Psychotic depression is a severe form of depression wherein, an individual tends to demonstrate depressive symptoms along with psychosis or irrational behavior. Although this form of depression is less common as compared to melancholic or non-melancholic depression, it is quite a serious psychological problem considering that it has the tendency to trigger suicidal tendencies in individuals. Statistics reveal that somewhere around 25 percent of the people hospitalized for any illness related to depression are diagnosed with psychotic depression.
Though the causes of this condition have been a topic of debate so far, it is widely believed that the same is triggered by abnormal functioning of thyroid or excessive production of cortical hormone as a result of stress. More importantly, it's also believed that psychotic depression can be hereditary in some people.
In addition to severely depressed mood and frequent mood swings, an individual suffering from this form of depression also tends to experience hallucination and delusion. He may often complain of hearing and seeing things which don't actually exist. In fact, hallucination - i.e. illusory perception, is quite common in a range of mental illnesses. One of the most common example of delusion is the individual going by the belief that something is wrong with his physical appearance with absolutely no reason to think like that whatsoever. At the same time, the individual suffering from psychotic depression will also show signs of anxiety and mental distress.
Other symptoms of this disorder include frequent frightening dreams, chronic sleeplessness, lack of interest in day-to-day activities, excessive fatigue and physical immobility. The individual may also spend hours together day dreaming, which in turn tends to affect his ability to concentrate on things happening in the surroundings. An unusual increase or decrease in sex drive is also one of the various symptoms of psychotic depression. As we mentioned earlier, an individual suffering from this condition also experiences suicidal tendencies now and then as a result of which he may often think about suicide, plan it or even attempt it.
As the individuals suffering from psychotic depression don't usually open up or admit that they need help, it becomes difficult to diagnose this condition in early stages. At the same time, the chances of misdiagnosis also exist in plenty, as its symptoms are more or less similar to symptoms of other forms of neuropathy such as schizophrenia. In such circumstances, these symptoms play a crucial role in the diagnosis of this condition.
An individual diagnosed with psychotic depression needs to be hospitalized as this disorder only responds to intensive treatment. More importantly, hospitalization also ensures that the patient is under proper medical observation. The treatment for this form of depression can be categorized into two different parts - medication and electro-convulsive treatment. As far as medication is concerned, the treatment is mostly dependent on antidepressant and anti-psychotic drugs; both of which are administered in combination to treat the symptoms of this disorder. Even though effective, these anti-psychotics have to be administered under strict medical supervision as each of these have some side-effects of their own.
Electro convulsive therapy (ECT) is mostly recommended when antidepressants and anti-psychotics fail to yield the desired results. In this method, electrodes are used to apply electric current on the scalp of the patient which in turn causes controlled convulsions and triggers massive neurochemical release in the brain. This form of treatment, which mostly lasts for somewhere around 30 to 90 seconds, is practiced for 6 to 10 times. It is carried out under the influence of anesthesia to ease the pain. Although one of the fastest and most effective treatment options for psychotic depression, it is known to cause short term memory loss in individuals. Usually, recovery takes around a year or so after the initiation of treatment and regular follow up.
Taking into consideration the suicidal tendencies associated with psychotic depression, it's but obvious that one can't afford to take it lightly. While ECT has been used effectively for the treatment of this condition for quite some time now, it is likely to be replaced by Transcranial magnetic stimulation (TMS) wherein, specific nerve pathways are stimulated by applying electromagnetic field to the cortex. In fact, TMS is pitched to be an apt alternative to ECT mainly because it doesn't have side-effects like short term memory loss which are associated with the latter.