What is psychotic depression?

Depression is a mental health condition that causes people to lose pleasure from daily life. It can befall anyone, at any age, irrespective of race or ethnic group. As commonly perceived, depression is not just sadness or something that goes away easily. In major depressive cases, it can even lead to suicide if left untreated. When a severe depressive illness includes some form of psychosis, the condition is known as psychotic depression. Psychotic symptoms are more likely to occur in people with severe depressive illnesses and are thought to occur in a few people with major depressive disorder. This type of depression doesn’t appear out of the blue and occurs in major depressive disorder or in bipolar disorder.

Psychotic depression is exactly what it sounds like – it’s a subtype of major depression characterized by the presence of both depression and psychosis. Psychosis can include hallucinations (seeing or hearing things that are not real), delusions (believing things that are not real) or any other break from reality.

People with psychotic depression experience a psychosis that is distinct from that observed in other illnesses, such as schizophrenia. Perhaps unsurprisingly, people with depression tend to experience hallucinations and delusions that confirm their negative self-worth. For instance, individuals might hear voices berating them or calling them stupid. They might experience delusions that people hate them or wish they would commit suicide. For people with psychotic depression, psychotic symptoms tend to emerge during a depressive episode and disappear when the episode is over.

The National Institute of Mental Health (NIMH) states that psychotic depression happens when a person has severe depression along with some form of psychosis. This may include both delusions and hallucinations, which means that along with sadness, this person is often out of touch with reality and appears to see or hear things others don’t.

Ways of early recognition

Not everyone who suffers from psychotic depression faces every possible symptom. The number of symptoms and its intensity depend on the person and the severity of the illness. Psychotic depression is more similar to schizophrenia than to nonpsychotic depression. Only a mental health professional would be able to differentiate it from other disorders and other types of depression.

There are certain signs that can help detect psychotic depression and enable early treatment. These signs are:

  • Agitation or aggressiveness for no particular reason
  • Spending a lot of time alone, be it in a room or in bed
  • Complete indifference to life and lack of interest for anything that’s going on
  • Neglecting their appearance, and refusing to talk to anyone due to their lack of will
  • Feeling guilty constantly. Individuals feel frustrated or ashamed for something they have done, or possibly never done, but the presence of guilt is always there.
  • Experiencing delusions that are usually paranoid or related to one’s body. For example, an individual may be convinced that something is eating away at their internal organs.
  • Experiencing hallucinations which are a common symptom. Individuals usually witness things that others don’t. They either hear or see something that’s not there.

Sometimes the signs of psychosis aren’t that evident, or the individual is simply ashamed to admit what they are suffering from. In many cases, psychotic depression is misdiagnosed because the patient may not be willing to reveal all the symptoms they are experiencing or because it’s hard to differentiate psychotic depression from other mental disorders.

A doctor’s diagnosis will confirm whether the patient is dealing with psychotic depression or another disorder that might provoke psychosis, such as bipolar or schizoaffective disorders. Before diagnosis, doctors might request urine and blood tests to confirm that the symptoms are not due to another illness. Doctors might also request an MRI or CT scan to gauge the brain’s structural integrity.

Remission is possible

Once diagnosed, patients with psychotic depression are usually treated with a mixture of antipsychotics and antidepressants. Although finding the right combination of medications might be difficult, people with psychotic depression are usually able to achieve remission, although they might need to continue medication and therapy to maintain their health. Both major depression and psychotic depression are serious illnesses that require early intervention and treatment.

If you or someone you know is displaying major depressive disorder symptoms or any other mental health disorder and is looking for inpatient programs for depression, get in touch with Medical Concierge. The medical team at our network facilities can help identify the mental disorder and the underlying causes. Based on this, it can individualize a treatment program that can be administered at our state-of-the-art facility. For more information about inpatient treatment centers for depression, call our 24/7 helpline 877-636-0042 and speak with a member from our admissions team. You can also chat online with a representative for further assistance.

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