What is psychotic depression? 

Psychotic depression is a very serious mood disorder. People with this condition have extreme feelings of worthlessness and hopelessness. They might also have visions of unreality. This means they can hear voices or have beliefs that aren't really there or true. One out of every four people who goes to the hospital with depression has a form of psychotic depression.

Causes of psychotic depression

Doctors and scientists don't fully understand the causes of psychotic depression. They think that chemical imbalances in a person's brain may play a large role. Other factors that may contribute to psychotic depression include:

  • Personal history of mental illness
  • Family history of mental illness
  • Changes to hormone balance
  • Periods of extreme stress

Risk factors for psychotic depression

People with another mental health condition may have a greater risk of developing psychotic depression. However, the condition may also happen on its own. Sometimes genetics and periods of great stress can increase the risk for this condition. Researchers believe chemical changes in the brain might also cause it to develop.

Symptoms of psychotic depression

Psychotic depression is different than clinical depression. The symptoms of worthlessness or failure may also include being out of touch with reality. You may hear voices or have bizarre ideas. Maybe you think someone is out to get you. You might feel a lot of guilt for something you didn't even do. 

Other symptoms of psychotic depression can include:

  • Staying in bed day and night
  • Saying things that make no sense
  • Neglecting hygiene or appearance
  • Unprovoked or unexplained anger
  • Extreme feelings of shame or humiliation
  • Feeling sure that something bad is going to happen

Diagnosis of psychotic depression

It can be very difficult to diagnose someone with psychotic depression. This condition isn't well-studied. Often, people hide their symptoms as part of their depression. But, it's essential that you talk with a trained mental health professional immediately if you have any symptoms of psychotic depression. This is because the rate of suicide or suicidal threats can be very high with this condition.

Your doctor does a physical exam to rule out any other health conditions that may be causing your symptoms. They may then refer you to a psychiatrist. This professional specializes in treating mental illnesses. They can give you a psychiatric evaluation. This determines if you have behavior or thought patterns that aren't based in reality. Drinking alcohol or taking recreational drugs before your diagnosis can impact the results. Be sure to stop using these substances as soon as you experience symptoms.

Treatments for psychotic depression

There's currently no cure for psychotic depression. There are treatments that can help relieve your symptoms. Your mental health professional can work with you and your loved ones to create a treatment plan. This may help you feel better and connect better with the world around you.

Nonsurgical treatments for psychotic depression include the following:

  • Medications are often a big part of treatment for psychotic depression. You might combine antidepressants and antipsychotic medicines so they work better. It can take some adjustment to find the right level of medicine for you.
  • Some people respond well to therapy that uses an electric shock to help restore balance to the chemicals in their brains. You're usually put to sleep under general anesthesia during this procedure.
  • You might need to stay in the hospital for a while. This is especially true if you're showing signs of suicidal thoughts. Doctors need to monitor your condition for your own safety.

Early diagnosis is important for successful treatment of psychotic depression. It may be a scary diagnosis, but you can easily get help. Be sure that loved ones are aware of the situation and your treatment program so they can support you during this time.