What IS Psychotic Depression, Anyway?

It's something I didn't know existed until it happened to me.

Psychotic depression is also called "Major Depressive Disorder with Psychotic Features" or "Major Depression with Psychotic Features.  When psychosis occurs in major depression, the patient is fully aware that what they're experiencing -- be it a hallucination or paranoia or delusion -- is not founded in reality.  With other psychotic breaks, such as those that occur with manic phases of bipolar illness or with schizophrenia, the patient believes their delusion.

Psychotic depression often requires hospitalization and treatment with anti-psychotics as well as antidepressants.  It can be hard to diagnose.  Like I said, we're fully aware that our thoughts are irrational.  Feelings of shame, which are bad enough in depression to begin with, often lead psychotic depressives to hide what's going on.  There is a high risk of suicide with psychotic depression.


I was concerned by my psychotic episode, but it went away after several hours, and I had an appointment with my pdoc in a few days anyway.  I also figured that I "wasn't really in trouble" because I knew that my thoughts were irrational -- and psychosis means a complete break with reality, right?  Psychotics don't know they're ill.  If you're asking whether you're crazy, it proves you're not, right?

Not so much.

I feel lucky that I was able to avoid hospitalization.  I came home from my psych appointment with a scrip for Abilify, which helped with the delusions, and orders to get a light box RIGHT NOW, which helped with my mood.

Less fortunately, it became clear that my pansy-ass 12.5 mgs of Zoloft were not doing the trick.  Any more of it and I got a weird combo of anxiety and sedation.  So I got switched to Lexapro, on the grounds that it was less activating ... and things went OK until I went off the Abilify.  Then the Lexapro turned me into the walking dead.  Hence the Lamictal.

To read more about what happened to me, click this link.