Experiencing different ways to feel are a normal part of life. Changing moods, feeling happy or sad and feels up or down are normal, everyday emotions. When you have depression, however, the normal ups and downs can take a turn for a bad situation and lead to a problem like psychotic depression. This is the most severe type of depression possible and often requires hospitalization. Psychotic depression has the highest rate of suicide and is marked by extreme aggression, delusions, hallucinations and loss of touch with reality. In most cases, medication is the only way to bring the patient back to reality and keep long term normalcy.
Different
The most important difference between psychotic depression and other forms of depressive illnesses is that the people who experience the symptoms are usually aware that the thoughts and hallucinations they are having are not true. For this reason they tend to hide their problem which makes it incredibly difficult to diagnose. It is when they lose touch with reality that the problem of danger to themselves and others occurs.
Symptoms
While some symptoms of psychotic depression are similar to other forms of depression, there are some that are unique to psychotic depression. You will find a combination of symptoms that include some normally found in depression and some normally found in psychosis. Some of the symptoms include:
Anxiety
Agitation
Hypochondria
Insomnia
Physical immobility
Constipation
Intellectual impairment
Psychosis
Evaluating
A psychiatric evaluation and physical examination are important for diagnosing psychotic depression. The doctors may want to perform laboratory procedures such as blood work to rule out any other health issues that could be causing the symptoms of psychotic depression.
Delusions and Hallucinations
Most people have heard about the delusions and hallucinations that are involved with psychotic depression, but few people have actually experienced them. These imaginary problems are usually negative thoughts the person has about themselves. They manifest as a feeling of rotting from inside, skin crawling, hearing voices and paranoia about people following or causing problems for them. These hallucinations and delusions are one reason that psychotic depression is considered the most severe and dangerous. In the midst of a hallucination the patient can cause serious injury or death to themselves or someone else.
Treatment
It is important to treat the symptoms of severe depression as quickly as possible upon recognition of an episode. Most of the time an antipsychotic medication is used in conjunction with an antidepressant to treat the symptoms. If the medication does not appear to have an effect, electroconvulsive therapy (ECT) can be used. ECT has about 95% rate of success and works quickly. It puts the patient and others out of danger and helps the patient return to their normal regimen of medication without change.
Outlook
Treatments for psychotic depression are quite effective and people usually recover within a year of drug and psychotherapy. It is important to continue medications and therapy to avoid a recurrence of the symptoms of depression. Hospitalization is often the way patients actually get help but it does not have to be the only way. If you or someone you know has symptoms of psychotic depression it is important to be evaluated by a professional.
