy-
chomotor changes are nearly always present and are observable by others.
Melancholic features exhibit only a modest tendency to repeat across episodes
in the same individual. They are more frequent in inpatients, as opposed to outpa-
tients; are less likely to occur in milder than in more severe major depressive epi-
sodes; and are more likely to occur in those with psychotic features.
With atypical features:  This specifier can be applied when these features predomi-
nate during the majority of days of the current or most recent major depressive epi-
sode. 
A. Mood reactivity (i.e., mood brightens in response to actual or potential positive
events).
B. Two (or more) of the following features: 
1. Significant weight gain or increase in appetite.
2. Hypersomnia.
3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs).
4. A long-standing pattern of interpersonal rejection sensitivity (not limited to epi-
sodes of mood disturbance) that results in significant social or occupational
impairment.