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Understanding and Treating Psychotic Depression

A gray cardboard cutout of a persons head against a white background with a twin cutout with deep blues and black watercolors halfway inside. An art piece that depicts depression

Psychotic Depression

Psychotic depression sometimes referred to as delusional depression, is characterized as a major depressive disorder in which an individual experiences a combination of depressed thoughts and loss of reality (psychosis), presenting itself in the forms of hallucinations and/or delusions. These delusions typically manifesting themselves in thinking that bad things are about to happen. When experiencing psychotic depression, individuals can be overcome by depressive, negative voices in their heads or see things that are not physically there. While psychotic depression can be hard to diagnose due to individuals feeling embarrassed or ashamed of their thoughts, it’s estimated that 20% of people who fulfilled the criteria for clinical depression also exhibited signs of psychotic features.

Signs of Psychotic Depression

Signs of psychotic depression are similar to clinical depression but include typical psychosis behavior such as paranoia, hearing voices, seeing things that are not there, and having strange and illogical ideas, all centered around depressive themes. An individual may experience delusions regarding their own health or well-being, such as having cancer when they do not or being convinced that law enforcement is looking for them even though they have committed no wrongdoings. They may also hear voices that tell them they should harm themselves, they are useless, nobody loves them, or they are crazy. These thoughts can lead to lowered self-esteem and suicidal thoughts and actions. All of these things being compounded can cause those struggling with psychotic depression to get caught in the vicious cycle of psychosis and to develop false beliefs about themselves, their circumstances, and their life.

Along with these unique symptoms, all the symptoms of generalized depression apply–things such as persistent feelings of sadness lasting longer than two weeks, loss of motivation, hopelessness, suicidal thoughts or actions, inability to maintain self-care, interrupted sleep habits, and loss of appetite.

Diagnosis and Treatment

Because psychotic depression causes a person to see, hear, and experience things that aren’t happening in external reality, it’s important that one suffering from this disorder is diagnosed and treated as soon as possible. Depending on the severity of the delusions they can greatly increase the risk of suicide. Appropriate treatment is a critical step in preventing someone from hurting themselves or others. Medication, counseling, and observation, amongst other treatments, can help individuals who are affected live a normal life.

The first step to diagnosing and treating psychotic depression is under close watch at a mental facility. This step is needed in order for mental health professionals to observe psychotic symptoms and pinpoint what antipsychotic medications need to be given in order to help the patient through the psychosis.

After the patient is more in touch with reality, treatment of the depression symptoms can then be targeted and treated through the use of antidepressant medication. There are a multitude of medications that can be used to treat psychotic depression, but it’s important for an individual and their doctor to work together to find out which combination of medicine works best. It may be necessary to try various combinations to get symptoms under control. These medications do not come without risk and side effects but under the care of a health professional, undesirable effects can be combated to give sufferers their best quality of life.

Ongoing therapy is also a critical and helpful part of dealing with psychotic depression. Qualified therapists can help people cope with struggles, find strength from within, reach their goals, and allow them to feel heard and valued.

Coping Mechanisms Outside of Treatment

It’s important to remember that mental illness, just like physical illness, is not a choice, and requires treatment to fix. During ongoing care, finding healthy ways to cope with psychotic depression can lessen its severity and help aid in recovery. Some coping strategies include:

  • Regular exercise
  • Healthy eating
  • Positive thinking
  • Healthy, supportive relationships
  • Good sleeping habits
  • Meditation and relaxation techniques
  • Inclusion in the community, such as volunteering
  • Finding a sense of purpose
  • Picking up a hobby
  • Deep breathing
  • Avoiding triggers

In America, over 16 million adults struggle with some form of depression. According to the World Health Organization, 450 million people all over the world suffer from mental illness, 300 million of those cases made up by depression alone. If you are experiencing or have been diagnosed with depression, it helps to know you are not alone. Counseling for Depression is available and can improve your quality of life greatly. For more information or to set up an appointment with one of our trained counselors, contact us today. We look forward to hearing from you and applaud you for taking the first step in taking back control of your life.