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Psychotic depression refers to a condition marked by symptoms of clinical depression combined with hallucinations or delusions that conflict with reality. A person suffering from psychotic depression might see and hear things that do not exist and suffer from irrational fear and suspicion. In severe cases, people with this disorder may be unable to provide for their own care and be deemed dangerous.
Signs of psychotic depression may include neglecting personal hygiene, such as wearing the same clothes for days and not bathing. The patient might avoid others when suspicions take over his or her thoughts. Explosive fits of anger or agitation are other common signs of the disease, along with conversations that make no sense to others.
The patient commonly exhibits signs of major depression. Those suffering from chronic depression might feel down for an extended period of time and feel helpless or hopeless. They commonly do not receive any enjoyment from life and believe there is no solution to their problems. Symptoms of major depression also include changes in appetite and sleep patterns. People suffering from major depression often turn to alcohol or drugs in an attempt to self-medicate.
There is no definitive cause for major depression that leads to psychotic depression outside of medical conditions linked to the disease. Some experts believe a chemical imbalance in the brain contributes to the disease. Others point to heredity as a factor, and some psychologists believe the inability to cope with painful life events triggers the disorder. Some health professionals consider all three possibilities, or a combination of them, when making a diagnosis.
Psychosis can evolve from diseases like Alzheimer’s that cause confusion in patients. A brain tumor or disease of the brain is also capable of causing symptoms that mimic psychotic depression, as well as some prescription medications. Doctors might also see signs of psychotic behavior when an addict is withdrawing from drugs or alcohol.
Treatment for this disorder generally involves antidepressant and antipsychotic medication over a long period. If a brain tumor is causing the condition, it can sometimes be treated with surgery. When medication alone does not work, electroconvulsive therapy may be an option. Treatment is usually deemed critical because those suffering from psychotic depression present a high risk for suicide.
Psychotic depression might affect people with other mental disorders, such as schizophrenia and bipolar disease. It has also been seen in patients with certain personality disorders. Diagnosis is usually done through blood tests that reveal abnormal hormone or electrolyte levels and brain scans.