What is Psychotic depression?

Major depression is an illness where you can have a depressed or irritable mood and a number of other symptoms that affect your sleep, appetite, energy level, outlook on life and so on. It is possible to be mildly, moderately, or severely depressed.

To determine the severity of depression, we usually assess the level of functioning. How do you function in your school, work, and personal lives? A mildly depressed person may struggle to get out of bed, have difficulty finding joy in life, and still work and care for the family. Even though there are children in the home crying out for food, a severely depressed person might not be able get out of bed. It doesn’t matter if your family or finances depend on it. Why? It’s not a choice. Depression can take control of your will when it strikes so hard.

Sometimes depression can become so severe that it is difficult to see the real world and you develop psychotic symptoms. These psychotic symptoms include hallucinations and delusions. Delusions are more common than hallucinations. Delusions can also take on a persecutor or nihilistic tone.

Persecutory refers to when you feel threatened in any way. It can feel like others are trying to harm or talk about you. You may feel that things are meaningless or have lost their value. What’s the point of life? It doesn’t matter. This can lead to suicide attempts or a desire not to live. Sometimes suicide attempts can be impulsive. But sometimes, they are born from nihilistic delusions. Existence is meaningless.

How do we treat psychotic depression?
Unipolar depression can be treated with antidepressants and an antipsychotic medication, or electroconvulsive treatment. The most effective antidepressants are medications such as venlafaxine, escitalopram, and fluoxetine. Quetiapine, aripiprazole, and other antipsychotic medications are examples.
Bipolar disorder can lead to psychosis, whether it’s the depressive or manic phases. This is why you need to be cautious about giving antidepressants to people with bipolar disorder. Antidepressants can trigger manic episodes or make it difficult for people to transition between phases quickly. For someone with bipolar disorder, this could be a problem. Electroconvulsive therapy could be used for the same reasons as psychotic unipolar disorder. If the person is currently on no medication, you can add an antipsychotic drug to their existing regimen. However, if they are already taking a mood stabilizer you could add an Antipsychotic medication.
Video on using antidepressants for bipolar disorder
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Video about Schizophrenia
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Disclaimer: The information contained on this channel is intended for education purposes only and does not constitute specific/personal medical advice. The videos and the answers to questions/comments do not create a doctor-patient relationship. These videos may be helpful for you if you are a patient of your own doctor.

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