Depressive Psychosis

Depressive psychosis, also called delusional depression or psychotic depression, is a mental health disorder characterized by symptoms of both depression and psychosis. Psychosis consists of a combination of fears and threats that are present in the mind but not true to life. If you have this condition, you may feel depressed while perceiving physical threats and experiencing hallucinations.

The cause of depressive psychosis is not known. You are more likely to suffer from the condition if depression, hallucinations, or delusions run in your family. These conditions may be genetic, due to chemical imbalances in the brain, and/or triggered by stress.

You are at higher risk if your family history includes depression or psychosis. People who experience life traumas or stresses such as physical abuse, financial loss, or social isolation may also be at greater risk. Women suffering from postpartum depression (depression after giving birth) with a history of psychotic illness in the family may be more prone to the condition. Some medications (e.g., steroids) can also trigger depression. The same goes for some medical conditions (e.g., cancer or chronic pain).

When you are depressed, your view of the world may change. Tasks that you previously managed easily might suddenly seem difficult. You might focus on the negative aspects of situations and see life as a series of problems. You might also develop a negative outlook on the people around you. Specific symptoms may include:

• eating more or less than usual
• feeling irritable and angry
• wishing for death
• withdrawing from social activities
• sleeping excessively or having difficulty falling asleep
• losing focus and concentration
• feeling less joy for life’s activities
• hating yourself or feeling worthless or guilty

People with depressive psychosis also experience delusions. For example, if you are feeling worthless and believe that no one likes you, you might believe that people want to harm you. You might think that cars are following you or that people have hacked into your computer.

Hallucinations involve seeing, hearing, or smelling things that are not real. For example, you might smell chemicals that no one else smells and assume that people have released them to harm you. You might hear voices threatening you or encouraging you to harm yourself or others. It is clear that these are hallucinations because others in your presence do not smell, hear, or see these same things.

Symptoms of depressive psychosis may appear with a number of different physical and psychological conditions. Your doctor may review your family history, conduct a physical exam, and possibly order a brain scan to make a diagnosis. A full psychiatric evaluation is usually necessary to distinguish depressive psychosis from other mental health conditions.

Treatment usually involves psychological counseling and a combination of medications. Your psychiatrist will likely prescribe antipsychotic medication to reduce or eliminate the delusions and hallucinations. Antidepressants are usually prescribed to treat the depression.

If your condition does not improve with medication, electroconvulsive therapy may be an option. This is a treatment for depression in which electricity is used to cause a seizure in the brain. It is generally only recommended if your condition does not respond to medications.

Depressive psychosis may be managed or eliminated with proper treatment. Because of its serious nature, treatment must be sought immediately. Some people may only need medication for a short time, and others may require long-term treatment. The recurrence of depressive psychosis is also possible, so it is important to continue medications and counseling. In some cases, patients must be hospitalized to reduce the risk of harm to themselves or others.

Depressive psychosis is difficult to prevent because its cause is unknown. When feelings of depression appear, see a doctor immediately to help to prevent the condition from getting worse.