Due to some distressing circumstances a patient finds changes in mood from time to time which can be called as depression. Around 25% of patients admitted in hospital for depression manifest psychotic depressive illness. It usually affects middle aged people of thirty five to fifty years of age.
Psychotic depression is another form of psychosis and it is a serious illness. It is important to distinguish psychotic depression from other psychosis disorders such as schizophrenia, because they can be cured rapidly and if left untreated, they are most likely to commit suicide.
A psychotic depressive person is aware that the thoughts which he has are not true.
The patient is usually a perfectionist, hard working, sincere, who has gone through various hardships in his life and achieved success. The earliest symptom is “Early morning Insomnia”. This means there is no difficulty in going to sleep. Patient becomes depressed, talks very little, does not reply for most of the questions asked by anybody, and becomes slow in thinking and acting. He feels that life is not worth living. Feeling of guilt is an important symptom. He dreams of terror e.g. somebody harming him physically and so he wakes up with a tired feeling. The other symptoms may be belching, impotency, constipation, empty head or dry mouth.
The most important symptom of psychotic depression is suicidal tendency. The sufferer plans it well and even succeeds most of the times.
Causes can be due to: drug abuse, hormonal imbalance, defect in neurotransmission, lacking skills to face stresses and traumas.
Treatment Psychotic depression is very effective and the recovery is usually very good. Various modes of treatment are employed.
The patient is usually hospitalized for few days so that he remains under careful observation of the medical professionals. Antidepressants and anti psychotic medications are given.
ECT is useful in patient having suicidal tendencies.
A regular follow up with the treating doctor is required.