Psychosis is a condition in which a person begins to see and/or hear things that aren’t really there or experience false ideas about reality.  When psychosis occurs alongside depression, it is called psychotic depression. Women are twice as likely as men to develop depression than men. About two-thirds of those who develop severe depression are women. Also, people who experienced adversity as children are more predisposed to depression. A person with psychotic depression will experience a combination of depression symptoms, such as depressed mood, diminished interest or pleasure in activities previously enjoyed, fatigue or lack of energy, feelings of worthlessness or guilt, inability to concentrate, significant changes in weight and appetite, and sleep difficulties.

One possible cause of psychotic depression is a combination of genes that are inherited from a person with this type of depression. Certain genes might be responsible for depression symptoms while others might be responsible for psychotic symptoms, making it possible for an individual to inherit a genetic vulnerability to depression, psychosis, or both. Another theory is that high levels of the stress hormone cortisol could be involved. High levels of cortisol are often found in people with depression.

The diagnosis of usually involves a medical history. Your doctor will ask questions about your symptoms and family history. An evaluation by a physician might also include testing to rule out other potential causes of the patient’s psychotic symptoms, such as drugs, another medical condition, schizophrenia. The American Psychiatric Association (APA) recommends either the combination of an antidepressant and antipsychotic or electroconvulsive therapy (ECT) as the first-line treatment for psychotic depression. Common antidepressant medication choices include serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Evidence suggests that combination therapy with an antidepressant like an SSRI or SNRI plus an antipsychotic is more effective than either of the two medications alone. MLA