Psychotic Depression

Psychotic depression combines the symptoms of regular depression, such as restlessness, social withdrawal and feelings of helplessness with hallucinations or irrational thoughts and fears. It is estimated that around 25% of all patients who are hospitalized for depression have psychotic depression. The difference between a patient with psychotic depression and schizophrenia is that the former is aware that his or her thoughts and feelings are unreal, and usually wants to be cured of them. This greatly improves the prognosis for recovery for those with psychotic depression.

Psychotic depression is accompanied by high levels of cortisol in the blood (cortisol is produced by the adrenal gland). The levels vary at certain times of the day, for instance, at 4 p.m. cortisol levels are usually at their lowest, and can be triggered by stress or trauma. This makes psychotic depression relatively easy to treat with medication that regulates cortisol levels. Hospitalization is also required for those suffering from psychotic depression; because they are more aware of their illness than those with schizophrenia, they might feel more despair and be more likely to harm themselves. Supervision, medication and follow-up consultations after the patient is discharged from the hospital contribute to successful treatment.

Psychotic depression is curable, and many people can recover from this ailment without a relapse. Those who have had a history of psychotic depression or have family members who suffer from it should be alert to the symptoms and seek treatment immediately if symptoms develop. The earlier psychotic depression is treated, the better the prognosis for recovery is.