What Is Psychotic Depression? Do I Have It ?

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Psychotic depression is the coexistence of severe depression with a type of psychosis.  The presence of both these conditions simultaneously can make both difficult to diagnose.  An understanding of both conditions and their interaction helps to shed light on this condition.

What Distinguishes The Diagnosis

Depression in its psychotic form has all the usual symptoms of depression with an element of psychosis added into the mix.  This means that the persistent sadness, feelings of worthlessness, loss of energy, and lack of interest in daily activities are all present.

Added to this is some element of psychosis.  This could be hallucinations or delusions.  Hallucinations are things seen or heard by the patient that are not present, and delusions are irrational thought patterns or fears.


Being psychotic means being out of touch with what is real.  This is the feared image of an insane person.  They may exhibit behaviours such as speaking and not making sense.  They might not maintain their appearance or personal hygiene.  It is possible that they will hear voices or have farfetched and bizarre ideas.

They may sincerely believe that other people can read their mind, or they may believe that they are, in fact, a famous person.  The expression of these thoughts may be intimidating or frightening to others as well as terrifying to an individual who has them yet is aware of their unreality.

People with the psychotic disorder are often aware that these hallucinations and delusions do not coincide with reality.  The problem with this awareness is that they may feel embarrassment or shame and choose not to seek out professional help.  If this is the case then the disorder is very hard to diagnose.

Symptoms And Treatment

Symptoms of this type of depression include agitation, hypochondria, anxiety, intellectual impairment, constipation, and psychosis.  The treatment of these and all the other symptoms is usually administered in a hospital setting.  Antidepressants are often used in conjunction with antipsychotic medications to help manage symptoms.

Sometimes electroconvulsive therapy is used in the treatment plan.  This involves a small shock of electricity being applied to the scalp.  The shock results in a seizure that aims to improve the functioning of the brain.  Several such treatments may be necessary over the course of several weeks to achieve results.

Psychotic depression is treatable.  Once diagnosed, treatment can begin, and it is usually resolved within one year’s time.  There is a necessary amount of follow up, but that is a small price to pay for recovery from this unsettling condition.

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