What Is Depressive Psychosis?
According to the National
Alliance on Mental Illness (NAMI), an estimated
20 percent of people who have major depression also have psychotic symptoms. This
combination is known as depressive psychosis. Some other names for the
depressive disorder with mood-congruent psychotic features
depressive disorder with mood-incongruent psychotic features
causes you to experience psychotic symptoms plus the sadness and hopelessness
associated with depression. This means seeing, hearing, smelling, or believing
things that aren’t real. Depressive psychosis is especially dangerous because
the delusions can cause people to become suicidal.
What Are the Symptoms
Associated with Depressive Psychosis?
A person who experiences depressive psychosis has major
depression and psychotic symptoms. Depression occurs when you have negative feelings
that affect your daily life. These feelings can include:
If you have clinical depression, you may also experience
changes in eating, sleeping, or energy levels.
Examples of psychotic symptoms include:
According to the Journal of
Clinical Psychiatry, delusions in depressive psychosis tend to be guilt-ridden,
paranoid, or related to your body. For example, you may have a delusion a
parasite is eating your intestines and that you deserve it because you’re so
What Causes Depressive Psychosis?
Depressive psychosis doesn’t have a
known cause. In some people, it’s thought that a chemical imbalances in the
brain is a factor. However, researchers haven’t identified a specific cause.
What Are the Risk Factors for Depressive Psychosis?
According to NAMI,
depressive psychosis may have a genetic component. While researchers haven’t
identified the specific gene, they do know that having a close family member,
such as a mom, dad, sister, or brother, increases your chances of having
psychotic depression. Women also tend to experience psychotic depression more
According to the journal BMC
Psychiatry, older adults are at greatest risk for psychotic depression.
An estimated 45 percent of those with depression have psychotic features.
How Is Depressive Psychosis Diagnosed?
Your doctor must diagnose you with
major depression and psychosis for you to have depressive psychosis. This can
be hard because many people with psychotic depression may be afraid to share
their psychotic experiences.
You must have a depressive episode
that lasts two weeks or longer to be diagnosed with depression. Being diagnosed
with depression also means you have five or more of the following symptoms:
- agitation or
slow motor function
- changes in
appetite or weight
- depressed mood
- difficulty concentrating
- feelings of
- insomnia or
sleeping too much
- a lack of
interest or pleasure in most activities
- low energy
- thoughts of
death or suicide
In addition to these thoughts
associated with depression, a person with depressive psychosis also has
psychotic symptoms, such as delusions, which are false beliefs, and
hallucinations, which are things that seem real but that don’t exist. Having
hallucinations can mean you see, hear, or smell something that isn’t there.
What Are the Complications of Depressive Psychosis?
Psychotic depression is often
considered a psychiatric emergency because you’re at an increased risk for
suicidal thoughts and behavior, especially if you hear voices telling you to
hurt yourself. Call 911 immediately if you or a loved one has thoughts of suicide.
How Is Depressive Psychosis Treated?
Currently, there are no treatments
specifically for depressive psychosis that are approved by the FDA. There are
treatments for depression and psychosis, but there aren’t any specifically for
people who have both of these conditions at the same time.
Your doctor may treat you for this
condition or refer you to a licensed mental health professional who specializes
in the use of medications for these conditions.
Mental health providers may
prescribe a combination of antidepressants and antipsychotics. These
medications impact neurotransmitters in the brain that are often out of balance
in a person with this condition.
Examples of these medications
include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine
(Prozac). This may be combined with an atypical antipsychotic, such
However, these drugs take several
months to be most effective.
Electroconvulsive Therapy (ECT)
The second treatment option is
electroconvulsive therapy (ECT). This treatment is typically performed in a
hospital and involves putting you to sleep with general anesthesia.
Your psychiatrist will administer
electrical currents in controlled amounts through the brain. This creates a
seizure which impacts your levels of neurotransmitters in the brain. This
treatment does have side effects, including short-term memory loss. However,
it’s thought to work quickly and effectively for people with suicidal thoughts
and psychotic symptoms.
Your psychiatrist can discuss these
options with you and your family to determine the best course of treatment for
your condition. Because relapse is possible, your psychiatrist may recommend
taking medicines after ECT as well.
What Is the Outlook for People with Depressive
Living with depressive psychosis
can feel like a constant battle. Even if your symptoms are under control, you
may be concerned they’ll come back. Many people also choose to seek
psychotherapy to manage symptoms and overcome fears.
Treatments can help reduce
psychotic and depressive thoughts, but they can have their own side effects.
- changes in
However, you can live a healthier
and more meaningful life with these treatments than you can without them.