Question: What is meant by the diagnosis of 'psychotic' depression?
Answer: Psychotic depression is a special form of extremely severe depression in which the individual experiences psychotic symptoms.
What do we mean by psychotic symptoms? Well one type of psychotic symptoms that depressed individuals may experience is hallucinations. Hallucinations can come in different forms. One common type of hallucination in severe psychotic depression is auditory hallucinations in which the depressed individual hears voices in his or her head that can often times be very critical or threatening. And sometimes may command the individual to take actions, such as acting on suicidal impulses.
Visual hallucinations also can occur in psychotic depression where the individual sees things, often quite disturbing images that other people are not able to see.
Psychotic depression may also be characterized by delusions, in which the individual experiences a break from reality and a breakdown in their thought process. Paranoid delusions are common in psychotic depression. The individual may feel that others are talking about him or her behind their back, often in a quite threatening or scary way. Also, individuals with psychotic depression tend to develop suicidal ideation and in the worst case scenarios may act on those suicidal impulses.
The diagnosis of psychotic depression is extremely important because it leads to distinct forms of treatment not only with antidepressant medications but also with antipsychotic medications and sometimes with electroconvulsive therapy or ECT.