Psychotic Depression: Symptoms And Treatment
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Psychotic depression can be defined as an extreme form of major depressive disorder with psychotic symptoms, such as disorganized thoughts, paranoia, delusions, and hallucinations. Risk factors for developing psychotic depression can include childhood trauma, stressful life events, substance misuse, and comorbid mental health disorders. Support can be crucial when coping with psychotic depression. Turning to friends and family is often helpful, and working with a licensed mental health professional is also recommended. Cognitive-behavioral therapy, interpersonal therapy, and family-focused therapy are often beneficial. Sometimes, medication may be prescribed by a doctor or psychiatrist. If you’re living with depression, online therapy may help you manage symptoms and potentially prevent psychotic episodes.
Understanding psychotic depression
At its core, psychotic major depression (PMD) can be viewed as an extreme form of MDD with added psychosis. A person experiencing psychotic depression may be unable to distinguish between reality and their thoughts or beliefs. Hallucinations, paranoia, and delusions can be common features of psychotic depression, as can feelings of guilt and worthlessness.
In addition to these symptoms, people with psychotic depression may also experience changes in their behavior. People with psychotic depression may experience mood swings from severe depression to manic states. During the depressive phase, they may experience suicidal tendencies*, feel hopeless, and experience anxiety. However, during a manic phase, they may experience restlessness, impulsivity, and increased energy levels. These drastic mood swings often make it more challenging to diagnose and treat the disorder accurately.
Psychotic depression vs. major depressive disorder
In some cases, individuals with psychotic depression may experience some unique symptoms compared to those of major depressive disorder. These symptoms can include agitation, lack of appetite, significant weight loss, and prolonged periods of insomnia. The psychotic symptoms can also be physical, such as visual and auditory hallucinations or paranoia, and cognitive, such as disorganization in thought processes or difficulty concentrating.
Psychotic depression can affect people of all ages, races, and backgrounds. However, the misconceptions and stigma around psychotic depression can make it difficult for people to seek the help they deserve. For example, some may think that psychotic depression is something they can "snap out of" or simply "will away." However, this usually isn't the case; the condition typically requires professional help and treatment to manage symptoms.
Risk factors for psychotic depression
While the exact cause of psychotic depression may still be unknown, several risk factors can increase a person's likelihood of developing this condition. As we explore some of the major risk factors associated with psychotic depression, keep in mind that not everyone who experiences these factors may develop the disorder.
One of the primary risk factors for developing psychotic depression can be having a genetic predisposition to the condition. A predisposition generally means that individuals with a family history of psychotic depression may be more likely to develop the condition themselves. While genetics alone cannot fully determine whether someone will develop psychotic depression, it can play a role in increasing their risk.
Another major risk factor for psychotic depression may be exposure to environmental factors that may trigger the condition. Some of these factors may include the following:
Childhood trauma
Traumatic childhood experiences, such as abuse*, neglect, or a lack of emotional support, can increase a person's risk of developing psychotic depression later in life. These experiences can disrupt the development of the brain and ultimately lead to mental health concerns.
If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.
Stressful life events
Stressful life events, such as the death of a loved one, a divorce, or a job loss, can also trigger psychotic depression. These events can cause significant emotional distress and may leave a person overwhelmed and unable to cope.
Substance misuse
Substance misuse may be another environmental risk factor for psychotic depression. Substance misuse can lead to chemical imbalances in the brain and trigger a range of mental health conditions, including psychotic depression.
Comorbid mental illness
Individuals with comorbid mental health disorders, such as anxiety or bipolar disorder, may also be at an increased risk of developing psychotic depression. These conditions can interact, potentially making each one more severe and harder to manage. However, mental health disorders aren’t always comorbid. Similarly to psychotic depression, people may experience symptoms of psychosis with certain health conditions like bipolar disorder.
While there may be no surefire way to prevent the development of psychotic depression, knowing the risk factors associated with the condition can help individuals take steps to safeguard their mental health. Whether through therapy, medication, or lifestyle changes, there may be ways to manage psychotic depression and reduce its symptoms.
Early symptoms of psychotic depression
Many people with psychotic depression may show early signs of the condition. If you know what to look for, it can help you identify the signs and seek out the necessary treatment.
- Emotional Symptoms: Persistent sadness or low mood, feelings of worthlessness or guilt, suicidal thoughts or behaviors
- Cognitive Symptoms: Difficulties with concentration and memory, delusions or false beliefs, and hallucinations
- Behavioral Symptoms: Social withdrawal and isolation, neglect of personal hygiene, and erratic or disorganized behavior
- Physical Symptoms: Insomnia or hypersomnia, appetite and weight changes, fatigue, or low energy
- Social Symptoms: Withdrawal from friends and family, loss of interest in activities that were once enjoyed, difficulty communicating with others
Seeking help for hallucinations, delusions, and other symptoms
If you notice any of these symptoms in yourself or a loved one, it may be time to seek professional help. A mental health provider can assess the situation and provide you with the necessary treatment and support.
The importance of support systems and therapy
As you manage your symptoms, it can be important to remember that you are not alone. There may be various support systems available to help you cope with this condition, such as family and friends, support groups, online communities, and mental health professionals.
Having a strong social support system can be essential for managing psychotic depression. Family and friends can provide emotional support and comfort, while support groups can help you connect with others who have similar experiences. Online communities can also be a helpful resource for finding understanding and guidance, as well as tools to help you manage the condition.
Mental health professionals can be another important resource for managing psychotic depression, as they can provide psychotherapy and other forms of treatment.
Cognitive behavioral therapy
Cognitive-behavioral therapy (CBT) is a type of psychotherapy that usually focuses on identifying and changing negative thoughts and behaviors. CBT can help people change how they think and act by teaching them coping skills, managing stress, and finding healthier ways to manage symptoms.
Interpersonal therapy
Interpersonal therapy (IPT) is another form of psychotherapy that can help individuals manage their relationships to improve mental health. IPT can help people develop better communication skills, understand their emotions and reactions to others, and improve relationships with family, friends, and coworkers.
Family-focused therapy
Family-focused therapy can also be helpful, as it typically promotes family support and understanding in coping with the condition. During these sessions, the family will likely work together to identify and address any issues contributing to the individual's depression. Family can provide much-needed support and guidance by creating a more positive and understanding environment.
No matter what type of treatment you choose, having a strong support system can make it easier to manage your symptoms and live a happier, more fulfilling life. With the right resources and support, you can take control of your mental health and well-being.
Benefits of online therapy for depression
Online therapy has become increasingly popular for those living with mental health conditions. With online therapy, you can get hold of qualified therapists from the comfort of your own home. Online therapy can provide a safe space for individuals to discuss their thoughts and feelings without judgment or stigma, which may help those living with depression feel more comfortable and at ease. Please note that those who are experiencing severe symptoms of psychosis, such as hallucinations, delusions, and the potential to harm oneself or others, may require in-person treatment.
Effectiveness of therapy for psychosis
A 2022 study indicates cognitive-behavioral therapy, a modality often employed in online therapy, may effectively manage psychotic depression. By preventing the first episode of psychosis in ultra-high-risk individuals and improving depression, self-esteem, and psychological well-being, CBT can be an important tool in recovery. Individuals can take charge of their mental health through CBT techniques like cognitive restructuring, problem-solving, and relaxation.
In addition, a 2020 systematic review suggested that online CBT could be more effective than in-person CBT for treating depressive disorders, showing that online therapy may be a valid choice for many people experiencing depression.
Takeaway
Does a person with psychotic depression have a depressed mood?
A person experiencing psychosis may display signs of mania, which typically involves an elevated mood. Conversely, they may experience depression, which is usually associated with a low mood.
What are the symptoms of psychotic disorders?
According to the American Psychiatric Association, psychotic disorders typically involve a disconnect from reality.
Symptoms of psychosis may include the following:
- Difficulty distinguishing reality from fantasy
- Paranoia
- Social withdrawal and isolation
- Delusions
- Hallucinations
- Disorganized thoughts and speech
Are hallucinations and delusions examples of psychosis?
An example of psychosis may involve seeing or hearing things that aren’t there. This may take place in the case of depression with psychotic features (sometimes called delusional depression) or various psychotic disorders.
How do you deal with someone with psychotic depression?
Interacting with someone who has major depression with psychotic features can be challenging. Try to be respectful and empathetic, and avoid passing judgment on any delusions they may be experiencing. If possible, you might encourage them to seek treatment. If you’re concerned for your safety, it can be best to remove yourself from the situation.
Can psychosis be cured with treatment such as antidepressants?
Psychosis can be treated. About 25% of people who experience a psychotic episode never have another one. Meanwhile, another 50% may experience additional episodes, but still go on to live normal lives. Others may require continued support and treatment.
Talk to your doctor about antidepressants and treatment options
Sometimes, treatment involves both antidepressant and antipsychotic medications, but it’s vital to speak to your doctor or psychiatrist regarding medication options.
How long does psychosis last?
Psychotic episodes can vary greatly in length. Some may only last for a few days, while others may last for weeks or months.
How can you tell if someone has a mental illness?
A few signs of mental health concerns may include the following:
- A persistent low mood
- Extreme worries
- Social isolation or withdrawal
- Delusions or hallucinations
- Mood swings
- Substance misuse
Is psychotic disorder a mental illness?
Psychotic disorders are usually considered a form of mental illness. Psychotic disorders generally include schizophrenia, schizoaffective disorder, delusional disorder, brief psychotic disorder, and others. Depression with psychotic features is normally categorized separately.
What are the five stages of psychosis?
Psychosis is typically believed to consist of three phases: the prodrome phase, the acute phase, and the recovery phase.
What triggers psychotic disorders?
The causes of psychotic disorders can vary. Extreme stress, trauma, differences in brain development, and genetic components of your medical history may all play a role in the development of psychotic disorders.
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