Psychotic depression - Clinical depression

Some people with severe clinical depression have symptoms of psychosis such as hallucinations and delusional thinking.

This is called psychotic depression.

Symptoms of psychotic depression

Psychotic depression means you have symptoms of clinical depression and symptoms of psychosis.

Symptoms of depression

If you have clinical depression, you will feel sad and hopeless for most of the day. You will feel like this most days and you will have no interest in anything. Getting through the day feels almost impossible.

Other symptoms of severe depression are:

• fatigue (exhaustion)
• loss of pleasure in things
• disturbed sleep
• changes in appetite
• feeling worthless and guilty
• being unable to concentrate or being indecisive
• thoughts of death or suicide

Clinical depression - symptoms

Symptoms of psychosis

Symptoms of psychosis include:

• delusions - thoughts or beliefs that are unlikely to be true
• hallucinations - hearing, feeling, smelling, seeing or tasting things that are not there
• not being able to relax or sit still and constantly fidgeting (psychomotor agitation)
• slowing down of thoughts and physical movements (psychomotor retardation)
• thinking about suicide

The delusions and hallucinations almost always reflect a depressed mood. For example, you may become convinced you're to blame for something or that you've committed a crime.

Causes of psychotic depression

The cause of psychotic depression is not fully understood. There's no single cause of depression and it has many different triggers.

For some, it can be as a result of stressful life events.

For example:

• bereavement
• divorce
• serious illness
• financial worries

Genes probably play a part. Severe depression can run in families. But it is not known why some people also develop psychosis.

Many people with psychotic depression had a traumatic event in childhood.

Treating psychotic depression

Treatment for psychotic depression can include:

• antipsychotics medicine
• antidepressants medicine
• psychological therapies
• social support - support with social needs, such as education, employment or accommodation

You may need to stay in hospital for a short time while you are getting treatment.