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What is Psychotic Depression?

Proper diagnosis is crucial for effective treatment, as psychotic depression increases the risk of bipolar disorder, recurring episodes, mania, and such.

  • 11 Jul 2023
  • min read
  • 311 views

Psychotic depression is a severe form of major depression with added psychosis. The condition essentially causes individuals to lose touch with reality. People with this condition may display anger, isolate themselves, neglect personal hygiene, or struggle to communicate coherently. While other mental illnesses, like schizophrenia, also involve psychosis, psychotic depression’s symptoms are depression-themed, while those associated with schizophrenia remain bizarre and unrelated to mood. Proper diagnosis is crucial for effective treatment, as psychotic depression increases the risk of bipolar disorder, recurring episodes, mania, and such.

What Are the Symptoms of Psychotic Depression?

Following are some of the commonly known symptoms to look out for.

  • Delusions: The thoughts or beliefs unlikely to be true.
  • Hallucinations: Sensory perceptions of non-existent things; this typically includes feeling, smelling, seeing, or tasting things that aren’t real. Hearing voices is common.
  • Alignment with depression: Symptoms often reflect a person’s deep feelings of depression, leading to self-blame or the belief of committing a crime.
  • Psychomotor agitation: Restlessness and constant fidgeting.
  • Psychomotor retardation: Slowing down of both thoughts and physical movements.
  • Increased risk of suicidal ideation: It is important to note that individuals with psychotic depression have a higher likelihood of thinking about suicide.

What Causes Psychotic Depression?

The exact psychotic depression causes are unknown. Factors contributing to its development may include the following.

• Genetics:

  • Family history of depression increases susceptibility.

   - Imbalances in brain chemicals (dopamine and serotonin) are associated with depression and psychosis.

   - Elevated cortisol levels (stress hormone) may contribute significantly to the condition.

• Environmental factors:

Traumatic or stressful experiences during childhood raise the risk.

   - Lack of close relationships, major negative life events, and financial difficulties increase chances.

• Other risk factors:

- Hormonal changes (postpartum, menopause)

   - Surviving extreme stress or trauma

   - Living with chronic pain or health conditions

    - Older adults may have a substantially higher risk

   - Cisgender women and transgender individuals have a higher risk

Psychotic Depression Diagnosis

Psychotic depression is considered a sub-type of major depressive disorder (MDD), not a separate illness.

  • To be diagnosed with psychotic depression, individuals must meet the criteria for major depressive disorder outlined medically. It is important to discuss with experts about the same before proceeding with any medically relevant test.
  • Symptoms of psychosis must be present to initiate any test.
  • The diagnosis process involves a thorough medical history assessment.
  • The doctor will generally inquire about symptoms and family history.
  • A medical practitioner may conduct tests to eliminate other potential causes leading to psychotic symptoms, such as substance abuse, medical conditions, schizophrenia, or bipolar disorder.
  • The evaluation aims to ensure an accurate diagnosis and appropriate treatment plan.

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