What is Psychotic Depression?

What is Psychotic Depression? Also known as depressive psychosis, psychotic depression is a subtype of major depression that includes some form of psychosis. The psychosis is usually hallucinations, delusions or another break with reality.

People with psychotic depression are out of touch with reality. They may hear voices telling them they are worthless or useless. They may believe people can read their thoughts or that people are trying to harm there or are otherwise out to get them. Their hallucinations also consistent with depression. In other words, their delusions or hallucinations support their belief that they are worthless and no good.

Those diagnosed with psychotic depression are likely to be paranoid and believe others can control their thoughts, read their thoughts or hear their thought. They are usually ashamed of their behavior and beliefs and go to great length to hide them. This can make diagnosing someone with psychotic depression difficult.

Psychotic depression is similar to schizophrenia except those with psychotic depression realize their thoughts aren’t true. Additionally, those with schizophrenia usually have more irrational thoughts and beliefs. The thoughts of someone with psychotic depression tend to have delusions and hallucinations that are consistent with depression – they believe they are failures, losers or otherwise worthless. Schizophrenics tend to have more bizarre and “out there” hallucinations and delusions.

Symptoms of psychotic depression usually follow after an individual has had several episodes of depression without psychosis. Once psychotic symptoms emerge they tend to be present with each depressive episode. Those who suffer from psychotic depression fare better than those diagnosed with primary psychotic disorders. Symptoms usually emerge between the ages of 20 and 40 and someone with psychotic depression can expect to have 4 – 9 episodes in a lifetime. Episodes usually last less than 24 months. People with psychotic depression usually function well socially and professionally between psychotic episodes.

Treatment includes antidepressants, antipsychotics or a combination of the two medications. Electroconvulsive therapy (ECT) has also been used to treat psychotic depression.