Psychotic Depression


By definition, psychotic depression (also known as Psychosis) is the impairment of one’s mental ability to such an extent that the patient’s thoughts and emotions are altered, thus disconnecting the person from reality. Such a patient might exhibit implausible behaviour, thoughts and emotions and may even experience delusions and hallucinations. In retrospect, depression refers to overwhelming emotions of sadness and hopelessness. Though psychosis is a branch of depression, it does have some noticeable differences.

The two words when combined, literally as well as clinically would imply that psychotic depression consist of alternating phases of depression and psychosis. Typically, at one moment the patient would go through a period of extreme distress and then might began hallucination at another moment.

Studies have revealed that a patient suffering from psychotic depression is more likely to have suicidal thoughts as compared to a patient suffering from any other mental disorder.

Causes of Psychotic Depression

Psychotic depression does not have a single cause, but studies actually show that it can be caused due to a number of factors. These factors generally include continuous stress, hereditary factors such as a family or personal history of a mental disorders, dwindling levels of thyroid or cortical hormones. Psychotic depression can also be caused through the use of drugs, but this has been proven to be a less likely occurrence.


Psychotic Depression Symptoms

A patient suffering from psychotic depression will often exhibit symptoms of both psychosis and depression.

In psychosis, the distorted thought process causes delusions and hallucinations. A hallucinated person would perceive something non-existent as real and would have clear in mind; vivid images of something that did not even have a stimulus. Generally, delusions are much more common in psychotic depression as oppose to hallucinations.

Other psychotic depression symptoms include:

  • Confusion
  • Delusions
  • Depression
  • Distorted thinking and speech
  • Hypochondria
  • Increased excitement
  • Illusions
  • Thoughts of suicide
  • Unsubstantiated fear

Diagnosis of Psychotic Depression

Suffering from a few symptoms in itself is not enough to consider yourself diagnosed with psychotic depression. Only a certified mental health professional can properly diagnose you.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has set the criteria of when someone is generally able to be diagnosed with psychotic depression. According to this manual, a person must exhibit at least 6 of the above mentioned Psychotic Depression Symptoms over a period of at least two weeks.

Among the symptoms of psychotic depression, the three most common include:

  • Being in a depressed mood the majority of the day
  • Lack of interest in nearly all the day to day activities
  • Delusions and hallucinations

To rule out the possibility of a physical illness, a routine blood test may be done. A brain scan would rule out the possibility of an underlying brain tumor.

Psychotic Depression Treatment

Treating someone who is suffering from psychotic depression is not an easy task, but nonetheless, it is most certainly treatable. Proper evaluation by a mental health professional is the key to proper diagnosis. Though there is no specific test to test one positive or negative for psychotic depression, a health professional will be able to make the best determination based on any noticeable symptoms.


Once diagnosed, depending on the severity of their symptoms, the patient may be required to stay and undergo observation in a hospital. Those who are considered to be a medium to high risk of committing suicide are generally hospitalized.

Psychotic depression can be treated through either psychotherapy, the use of medications, or Electro-Convulsive therapy.

If the medication route is chosen by your health professional, generally a combination of anti-psychotics and anti-depressants will be prescribed. However, these drugs have several side effects and should not be administered unless they are prescribed by a mental health professional. In many cases, a combination of prescription medication and psychotherapy are used to battle psychotic depression. Psychotherapy is a type of counselling that attempts to uncover the root of the persons depression.

If medication fails to treat the disorder, Electro Convulsive Therapy (ECT) is used sometimes used as a last resort. ECT is a method in which an electric current is passed through the patient’s brain, which causes a series of neurochemical reactions and results in a mild seizure. Almost always given under anaesthesia, ECT is highly effective in the treatment of psychotic depression.

Although effective, it is not widely accepted in the medical world due to the negative image it has been given. People generally perceive it as being an immediate solution to their depression, when in fact this is not the case. Additionally, it can lead to short term memory loss, which is simply a risk most are not willing to take.

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