Psychotic Depression: Causes, Symptoms & Treatment

When phases of psychosis accompany depression, it is called Psychotic Depression. It is a subtype of depression. Psychotic depression could include psychotic episodes of delusion, hallucination, and any break from reality. Almost one in every four patients with clinical depression is affected by psychotic depression. Here, you will learn about the significant differences between psychotic depression and clinical depression, the causes and symptoms of psychotic depression, and how psychotic depression can be treated.

What is Psychotic Depression?

Psychotic depression is a major depressive disorder (MDD) that involves episodes of psychosis. The psychotic episode could involve hallucinations, delusion, a state of stupor, and psychomotor impairment. According to WHO, MDD can affect almost 5% of people coping with depression. However, some experts believe that the rate could be higher.

Symptoms of Psychotic Depression

The major symptoms of psychotic depression are as follows:

• Delusions

• Hallucinations

• Psychomotor agitation or retardation

• Intellectual impairment

• Agitation

• Insomnia

• Suicidal thoughts

Let’s delve deeper and try to understand the symptoms in detail.

Psychotic depression, a severe mental disorder, affects a person's thoughts, emotions, and behaviour. One of the main symptoms of psychotic depression is psychomotor retardation, which causes a significant slowing down of physical movements and thinking. This can result in the individual speaking and acting slower than usual.

Another common symptom is the presence of delusional thoughts or beliefs that are not based on reality. These can be very distressing for the individual and may lead to feelings of confusion and anxiety.

Hallucinations are another potential symptom of psychotic depression. These can involve seeing, feeling, hearing, or tasting things that are not present. Suicidal thoughts and tendencies are also common in individuals with psychotic depression and can be extremely severe.

Intrusive thoughts are another hallmark of psychotic depression. These thoughts can manifest in different ways, such as the belief that others are trying to harm the individual, that demonic forces have possessed them, or that they have committed a crime and are being pursued by the police.

Excessive psychomotor agitation can cause the individual to become restless and fidgety, making it difficult to stay in one place for long periods. Overall, psychotic depression is a complex and severe mental health condition that requires medical intervention and support.

How Is Psychotic Depression Different From Clinical Nonpsychotic Depression?

Psychotic depression is a severe form of depression where the symptoms of clinical depression are combined with episodes of psychosis. Psychotic depression involves the symptoms of clinical depression and psychosis.

Major or Clinical Nonpsychotic depression is a mental health condition that can cause a range of symptoms, including fatigue, irritability, difficulty concentrating, feelings of hopelessness, worthlessness, helplessness, social isolation, and sleeping too much or too little. People with nonpsychotic depression may feel like they lack energy and motivation, and may have trouble carrying out everyday tasks. They may also experience changes in appetite, weight, and physical activity. If left untreated, nonpsychotic depression can have a significant impact on a person's quality of life and overall well-being.

The following table will help you understand the difference.

What Causes Psychotic Depression?

The exact cause of psychotic depression remains unknown. Some probable causes are as follows:

• Stressful life events

• Severe illness

• Genes play a role. It can affect those who have a close blood relation like parents, grandparents, siblings, or uncle/aunt suffering from any MDD

• Imbalance in brain chemicals

How Is Psychotic Depression Treated?

The treatment for psychotic depression involves the following —

• Medicine

A combination of antidepressants and antipsychotics

• Cognitive Behavioural Therapy (CBT)

Talk therapy and encouragement to change behavioural patterns have proved effective

• Electroconvulsive Therapy (ECT)

Although these days, ECT is no longer considered a safe therapy for patients, in extremely severe cases where antidepressants and CBT fail, and the patient turns suicidal or homicidal, ECT can be used as a treatment.

• Support Groups

This is not direct mode of treatment but support groups can effectively change a patient’s behaviour. Often, patients get encouragement and support in these groups. In some places, these groups also provide patients employment, accommodation, food, and education.