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Psychotic Depression
Understanding Psychotic
Depression
BY JENNIFER SELLERS
The word
"psychosis" can stir to mind images ranging from a crime-drama
plotline to, perhaps, an expert's commentary on an Investigation Discovery
show.
But
the day-to-day struggles of someone with psychotic depression are much less
sensational than those of psychologically troubled people on TV -- and almost
never criminal.
In fact, psychosis
in general rarely leads to violence [source: Kirn].
What
the disorder can cause, however, is a great amount of confusion and suffering
on the part of the person who has it -- as well as his or her loved ones.
Both depression and
psychosis can occur as standalone disorders, or as symptoms of another illness.
For
example, depression can be a symptom of bipolar disorder; whereas psychosis can
accompany schizophrenia.
However,
when major depression and psychosis coexist outside of other conditions, it's
called psychotic depression.
Despite the fact
that depression is a fairly common mental health disorder, the likelihood that
it would be present with psychosis is much slimmer.
In
fact, only about 15 percent of people with major depression exhibit the primary
signs of psychosis: hallucinations and delusions [source: Croft].
As a team,
depression and psychosis can be particularly harmful -- putting their victims
at risk for alienation, reduced quality of life, hospitalization and even
suicide.
And
while psychotic depression is not a common mood disorder, it accounts for more
than a quarter of all hospital admittances for depression [source: WebMD].
Even though
psychotic depression is a serious problem, the news isn't all bad. Most people
with the condition can expect to recover from the depression and the psychosis.
And
new studies in brain imagining suggest that computer analysis of brain scans may
be able to help doctors predict the severity of psychotic episodes, allowing
for better, more customized treatments [source: Kelland].
To better
understand psychosis and other symptoms related to psychotic depression, keep
reading.
Symptoms of Psychotic
Depression
Imagine you wake up one morning believing you're
President of the United States. Perhaps the next day you think you're an
undercover spy.
No,
these aren't the playtime imaginings of a young child; they're the delusions of
a person who has experienced a break from reality.
The primary symptoms that differentiate psychotic
depression from typical depression are hallucinations and delusions.
A
delusion is believing something that, in reality, isn't true -- like being the
President or a spy.
Hallucinations,
on the other hand, are imaginary voices or visions.
In
the film, "A Beautiful Mind," (this would be your spoiler alert), the
roommate, Charles, was one of main character John Nash's hallucinations.
Unlike John Nash, who was schizophrenic, a person with
psychotic depression likely realizes what he or she is experiencing isn't real.
While
there's value in this awareness, it can also lead to feelings of shame and
embarrassment.
And
when a person hides his or her symptoms of psychotic depression, it can
increase his or her likelihood of not getting a proper diagnosis or treatment.
Of course, hallucinations and delusions aren't the
only symptoms of psychotic depression –anxiety, hypochondria, intellectual
impairment, agitation, insomnia and physical immobility can be signs as well.
These
will be accompanied by symptoms of depression, which the Mayo Clinic reports,
can include:
· Sadness
· Irritability
· Loss
of joy or pleasure
· Reduced
sex drive
· Changes
in appetite
· Fatigue
and tiredness
· Chronic
pain with no obvious cause
· Feelings
of worthlessness
· Frequent
crying
· Thoughts
of death
Keep reading to find out more about the causes of
psychotic depression.
WHERE TO GET IMMEDIATE HELP
If you or a loved one are feeling
suicidal, contact the National Suicide Prevention Lifeline at 1-800-273-TALK
[8255], or call 911 right away.
.
Here's a quick quiz for you: Faulty
neurotransmitters, such as serotonin, dopamine and norepinephrine, are the
causes of depression -- true or false?
If
you answered "true," you've probably had some experience with
antidepressants -- or, perhaps, you've watched one too many pharmaceutical
commercials.
While most modern
antidepressants are designed to interact with these brain chemicals -- and many
have done so with successful results -- scientists still aren't sure of the
exact causes of clinical depression.
So,
it should be no surprise that the roots of psychotic depression are also
unknown.
There
are, however, certain risk factors that make a person more susceptible to
developing the disorder. Family history of psychotic depression can increase a
person's odds of developing it.
According
to the Mayo Clinic, risk factors for depression, in general, include:
· Personal or family history of depression and/or
substance abuse
· Female gender
· Low socio-economic status
· Traumatic childhood
· Stressful life events
· Isolation
· Negative outlook and behaviors
· Life-threatening chronic illness
If a person is
experiencing psychosis only, there's a chance that another psychological
disorder is behind his or her delusions and hallucinations.
Schizophenia,
bipolar disorder and substance abuse are also known causes of psychosis.
Fortunately, there
are many effective treatments available for psychosis as well as depression.
We'll explore those therapies in the next section.
Psychotic
Depression Treatments
Pioneering 20th century psychologist Rollo May believed
that depression is, essentially, the inability to build or conceive of a
future [source: Jones-Smith].
For
someone who has psychotic depression, that philosophy might apply with an even
heavier force.
A
person who experiences both major depression and psychosis is seemingly stuck
in a dark, confusing present with no way out.
This
is likely why depressives with psychosis are at a higher risk of suicide than
are those without [source: MedlinePlus].
But
while it might not feel like it to the person with the disorder, there are ways
out of psychotic depression and into a brighter future.
People who have psychotic depression are usually given
a combination of antidepressants and antipsychotics.
Frequently
prescribed antidepressants include fluoxetine, fluvoxamine, citalopram,
escitalopram, paroxetine or sertraline; common anti-psychotic medications are
risperidone, olanzapine, quetiapine and ziprasidone.
All
of these drugs carry side effects, and it sometimes takes a little bit of
experimentation (with the help of a doctor) to find the ones that work best for
a particular person.
It's
for this reason that doctors prefer to initially treat psychotic depressives in
a hospital environment until the right combination of medication is achieved.
Antipsychotics are normally necessary for just a short
period of time. However, most doctors recommend that someone with major
clinical depression take antidepressants on an ongoing basis.
If
medications aren't effective, electroconvulsive therapy (ECT) may be considered
as a treatment. Fortunately, drugs are usually successful at treating
psychotic
depression, and are considered the first-line of treatment.
Psychotic depression requires ongoing monitoring. Even
though most people can expect to recover from it, continued treatment can help
prevent recurrences of the disorder.
For lots more information on mental health, visit the
links and resources below.
WHO'S DEPRESSED?
Each year, more than 9 million
Americans experience clinical depression. And, considering that many people
never seek treatment or diagnosis, that number is likely much higher [source: Stanford School of Medicine].
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