Major Depression with Psychotic Features

If you, or someone you love, has been diagnosed with Psychotic Major Depression (PMD) or Major Depression with Psychotic Features, you may wonder what your life will be like, or how you can help your loved one get the help they need to feel better. Psychotic Major Depression can range from severe depression to mild depression that is estimated to affect about one in every 250 persons, so it is not rare.

What are the differences between Psychotic Major Depression and other mental illnesses?

It is important to know there are different types of depression disorders and the symptoms of Psychotic Major Depression are different than the symptoms of what is called Non-psychotic Major Depression Disorder or NPMD. One of the key differences between these two diagnoses is that persons with PMD often experience delusions. Delusions are ideas, or ways of thinking, that are not true and are not supported by reality. The difference between schizophrenia and Psychotic Major Depression is that a person with PMD knows that what they are thinking isn't real, they just can't get it out of their minds. A person with schizophrenia does not know their delusions aren't real.

What are the symptoms associated with Psychotic Major Depression?

Psychotic Major Depression is a form of severe depression. Individuals with PMD, who have mild to moderate depression, can also experience psychosis or psychotic features. A psychotic feature refers to loosing contact with reality or having a distorted sense of reality. Along with delusions, someone with Psychotic Major Depression may also have one of the most common symptoms of PMD referred to as paranoid delusions of guilt. With this type of delusional thinking, individuals believe they are being rebuked or punished for things they have done wrong - or they think they have done wrong. There is another common delusion that many persons with Psychotic Major Depression experience and it is related to feeling people are paying too much attention to them and that these people are trying to persecute them.

Delusions are typically more common than hallucinations with Psychotic Major Depression, but it is not unusual to also see hallucinations in a patient with PMD. Hallucinations are most generally associated with seeing and hearing things that are not there. Auditory hallucinations are the most common and individuals believe they hear voices telling them what to do and what not to do.

Besides having delusions and sometimes hallucinations, persons with Psychotic Major Depression also exhibit agitation, have difficulty falling asleep and staying asleep during the night. There is a higher risk of suicide with PMD than with NPMD. It is typical to find greater cognitive deficiencies in individuals with Psychotic Major Depression than NPMD. These kinds of deficits are related to thinking, memory issues, and problem solving.

What is the duration of Psychotic Major Depression?

The most common ages for onset of Psychotic Major Depression are 20 years old to 40 years old. An individual with PMD can have anywhere from 4-9 episodes over the span of their life. PMD is typically intermittent and lasts for a certain amount of time. Unfortunately, some people have what is called chronic PMD and have symptoms regularly. An average length of time for a PMD episode is less than two years. There are some chronic cases where the episodes last longer than two years. During the periods when an individual is not having an episode, they are able to live a fairly normal life and typically function well socially and professionally.

What options are available for treatment of Psychotic Major Depression Disorder?

Treatment for Psychotic Major Depression usually includes the use of antidepressant and antipsychotic drugs. Electroconvulsive therapy has been shown to be quite effective with PMD and is most often used following medication.

A diagnosis of Psychotic Major Depression or Major Depression with Psychotic Features is indicative of severe depression, and in some cases indicative of mild to moderate depression. Even though it is seriously debilitating during episodes, there is much reason to have hope. Science has developed several different kinds of pharmacological approaches to treatment and electroconvulsive therapy is very helpful. There is continuing research looking for ways to help people faster and to give them longer lasting effects.