Have you ever had a very close friend, a relative, or even yourself, experience strange experiences when you are feeling very sad, lonely, and stressed, such as seeing or hearing things that aren't there? Do you hear someone whispering in your ear, "I'm worthless"? Or have you ever been unable to shake thoughts like, "I've done something wrong and I deserve to be punished"? This may not be just simple depression. Today we are talking about psychotic depression, a condition that can occur alongside major depression and is very serious, but can be cured with treatment.
What exactly is Psychotic Depression?
Simply put, this is a subtype of Major Depression. What happens here is that when the depression reaches a severe level, it is accompanied by a state of psychosis. The word "psychosis" may scare you. But what it means is that a person loses touch with the real world, or confuses reality with illusion.
This can happen in two ways:
1. Hallucinations: Seeing, hearing, feeling, tasting, or smelling things that are not there. For example, hearing voices saying, "You are worthless," "You are a sinner."
2. Delusions: Strong beliefs that have no basis in fact and cannot be changed no matter how much explanation is given. For example, believing things like "I am the worst person in the world," "I have committed a terrible sin, and the police are coming to arrest me."
It is reported that this condition affects about one in four people hospitalized for depression, so it is not an uncommon condition.
How is this different from general depression and schizophrenia ?
You might be wondering if this is the same mental illness as schizophrenia . No, there is a clear difference between the two.
In normal depression, a person feels extremely sad, frustrated with life, and has lost interest in work, but they don't escape reality. That is, they don't see or hear hallucinations. But in (Psychotic Depression), along with depression, those hallucinations and delusions that we talked about earlier also occur.
The difference with schizophrenia is that the delusions that occur in (Psychotic Depression) fit the theme of depression. That is, the delusions are built around topics that make him feel sad and worthless (such as "I am worthless"). But in schizophrenic depression, the delusions can be much more bizarre and bizarre. They may even have little to do with his mood (such as "Aliens are controlling the thoughts in my head").
The main reason why this condition is difficult to recognize is that the patient is ashamed and humiliated by these delusional thoughts and tries to hide them from others.
Hiding this condition will only make the disease worse. Therefore, it is very important to seek medical advice without shame or fear.
How do we recognize these symptoms?
If you suspect that someone close to you has this condition, keep an eye out for the following symptoms. You may see one or more of these together.
| Symptom | To explain simply: |
|---|---|
| Agitation | Unable to stay in one place, constantly restless and agitated. |
| Anxiety | Feeling excessive fear and anxiety about the future or for no reason. |
| Constipation | Stress can cause changes in physical activity and constipation. |
| Hypochondria | Constantly and unnecessarily fearing that they have a serious, incurable illness. |
| Insomnia | Inability to sleep at night, or sleeping during the day and staying awake at night. |
| Intellectual impairment | Decreased thinking speed, attention span, and decision-making ability. |
| Physical immobility | To remain motionless in the same position for a long time, doing nothing. |
| Delusions or hallucinations | Seeing, hearing, or believing things that are not really there, or having strong beliefs that have no basis. |
What are the treatments for this?
This is a very important issue. Treatment for this condition is usually done as an inpatient in a hospital, so that doctors and nursing staff can keep a close eye on the patient.
A combination of two main types of drugs is used for treatment:
1. Antidepressants: To control depression.
2. Antipsychotics: To control hallucinations and delusions.
These antipsychotic drugs work by balancing the activity of the chemicals that carry messages between nerve cells in our brain, called neurotransmitters . This restores our ability to distinguish between reality and illusion. Currently, more effective drugs with fewer side effects are used (e.g., `(Olanzapine)`, `(Risperdal)`, `(Quetiapine)`). Only your doctor can determine the most suitable drug and dosage for you or your loved one.
Is the treatment really successful?
Yes, absolutely. This is the best news I can give you. Treatment for psychotic depression is very effective. With proper treatment, you can make a full recovery within a few months.
However, it is very important to continue to follow your doctor's instructions and visit your doctor on time even after recovery. Sometimes, there are cases where medications do not produce the desired results. In such cases, doctors may decide to use a very safe and effective treatment called Electroconvulsive Therapy (ECT) .
Because this condition is so serious, there is a high risk of suicide. Therefore, referring someone who is showing symptoms to a doctor as soon as possible can be a life-saving factor.
Take-Home Message
- Psychotic Depression is not just sadness, it is a serious medical condition that combines severe depression and detachment from reality.
- If you hear voices that aren't really there, see hallucinations, or strongly believe things that have no basis, they may be part of depression.
- Don't hide this condition out of shame or fear. Doing so will only make the disease worse.
- This condition is best treated with treatment, which may require hospitalization and medication.
- If you or someone you know is showing these symptoms, please see a doctor as soon as possible. If you are having suicidal thoughts, seek medical help immediately.
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