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Psychotic Depression

What is Psychotic Depression?

Psychotic Depression = Depression + hallucinations/delusions

• It is a state of depression so severe that the person loses contact with reality and suffers a variety of functional impairments.
• In addition to the symptoms of depression, psychotic depression includes some features of psychosis - like hallucinations (seeing or hearing things that aren't really there) or delusions (irrational thoughts and fears).
• These hallucinations are not "positive", instead, the sufferer of psychotic depression imagines frightening and negative sounds and images.
• Having an episode of psychotic depression increases your risk of bipolar depression, recurring episodes of psychotic depression, and suicide.

Symptoms of Psychotic Depression

• Includes symptoms of depression.
• Presence of psychosis (hallucinations/delusions).
• Hypochondria (obsessive preoccupation with the possibility of becoming ill or with imagined symptoms of an illness).
• Intellectual impairment.
• They feel guilty of shameful deeds or crimes which they could not possibly be responsible for, such as a war or a natural disaster.
• They are at risk of serious self-neglect.
• Psychotically depressed people often believe that their thoughts are not their own or that others can ‘hear’ their thoughts.
• Other symptoms of psychotically depressed people may include anxiety, agitation, insomnia, constipation, physical immobility.

Psychotic Depression - How it differs from other mental illnesses?

The people with other mental illness, like schizophrenia also experience these symptoms. However, these people really think their delusions to be true. But, people with psychotic depression are usually aware that these thoughts are not true. So, they may feel ashamed or embaraased and try to hide them, making psychotic depression difficult to diagnose.

Cause of Psychotic Depression

Exact cause of psychotic depression is not known. However, it is frequently associated with high levels of a hormone called 'cortisol' in the blood. (Cortisol is a hormone produced by the adrenal cortex. High levels of cortisol have been associated with stress.) It is also known that those with a family history of depression or psychotic illness are more susceptible.

Treatment of Psychotic Depression

• Person suffering from psychotic depression must be properly diagnosed as the treatment is different from other depressive illnesses and risk of suicide is greater.
• Combinations of antidepressants and antipsychotic medications are given to ease the symptoms.
• Electroconvulsive therapy (ECT) may also be used in the treatment of psychotic depression.
• Requires a close follow-up by a mental health professional.
• Usually requires a longer hospital stay.
• People are often recovered within a year, but continual medical follow-up may be necessary.

Depression Types

Normal Depressed Mood

Dysthymic Disorder (or Mild Depression)

Major Depression

Cyclothymic Disorder

Unipolar and Bipolar Depression

Bipolar Disorder (or Manic Depression)

• Hypomania
• Bipolar Disorder Treatment

Seasonal Affective Disorder (SAD)

Psychotic Depression

Atypical Depression

Post Partum Depression

Endogenous Depression

Bone Marrow Depression

Winter Depression

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