We will discuss the meaning behind what we have learned about psychotic depression symptoms info so far.
On the face of it, Psychotic Depression is merely depression with psychosis added on. Sounds a fair answer to 'what is psychotic depression', doesn't it? But
it isn't quite so simple. In some ways, it can be more confusing to the patient and certainly more embarrassing.
Psychosis by itself exhibits symptoms that the sufferer thinks are real. They really do see things, people, objects, that aren't there. Their delusions are
strongly held beliefs. Their thinking and speech are confused and muddled. They're completely unable to differentiate between what's real and what isn't.
Their statements and behaviour are often bizarre, and they withdraw socially.
Psychotic Depression sufferers hear voices telling them that they're not good enough, that criticize them, sometimes even telling them that they're downright
bad people. Further, that they don't deserve to live and should end it all. At the same time, of course, they have the full symptoms of depression and
because of the added burden of psychosis, it makes the depression that much worse.
The difference between Psychotic Depression and straight forward Psychosis, or even Schizophrenia for that matter, is that the depressed person knows
that the delusions and hallucinations they're experiencing aren't real. Nevertheless, the voices telling them that they're not good enough and should end it
all, etc., are most disturbing and of course they can tumble the patient into a much worse depressive state.
After all, imagine you yourself, as a perfectly well balanced, strong minded person, being told time after time that you're useless, you don't have a clue how
to do your job and that you're only taking up space that could be used by someone far better and much more accomplished. It would make even you stagger
around a bit on your perch.
Then there's the added embarrassment that some people feel about admitting to hearing voices. Remember that these depressed people aren't psychotic in
the true sense. They know that these hallucinations and delusions aren't real, so they may become very afraid of telling anyone, even a qualified
psychiatrist, that they experience them for fear of being thrown into a padded cell.
I know when I was put on suicide watch for twenty four hours, I felt very foolish. I'd learned my lesson only too well, but of course the hospital wasn't taking
any chances.
So this difficulty in telling anyone about their delusions, etc., can make diagnosis very difficult. Again, it's another of those conditions about which researchers
don't have a clue, although it's frequently associated with high levels of cortisol in the blood. Cortisol itself is a steroid hormone produced by the adrenal
glands.
Usual symptoms of the psychotically depressed person are as follows; Anxiety, Agitation, Hypochondria, Insomnia, Physical immobility, (not catatonic, but
sitting for long periods without moving about), Constipation and difficulty following conversations and in some cases recognizing everyday objects.
It's estimated that 25% of people brought into hospital for depression also suffer from psychosis, but it's a difficult statistic to be sure about, bearing in mind
the problem some people have in admitting the psychotic element.
Treatment requires a longer stay in hospital and a close follow-up. Tricyclic antidepressants and antipsychotic drugs have proved most efficacious. Lithium
can help a lot if someone happens to have a bipolar disorder. As a second line of treatment, Electroconvulsive therapy has proved most useful.
Perhaps surprisingly, researchers have found that the drug RU-486, the 'abortion' pill has proved remarkably successful in relieving Psychotic Depression
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