Therapy for Psychotic Depression

Psychotic depression is a mental disorder characterized by a chronically depressed mood accompanied by psychotic symptoms. These psychotic symptoms can include any type of break with reality, such as delusional thinking or auditory and visual hallucinations. The difference between psychotic depression and other psychotic disorders is that sufferers are fully aware that their psychotic symptoms are not real. Psychotic depression can become extremely debilitating for its victims, so proper treatment is vital. Two effective treatments for psychotic depression are an antidepressant/antipsychotic medication combination and electroconvulsive therapy.

Antidepressant/Antipsychotic Therapy

• Psychotic depression often is treated with a combination of tricyclic antidepressants and antipsychotic medications. Tricyclic antidepressants are a class of medications that manipulate levels of three neurotransmitters in the brain: dopamine, serotonin and norepinephrine. These medications work to regulate mood and relieve feelings of depression and anxiety. However, antidepressants typically are not an effective treatment for psychotic depression on their own. Treatment with antidepressants usually is more effective when used along with antipsychotics. Antipsychotic medications treat psychotic symptoms such as hallucinations and delusions. When both an antidepressant and an antipsychotic are used, they can help reduce both symptoms of psychotic depression.

Electroconvulsive Therapy

• Another effective, yet controversial, option for treating psychotic depression is the use of electroconvulsive therapy, or ECT. Also referred to as shock therapy or electroshock therapy, ECT is recognized as a valuable treatment. However, it has a rather negative connotation for many patients and supporting family members. Many people see ECT as a traumatic or painful experience. Some of the fear surrounding this treatment comes from the fact that the point of the process is to induce a seizure, which is thought to "reset" the brain.

  ECT is performed while the patient is under the influence of a sedative and a muscle relaxant, so the severity of the seizure is greatly reduced. The seizure usually lasts for less than a minute. There are some side effects associated with ECT, the most well-known of which is temporary short-term memory loss. Other side effects include headache, nausea, increased heart rate, increased blood pressure and muscle aches.