How to Treat Psychotic Depression

Psychotic depression is a sub-type of major depressive disorder, characterized by the presence of psychotic features. Psychotic depression may involve hallucinations and delusions. This condition can interfere with regular activities and requires immediate attention. To effectively manage psychotic depression, be aware of symptoms and treatment options. [1]

Method 1
Method 1 of 3:

Considering Treatment

  1. Being aware of common symptoms will help you and your loved ones treat your condition and alleviate some of your difficulties. Some of the symptoms and conditions associated with psychotic depression are: [2]
    • Sleep disturbance.
    • Decreased appetite.
    • Suicidal ideation.
    • Agitation and anger.
    • Hallucination and/or delusions.
    • Irritability.
    • Deteriorating social and occupational life.
  2. Medication is commonly necessary to treat a person with psychotic depression. A doctor may prescribe an antidepressant to treat symptoms generally associated with depression and an antipsychotic to treat the symptoms of psychosis. [3] Antipsychotics may only be prescribed for a short time. Depression will likely be the main focus of treatment. [4]
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  3. Psychotic depression is one of few disorders that may be treated by ECT. The treatment involves passing electrical currents through the brain, triggering brief seizures that change brain chemistry. [7]
    • While current ECT practices are relatively safe, be sure to discuss possible side effects with your doctor.
  4. Talk therapies are often recommended in conjunction with medical treatments. Your doctor or therapist will be able to help you find the best treatment options for your needs.
    • Cognitive behavior therapy can help identify problematic thoughts and behaviors and replace them with functional ones.
    • Rational emotive behavior therapy can help identify the unnecessary demands from the self, the world and others, and contributes to change by challenge irrational ideas associated with depressive rumination.
  5. Regular routines will ensure treatment compliance and shift your focus to functional activities. Following regular routines can help you relieve depressive symptoms by adding structure to your days. [8]
    • Schedule your day, including grooming, eating and sleeping, in addition to typically scheduled items like work or appointments.
    • Include healthy activities, like exercise, and pleasurable activities, like hobbies.
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Method 2
Method 2 of 3:

Finding Support

  1. As a person having depressive or suicidal thoughts, potentially suffering from hallucinations and delusions, you should build up a strong network of social support. [9] As the psychotic features become less severe, having a network that can help counsel you and identify your misconceptions, delusions, and hallucinations is very helpful.
    • Look for support groups at local community centers. If you are unable to participate in groups in your community, look for online support groups.
  2. Invite family members to participate in support groups with you or to accompany you to a counseling appointment. This will help them better understand your experiences and feel more comfortable talking to you about your condition.
  3. Join a local advocacy group for depression or psychosis to help you better understand your condition and effectively communicate with others. This will create networking opportunities and help you identify resources.
    • National Alliance on Mental Illness is a good place to start. [11]
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Method 3
Method 3 of 3:

Preventing Relapse

  1. Feelings of worthlessness, hopelessness and helplessness are common in people with depression. These feelings can be further exacerbated by psychotic features such as delusions, which may have paranoid, persecutory or somatic themes. Challenge negative beliefs frequently to reduce negative self-talk. [12]
    • Identify negative thoughts by recognizing key words. If your thoughts involve words like "can't", "never", and "won't", they are probably negative.
    • Consider alternative possibilities. When you catch yourself thinking negatively, try stating the thought with positive terms, like can and will.
  2. Stress contributes to depression and may trigger relapse. Healthy coping strategies will help mitigate the effects of stress. [13]
    • Exercise promotes a sense of wellbeing and contributes to resilience.
    • Practice deep breathing or relaxation exercises.
    • Schedule regular dates with friends and family to maintain healthy relationships.
  3. You are not the only person to experience this. Psychotic depression can be effectively treated and recovery is likely.
    • Keep track of your progress to maintain motivation.
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Expert Q&A

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  • Question
    How do you deal with unsupportive people?
    Noel Hunter, Psy.D
    Clinical Psychologist
    Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.
    Noel Hunter, Psy.D
    Clinical Psychologist
    Expert Answer
    Try not to engage with people who don't support you or your mental illness, as they aren't worth your time.
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      References

      1. ↑ https://www.nlm.nih.gov/medlineplus/ency/article/000933.htm
      2. ↑ https://www.nlm.nih.gov/medlineplus/ency/article/000933.htm
      3. ↑ http://www.sane.org.uk/resources/mental_health_conditions/psychotic_depression
      4. ↑ http://www.cochrane.org/CD004044/DEPRESSN_pharmacological-treatment-psychotic-depression
      5. ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
      6. ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
      7. ↑ http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161
      8. ↑ http://www.webmd.com/depression/features/natural-treatments
      9. ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
      1. ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
      2. ↑ http://www.nami.org
      3. ↑ http://psychcentral.com/lib/challenging-negative-self-talk/
      4. ↑ http://www.helpguide.org/articles/depression/depression-treatment.htm

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