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Psychotic depression

Psychotic Depression is a sub-type of major depression – it occurs when severe depression symptoms include signs of psychosis – strange behavior, intense feelings of worthlessness or failure, hallucinations, delusions, dangerous actions, suicidal thoughts and/or suicidal attempts.

In most cases women with Psychotic depression have some break with reality and/or they are out of touch with reality; and sometimes women become paranoid, they could hear “voices” or believe that other people could hear their thoughts, they could be “possessed” by the devil. Women with this type of depression could easily get angry for no apparent reason.

Behavior of clients with psychotic depression is also very specific – they barely talk, they could spend a lot of time alone (sometimes in the bed), they could sleep all day time and be awake at night, they could refuse ordinary daily necessary hygiene (bathing, washing, etc.), they could also refuse changing clothes.

Police officers are reporting cases of Psychotic Depression when clients confess about committed crime which they never did.

Psychotic depression causes and risk factors

Exact cause of Psychotic Depression is not known yet but most scientists noted increased frequency of high blood pressure triggered by increased levels of adrenal hormone called “cortisol”. It is well known that different types of stress (psychological, physical or emotional) always accompanied with increased levels of cortisol. This is why some scientists suggested direct correlation between dramatic severe stress and this type of depression.

It was noted that following risk factors could increase chances for development of psychotic depression:

  • Family history of depression or psychosis;
  • Hormonal dysfunctions (often female hormones disturbances);
  • Biological problems with the neurotransmitters or glands situated in the brain;
  • Episodes of severe stress;
  • Severe physical traumas;
  • Specific characters – narcissism, selfishness, permanent excessive fears, decreased self esteem, lack of empathy, impulsiveness;
  • Drug abuse or substance abuse.

All above mentioned factors are making human body very sensitive to psychosis.

Psychotic depression symptoms

Women could experience several symptoms but most common and typical symptoms include:

  • Abnormal even strange behavior (passive loneliness, permanent pessimism, social isolation, hypochondria, physical immobility);
  • Hallucinations (hearing a strange voices, communication with not visible bodies which could see person’s weaknesses, etc.);
  • Delusions (permanent on-going feelings of worthlessness, hopelessness, failure or feelings about committed sins);
  • Phobias (worries about health, fear from diseases);
  • Lost reality (break with reality and/or out of touch with reality);
  • Suicidal thoughts and/or suicidal attempts.

Additional symptoms of psychotic depression could include the following:

Psychotic depression

Psychotic depression

  • Bad mood and irritation,
  • Fatigue,
  • Agitation,
  • Sleeplessness (insomnia),
  • Anxiety,
  • Paranoia,
  • Constipation,
  • Intellectual impairment

Psychotic depression treatment

Usually the treatment is very effective – in most cases it should be organized in the hospital. Main treatment includes combinations of medications (depending on severity, age, sensitivity). In most cases combination of antidepressants and anti-psychotic medications is recommended.

Electroconvulsive therapy (ECT) is a very rapid and effective treatment for psychotic depression. Because of the severity of psychotic depression symptoms, electroconvulsive therapy is often the treatment of choice.

Untreated this type of depression could lead to very serious mental disorders – this is why urgent complex treatment is always recommended.

Psychotic depression prognosis

In most cases treatment is effective (if illness is recognized in time and if treatment was started in right time). Recovery from this type of depression could be noted during 6-12 month. Recurrence of depressive symptoms was noted more often and at the same time, symptoms of psychosis have rare recurrence rate.


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