Psychotic depression is characterized as a severe case of major depression coupled with some form of psychosis such as delusions, hallucinations, both or some other type of a break from reality. It is a very serious condition and those experiencing this type of depression should seek professional help immediately. Those suffering from psychotic depression make up an estimated 25% of all patients admitted to a hospital for mental illnesses.
Since this disorder is made up of two parts, the depression aspect and the psychosis aspect, it is important to know the symptoms for each and how they manifest themselves as well as the treatment options for those suffering from psychotic depression.
Symptoms of Psychotic Depression
Those with this disorder may experience any of the normal symptoms of depression, but most notable may be:
- Agitation, short temper, quick to get angry
- Insomnia or excessive sleeping
- Feelings of worthlessness
- Mental impairment, not being able to think clearly or concentrate
- Neglect of appearance, does not bathe regularly or change clothes
This disorder is also marked by the appearance of psychosis in the patient. Delusions (a false sense of one’s self or of what is going on) and hallucinations (seeing things or hearing things that are just not there) are the two major manifestations of the psychosis aspect of the disorder.
A patient experiencing delusions with psychotic depression may be unusually distrusting of others believing that others can hear their thoughts. They may also think that they are dying from a terminal disease such as cancer. They can believe that they are guilty of a serious crime that they never committed. They can also have a false sense of themselves believing that they are someone famous or overly important.
If they experience hallucinations then they may hear voices that insult them making them feel worthless and belittling them or telling them to harm themselves or others. They may see the devil or other incarnations of evil.
Unlike other mental illnesses that include psychosis such as schizophrenia, where the patient truly believes that their delusions or hallucinations or in fact real, someone suffering from psychotic depression knows that what they are seeing or hearing or believing about themselves is not real or based in reality. This produces a sense of shame in the patient and makes it harder to diagnose them since the shame they feel keeps them from talking about it or admitting their psychosis to health care providers. This sense of shame and not being able to control their thoughts may also lead to or make worse their depression.
Psychotic depression ideally should be treated in a hospital setting where proper monitoring of the patient can take place. The risk for hurting themselves or others is higher than normal for those suffering from this form of depression so being under medical supervision until being stabilized is preferred.
Different medications can be used to treat psychotic depression. Usually a combination of depression medications along with anti-psychotic medications are used to stabilize the patient. Normally, antidepressants will have to be taken for a longer period than the anti-psychotic drugs. Treatment with medications can be effective and, if successful, results can be seen within one year. Follow up and maintenance treatment is highly recommended for patients as well.
For severe cases, or for cases in which medication did not produce adequate results for the patient, electroconvulsive therapy might be recommended. ECT has a very long and successful track record in helping those suffering from a vast array of mental health illnesses.
What Causes Psychotic Depression?
The exact cause of psychotic depression in not currently known. Some research points to a possible link between high levels of cortisol in the body. Cortisol is a hormone the body produces during high levels of stress or when presented with trying circumstances. Also a family history of mental illness may increase a person’s chances of developing a mental disorder.
Psychotic depression is a serious matter. Severe major depression along with psychosis often leaves one suffering from this disorder unable to take care of themselves. It also carries a high risk of someone afflicted with this form of depression to hurt themselves or others. Anyone at risk of or thought to be suffering from psychotic depression should seek immediate help. It is recommended to treat patients of this disorder in a hospital setting so they can be properly monitored while being stabilized. Treatment can be highly effective, so it is important to keep in mind that there is always hope for those going through psychotic depression.