Symptoms Of Psychotic Depression, A Recurrent Clinical Reality

Major depression is one of the most serious clinical realities, but the symptoms of psychotic depression are also debilitating and frightening. It occurs more often than we think, especially in geriatric patients. Hallucinations, delusions, sadness, feelings of guilt and even self-injurious behavior. We are facing a psychological situation that deserves more attention.

We emphasize the relevance of making early diagnoses of this type of depression due to a specific fact. Most people who resort to suicide do so when they enter the acute phase of this disorder. This is especially true for people who are experiencing major depression that has not been diagnosed for some time, or when they drop out of treatment.

This severe mental disorder has a good prognosis when intervention begins in the early stages. What is decisive, in all cases, is that assessment and intervention start as soon as possible. Another variable that has an important weight in the prognosis is the quality of social support that the person has.

Let’s understand how this type of depression manifests itself.

What are the symptoms of psychotic depression?

The scientific literature gathers a great deal of information about schizophrenia, bipolar disorder and non-psychotic depression. However, psychotic depression has so far received little attention. Studies such as those carried out at the University of Cambridge, for example, highlight this and the need to understand a little more about the etiology of this clinical reality.

It is known that it is more common in the elderly, especially when they have a family history of psychosis or bipolar disorder. Likewise, there are data showing that one in four people admitted to hospitals due to major depression has psychotic depression. We are, therefore, facing a mental condition that is more common than we think, and with consequences that are often problematic.

Let’s find out what your symptoms are based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) , in which it is described as a form of major depression.

mood swings

The person with psychotic depression has a sad mood and a great despondency. However, something that also appears frequently is bad mood, as well as tantrums and rage for no apparent reason.

Low self-esteem accompanied by delusions

One of the most recurrent psychotic symptoms is the constant feeling of guilt, helplessness and lack of self-love. However, this can reach extreme situations due to the perception that they are being relegated by the family and socially.

The delusions that they suffer from time to time always bring out the idea that they are not loved, that they are a leading zero for everyone. This often causes great confusion among figures close to the person with psychotic depression.

Changes in sleep habits

A common fact among the symptoms of psychotic depression is sleeping during the day and staying awake at night. Changes in sleep habits are a constant in these types of patients.

They suffer from hallucinations they don’t usually share

A common (and at the same time problematic) fact of this psychological condition is that people experience hallucinations, a symptom that is not always shared with others. The most common hallucinations are auditory, that is, they hear voices that say, for example, that a certain family member does not love them and wants to poison them.

People with this type of depression are aware that this is not normal. Therefore, most of the times they choose to be silent and keep this symptom in silence, which ends up making the diagnosis difficult.

Symptoms of psychotic depression: lack of concern for personal cleanliness

Another of the symptoms of psychotic depression is the absolute lack of concern with the habits of hygiene and personal cleanliness. These people don’t take a shower, don’t change their clothes, don’t care about housekeeping, etc.

They stop relating and communicating with the people around them

In more severe cases, the family can see how the person with this type of depression gradually disconnects. She stops interacting, worrying about others, devoting time to her hobbies. Your daily life is transformed.

Likewise, it is also common for their mobility to be reduced to the point where they lie silently on their bed or, often, on the sofa – from which they rarely get up.

How is psychotic depression treated?

One of the reasons psychotic depression is not easily diagnosed is because psychotic symptoms are often masked. People are aware that delusional voices and thoughts are not normal, so they keep them to themselves. However, the suffering is so devastating that, in certain cases, they resort to self-injury or even suicide.

It is crucial that the family is aware of the personal reality that the person with psychotic depression lives. An early diagnosis of major depression, for example, often avoids drifting into such extreme situations. As we said at the beginning of the article, this condition has a good prognosis.

Treatment based on antidepressants and antipsychotics favors mood regulation. Likewise, cognitive-behavioral therapy also works well in most cases. Last but not least, it is essential to establish continuous medical and psychological monitoring of the patient.