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Insight into Major Depression with Psychotic Features

written by: Rene Wolf • edited by: Paul Arnold • updated: 12/30/2010

Major depression with psychotic features occurs when someone is depressed and also experiences a loss of reality, hallucinations (seeing/hearing things that aren't there) and delusions (false thoughts/ideas).

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    Other names for major depression with psychotic features include psychotic depression and/or delusional depression. While experiencing hallucinations and/or delusions the person will hear and/or see things that are not there. They often believe that others can hear their thoughts and they may become paranoid. A depressed person with psychotic features may be at risk of harming themselves or others.

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    Causes of Psychotic Depression

    Psychotic depression, as is the case with other forms of depression, does not appear to have just one underlying fundamental cause. Possible causes are;

    • Blood containing high levels of the hormone cortisol
    • A history of depression and/or hereditary factors
    • Substance abuse of both drugs and alcohol

    Though psychotic depression can run in families, it is also possible for depression with psychotic features to be present without a family history. Symptoms of psychotic depression can be triggered as the result of stressful life events.

    The condition can occur in men and women of all ages and affect those from any social/economic status; however, women experience the symptoms more often than men. Women following delivery of a baby are often at risk of psychotic depression in various forms due to the physical and hormonal changes they endure. Although it is rare, a new mother may experience symptoms of major depression with psychotic features, known as postpartum psychosis.

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    Risk Factors

    The risk factors for psychotic depression are not clear, however, there are certain factors that may increase the risk of developing the illness. Some possible risk factors may include, family history of depression or other psychotic disorders, Dementia/Alzheimer’s disease, brain tumors, alcohol/drug abuse, epilepsy, stroke and some mental health illnesses such as schizophrenia and/or bipolar disorder.

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    Symptoms of Psychotic Depression

    The symptoms of depression with psychotic features are those typical of depression as well hallucinations (hearing/seeing things that are not there) and/or delusions (irrational fears/thoughts). The individual may believe that their thoughts are not really their own, but are there through insertion and they think their thoughts are being heard by others through thought broadcasting. Although psychotic depression is believed to be a severe type of major depression, it is possible for some people with mild to moderate depression to experience psychotic features. Psychotic depression includes:

    • Loss of energy
    • Changes in appetite/eating disorders
    • Difficulty concentrating
    • Unable to make decisions
    • Reduction in previously enjoyed activities
    • Sleep disturbances
    • Feelings of sadness
    • Suicidal thoughts/behaviors
    • Hallucinations
    • Delusions
    • Paranoia

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    Someone experiencing major depression with psychotic features may be at risk of self harm, including possible suicide or they may be at risk of harming others. Medical attention should be sought immediately if you or someone you know is experiencing psychotic depression. More information regarding treatment can be found in the Bright Hub article - What are the Most Effective Treatments for Psychotic Depression?

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    Medline Plus: major depression with psychotic features

    University of Maryland medical center: Major depression with psychotic features

    Depression Symptoms: major depression with psychotic features