Psychotic depression is a serious mental health condition where someone experiences both depression and symptoms of psychosis, such as delusions or hallucinations. It can affect anyone and often needs specialist support.

Understanding psychotic depression

Psychotic depression, sometimes called depression with psychotic symptoms, is more than feeling low. It means living with moderate or severe depression alongside psychosis. This combination can make daily life especially challenging.

What are the symptoms?

Symptoms of depression:

• Persistent low mood, sadness, irritability, or anger
• Loss of interest in things you usually enjoy
• Tiredness and low energy
• Changes in sleep or appetite
• Feelings of guilt or worthlessness
• Thoughts of suicide
  
  

Symptoms of psychosis: 

• Delusions: strong beliefs that aren’t shared by others, such as feeling watched or believing you have special powers
• Hallucinations: seeing, hearing, or sensing things that others don’t
• Cognitive difficulties: trouble with memory, concentration, or making decisions
  
  

How is psychotic depression diagnosed?

A psychiatrist will carry out a mental health assessment, often using guidelines like the ICD-11 or DSM-5. This helps them understand your experiences and decide on the best support.

What treatment is available?

Treatment usually involves a mix of:

• Medication: antidepressants and antipsychotics.
• Talking therapies, such as cognitive behavioural therapy (CBT).
• Social support, which might include help from family, friends, or support groups.
  
  

In some cases, hospital care or electroconvulsive therapy (ECT) may be recommended, especially if symptoms are severe.

Getting support

If you or someone you know is affected by psychotic depression, you’re not alone. Rethink Mental Illness offers information, advice, and support for people living with mental health conditions and their loved ones.