“Psychotic depression” is condition of severe depression coupled with psychosis.  The Symptoms of depression become so severe, that the person loses touch with reality. Psychosis that accompanies a depressive disorder can show up in a variety of ways. 

A person with psychosis may experience hallucinations, delusions, or have trouble communicating because their thought processes are abnormal.  Their thoughts can seem disjointed or illogical, making it impossible to understand what they are trying to say.

Delusions and hallucinations are two of the most common symptoms of psychosis, but there are other ways psychosis is expressed.  The important thing to remember is if you or someone you know appears to be depressed and out of contact with reality, seek professional help right away.

You can contact your local Mental Health center, crisis line, or 911 if you or a person you know are experiencing these symptoms.  There are resources listed at the end of this article.

What Does Psychosis Look Like?

Hallucinations

People experiencing psychosis commonly have hallucinations such as hearing voices or seeing things that aren’t there. It is possible to experience unusual changes to other senses as well, such as smell and touch (e.g., feeling something crawling under their skin).  Hearing things that aren’t there are referred to as auditory hallucinations, while seeing things are called visual hallucinations.

Delusions

A delusion is a false belief.   For example, a person may feel as though a neighbor is stalking and out to get them even, though there is no reason to believe this.   This type of delusion is referred to as paranoid.

Other common paranoid themes include the belief a person is being targeted by a government agency such as the FBI or some other threatening entity such as a crime ring.  These are only considered delusions if the person’s concerns aren’t credible.

Another common type of delusion people may with psychosis may experience is the belief they are extraordinary in some way.  As the term “grandiose” suggests, grandiose delusions are beliefs a person possesses exceptional greatness, above the average human’s abilities.   

A person with grandiose delusions may claim to be Jesus Christ or some other important historical figure, for example. They may insist they know influential people when reality doesn’t support their claim.

Psychomotor Agitation

One final symptom of psychosis worth mentioning here is agitation.  Psychomotor agitation means unintentional behaviors that might look like anxiety or restlessness.  The behavior is not intentional.  Some of these behaviors include repetitive non-purposeful movements such as pacing and hand-wringing.

Given we are speaking of depression with psychosis, it’s worthwhile to review the symptoms of depressive disorder. This is not an exhaustive list of symptoms; however, if you or someone you know suffer from these, further evaluation is recommended. 

What are the Symptoms of Clinical Depression?  

Below are some common symptoms of depression:

• Feelings of helplessness, hopelessness, and/or worthlessness
• Insomnia or hypersomnia (sleeping excessively)
• Preoccupation with death or thoughts of harming oneself or others. Contact emergency services if you or someone you know is thinking of suicide or of harming another person. 
• Weight loss or decreased appetite
• Disinterest in things that used to be enjoyable
• Decreased energy or motivation
• Fatigue
• Difficulty making decisions

How is psychotic depression treated?

Typically, psychotic depression requires inpatient treatment in order to stabilize a person in a safe environment. 

This severe form of depression is treated with medication, usually an antidepressant to address the depression and an anti-psychotic to resolve the psychotic symptoms.

If you or someone you know is experiencing symptoms of depression and psychosis, please contact your local mental health center or call 911.  Below are some online resources.

Online Referrals and Resources

Substance Abuse and Mental Health Service Administration (SAMHSA)
Phone 24/7: 1-800-662-HELP (4357)
Website: http://www.samhsa.gov/find-help/national-helpline

Suicide Prevention Hotline
Phone 24/7: 1-800-273-TALK (8255)
Website: http://www.suicidepreventionlifeline.org/

National Alliance of Mental Health (NAMI)
Website: http://www.nami.org/Find-Support/NAMI-HelpLine

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