A diagnosis of psychotic depression is vastly different from major and clinical types of depression which are nonpsychotic. The psychotic person lives in a non-realistic world and may hear voices, think others know their thoughts or could be attempting to inflict harm.
They might also think they’re demon-possessed or being watched by others. Paranoia, delusions, and hallucinations may be part of this very complex form of depression and those with the disorder are usually consumed with negative thoughts and self-criticism.
People suffering from depression or bipolar disorder may have psychotic episodes, but they are more inclined to happen to those with extreme depression. Psychotic depression is a type of major depression that occurs in one of four people admitted to the hospital for severe depression.
Psychotic depression may be difficult to diagnose because of the person’s shame and humiliation about their thoughts. They typically attempt to hide the thoughts – making the correct diagnosis extremely difficult.
It’s helpful when you understand the differences between psychotic depression and other forms of depression so that you are aware of the differences in symptoms and can better recognize them in yourself or others.
Causes of Psychotic Depression
As with most other types of major depression, the causes of psychotic depression are not fully understood but may include changes in the brain structure or chemical imbalances and less gray matter than a normal person’s brain.
Genetics are also thought to be a possible cause of certain types of depression including psychotic, bipolar and schizophrenia. Postpartum changes in hormonal balance may also cause psychotic depression as well as a disruption in sleep patterns.
Other psychiatric conditions may also trigger the onslaught of psychotic depression, but it can also occur without any other condition. Dementia or Alzheimer’s disease, brain tumors or cysts and neurological disorders such as Huntington’s or Parkinson’s diseases may be triggered by psychotic depression.
Research of psychotic depression is ongoing, but researchers have not yet come to a final decision on its causes. There is always conflicting information being presented, so you need to be informed about everything.
Recognizing the Symptoms of Psychotic Depression
Many symptoms of psychotic depression are the same as other types of major depression. Negative thoughts and feelings of sadness, guilt, irritability, and hopelessness may be among the symptoms as well as changes in sleeping patterns, dietary changes and energy fluctuations.
Other common psychotic depressive symptoms may include agitation, anxiety, constipation, severe lack of mental acuity, physical immobility and hypochondria. All of these symptoms may become extremely magnified and worsen as time goes by.
Psychotic depression also adds the serious symptoms of hallucinations, paranoia and delusions. The person may neglect himself by not taking baths or changing clothes. When speaking, the person may be irrational or make no sense.
Delusions that occur with psychotic depression include having false opinions or beliefs of what is going on around him and no clue about who he really is. False beliefs might include thoughts of having cancer or a terminal disease.
Before the physician can diagnose psychotic depression, you must be completely honest with him or her about your symptoms. One criterion for diagnosis is that you must have had an episode of depression lasting two weeks or longer.
Five or more specific symptoms are also required for a complete diagnosis, such as inability to function, inability to concentrate, guilty feelings, agitation, weight gain or loss, fatigue and low energy, sleeping too much or too little, social withdrawal and persistent thoughts of suicide or death.
After a diagnosis of major depression, the doctor will further diagnose the depression as psychotic if symptoms of delusions, hallucinations or false beliefs persist. They may or may not be present constantly.
Diagnosis and Treatments for Psychotic Depression
All types of information about your life and your thoughts and feelings come into play before a diagnosis for psychotic depression can be determined. You’ll want to know if one or more close family members such as a mom, dad or siblings have suffered from psychotic depression and pass that information on to the doctor.
If you’re a woman, your risk for psychotic depression disorder is ranked higher than for men. Older adults are also at a greater risk for this type of depression. Unfortunately, psychotic depression isn’t as easy to diagnose as physical pain or other types of illnesses.
Usually, a battery of tests can be run to determine what is causing pain. Diagnosing psychotic depression disorder takes a much different path and can easily be misdiagnosed as bipolar disorder or schizophrenia.
At the moment, there are no specific treatments especially designed for psychotic depression – mainly because no two people react the same to the same medications. A licensed mental healthcare professional is the best choice to determine which medications are best for you.
Antidepressants and antipsychotic meds may be prescribed in combination to better balance the neurotransmitters in the brain exacerbating the condition. For example, an Atypical, antipsychotic drug such as olanzapine, risperidone or quetiapine may be paired with a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine.
ECT (Electroconvulsive Therapy) may also be a treatment option. This treatment involves a general anesthesia so it must be performed in a hospital. Short term memory loss is a side effect of this treatment, but it is effective for those who have psychotic symptoms such as feelings of suicide.
Talking therapy (one-on-one) and CBT (cognitive behavioral therapy) is known to be helpful to some people suffering from psychotic depression. And, it’s absolutely imperative for the patient to have as much support as possible from family and friends.
Tips for Managing Psychotic Depression
The first and most important tip for managing psychotic depression is to strive to identify and understand the symptoms of the disorder. Note changes in your lifestyle such as decreased appetite, too much sleep or insomnia, thoughts of suicide, irritability, extreme anger or agitation, downturn in social activities and delusions and hallucinations.
Another important tip is to immediately seek medical help and then do everything the doctor says. You’ll probably be prescribed certain medications such as antidepressants and antipsychotics.
It’s important that you strictly adhere to the treatment guidelines and follow the instructions given by your doctor. Never stop taking medications without first consulting with your healthcare provider. It could trigger a dangerous relapse.
Find out if ECT (electroconvulsive therapy) may be right for you. It’s currently one of a very few treatments that can help psychotic depression. ECT is usually safe, but be sure to discuss side effects with your doctor.
Cognitive behavior therapy can be helpful in recognizing negative and triggering behaviors and thoughts and help you learn how to use positive ones to help you function.
Often, psychotic depression is characterized by irrational behaviors and thoughts. One type of therapy – rational emotive behavior – may help you recognize irrational demands on yourself and others so you can understand and challenge them with rational thinking.
Talk therapies along with medications can put you on the right track to dealing with psychotic depression. You can engage on an individual basis or participate in group therapy or support groups.
Daily routines can help you deal with psychotic depression by changing your focus on a daily basis and add structure and dependability to your days. Include time for work and appointments as well as grooming, sleeping and eating.
You’ll also want to schedule activities such as hobbies, exercise and other things you enjoy. Be sure to involve your most trusted friends and family members to support and help you with counseling and understanding your disorder. You’ll be able to talk more comfortably if you know they understand what you’re going through.
Improve your ability to recognize negative thoughts by keeping in mind that words such as “never,” “won’t,” and “can’t” are usually negative in context. Avoid them and other negative “self-talk” in your private thoughts.
Join an advocacy group for depression. You’ll learn a lot from others who have been through the same things you’re going through and the social networking can help you find valuable resources.
Stress in your life can wreak havoc on anyone dealing with psychotic or any other type of depression. You can help yourself to manage stress by developing healthy coping strategies such as deep breathing and relaxing exercises (yoga), aerobic exercise to release valuable dopamine into your system and by maintaining strong relationships with family and friends.
Above all, don’t lose hope. Other people have gone and are going through the same experience you are. Psychotic depression can now be treated successfully and recovery is definitely in your future.
Best Natural Remedies for Psychotic Depression
Any type of major depressive episode is much more than feelings of sadness and hopelessness. Depression – especially psychotic depression – can affect your physical and mental health so much that you may not be able to function normally.
Psychotic depression remedies and treatments require treating the entire body and not just the brain – although anti-depressants and anti-psychotic medications are essential to the recovery process.
Some other theories on how to help psychotic depression naturally include supporting your digestive system. Since your intestinal tract encases the enteric nervous system (or “second brain”) and produces many of the chemicals your brain uses to process information, it’s vital that you optimize its health.
You may not know that almost 100% of serotonin linked to depression is produced in your intestinal tract. Serotonin helps you keep stress at bay, boosts feelings of happiness and calms your moods.
Proper nutrition is another natural way to ease the symptoms of psychotic depression. B and D vitamins and amino acids boost necessary brain chemicals to better regulate your moods.
Know that certain foods may affect your nutrient status and cause problems in your immune system as well as fatigue, mental acuity problems and sadness. You may want to submit to food sensitivity testing to make sure the foods you’re ingesting aren’t affecting you negatively and you can better plan a diet that’s best for you.
Sometimes those with severe depression may have high levels of toxins within their bodies that can negatively affect mental status. Some toxins even cause damage to the brain. Ask your doctor about a detoxification to cleanse your body and improve your brain’s acuity.
Massage therapy is beneficial to most people suffering from depression and can be an integral part of the treatment plan. A good massage can help you feel empowered, boost relaxation and ease tension.
See a chiropractor to correct structural misalignment of your spine and to better help your brain communicate with your nervous system. Chiropractic care can help with poor posture, grinding of teeth when sleeping and much more that can increase blood circulation and regulate moods.
Test your hormone levels to see if they’re out of balance and could be causing negative emotions, depression and sadness. Low levels of some hormones may make you feel fatigued and sad and unable to cope. Hormonal imbalance is especially prevalent in women and they should be tested if stress or other problems are causing depression.
Keep yourself busy. Take on some responsibilities that will make you feel productive, but be sure you don’t take on too much. Large responsibilities can become overwhelming to those with a severe depressive disorder such as psychotic depression.
It may be difficult to accomplish – but try to have fun. Try not to avoid social interaction because you’re depressed or experiencing negative emotions. It’s important to stick to experiences you once enjoyed and develop a sense of normalcy in your life.
Above all, don’t give up hope. Research is revealing many underlying causes of psychotic depression. Such strategies as Transcranial magnetic stimulation (TMS) are now being researched as an effective alternative to ECT to treat major types of depression.
Potential causes are also being researched and underlying biological factors are continually studied for answers to help treat this difficult disorder. Although the long-term prognosis for this disorder is poorer than other types of depression, hope is high among scientific researchers.