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Depression with Psychosis


A rare but extremely debilitating form of depression, depression with psychosis impacts an estimated .4 percent of the population. Known as psychotic major depression (PMD), this breed of the popular mental condition is more serious than most common mental disorders. Most sufferers from this very serious variation of the disorder experience different types of delusions that heavily influence the way they live their lives.

Depression with psychosis, for the most part, is episodic. It lasts for a certain amount of time and that’s it. However, despite the rareness, there have been documented cases of chronic PMD. This disorder is treated with a unique combination of antidepressants and antipsychotics.

While PMD theoretically is considered a very severe form of major depression, patients with lesser or more mild cases may still experience psychotic features. Paranoid delusions and various cases of misplaced guilt are not uncommon for people dealing with these types of episodes, regardless of the severity of their particular case.

The other well-known symptoms that generally accompany PMD include, but aren’t limited to: insomnia, agitation and a tendency to experience suicidal thoughts.

As per the Diagnostic and Statistical Manual of Mental Disorders (DSM), patients who show at minimum six of the following symptoms over a period of two weeks may be diagnosed with PMD. More specifically, the sufferers need to report either (1) or (3), and (11) along with three or four other symptoms. The symptoms are:

1. depressed mood most of the day nearly every day
2. noticeably increased or decreased sex drive
3. loss of interest or pleasure in all, or almost all, activities most of the day nearly every day
4. significant weight loss or weight gain, OR decrease or increase in appetite nearly every day
5. insomnia OR hypersomnia (sleeping excessively) nearly everyday
6. psychomotor agitation (moving more quickly) OR retardation (moving more slowly) nearly every day, so much that other people notice
7. fatigue OR loss of energy nearly every day
8. feelings of worthlessness OR excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
9. diminished ability to think or concentrate, OR indecisiveness, nearly every day
10. recurrent thoughts of death (not just fear of dying), recurrent ideas about suicide without a specific plan, or a suicide attempt or specific plan for committing suicide
11. delusions or hallucinations
12. increased and intense daydreaming

PMD is a serious mental disorder, and anyone experiencing the aforementioned symptoms should get themselves checked out by a mental health specialist as soon as they can.

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