Psychotic Depression: Losing Touch with Reality

Do you know someone who is losing touch with reality? Or someone who believes in their stories and believes things that are not normal? Well, these are the very common symptoms of psychotic depression!

You may already know that clinical depression causes a very sad mood, a lot of tiredness, and an overwhelming feeling of hopelessness. Some people think that psychosis and depression come from the same place.

Psychotic depression is a type of major depression that happens when psychosis happens during an episode of major depression. Getting out of touch with reality can lead to hallucinations or false beliefs. A quarter of people who are hospitalized for depression have psychotic depression.

How Does Clinical Nonpsychotic Depression Differ From Major Depression?

The National Institute of Mental Health says that a person who is psychotic has lost touch with reality. Psychosis is often marked by hearing "voices." Another possibility is that they have very strange and illogical ideas.

The person might think, for example, that other people can read their minds or are trying to hurt them. In other cases, people may think Satan possesses them or that the police are looking for them for a crime they did not commit.

Some people with psychotic depression get angry for no reason, which seems irrational. They may also spend most of their time alone or in bed, sleeping during the day and staying up at night. When someone has psychotic depression, they may stop caring about their appearance and stop showering or changing their clothes.

Or maybe it's just that you can't get along with them. Maybe they can't communicate well or make no sense when they do. Psychosis is something people with a wide range of mental disorders, such as schizophrenia, share.

People with psychotic depression, on the other hand, often have delusions or hallucinations that fit with common themes of depression, like feelings of worthlessness or failure. People with schizophrenia, on the other hand, are more likely to have strange or illogical beliefs that have nothing to do with how they feel. For example, they might think wrongly that strangers are following and bothering them.

People who are psychotic and depressed may also feel bad about their thoughts and try to hide them. If you do this, it will be harder to figure out why you have this kind of depression.

Yet, a proper diagnosis is crucial. Depression with psychotic symptoms needs a different way to treat it. Also, having even one episode of psychotic depression makes the chance of having bipolar disorder, which can lead to repeated bouts of psychotic depression, mania, and suicide.

Types of Psychotic Depression

There are many different kinds of psychotic illnesses, and each one has its own set of symptoms. Below we have listed some examples of these situations −


The vast majority of psychosis cases fall into this group. Losing touch with reality can cause hallucinations, delusions, angry outbursts, and big changes in mood.

Schizoaffective Disorder

This is a type of schizophrenia in which episodes of depression and mania happen at the same time.

Short-term Psychosis

A traumatic event can sometimes cause a person to become psychotic for a short time.

Schizophreniform Disorder

This disorder is very similar to schizophrenia and usually affects young adults and teenagers. It can last between 1-6 months.

What Are the Symptoms of Psychotic Depression?

Disconnection from reality is the defining trait of psychosis and psychotic depression. All these illnesses, even those that share a name, will manifest differently. Yet, there are sure common signs and symptoms. Some examples of common symptoms are −

  • Insomnia.

  • Sensations of surveillance.

  • Incoherence in thought.

  • Weird hallucinations, both auditory and visual.

  • Cognitive dissonance leads to delusion.

  • Spoken or written communication that is difficult to understand.

  • Lack of appropriateness.

  • She stays away from parties and other social gatherings.

  • Deterioration in one's academic or professional performance.

  • Facial contortion or another unusual bodily movement.

  • Behavior is indicative of paranoia.

  • Strange fixation.

  • Misplaced anger or irrationality.

  • Having a hard time focusing.

  • Absence of care or concern for one's physical appearance or personal hygiene.

  • The way one acts and thinks evolves through time.

  • Positive clinical outcomes are more likely when the condition is diagnosed and treated early.

Treatment for Psychotic Depression

People with psychotic illnesses are mostly helped by psychotherapy and medicine. Listed below are a few ways to treat a patient with psychotic depression −

  • During treatment, the person will take part in psychotherapy sessions. The main goal is to get the person's mind working normally again. Individual counseling and group/family therapy are both part of the curriculum.

  • Depending on what the meetings are about, people can talk about their mental health struggles in a safe and supportive setting. These groups encourage peer support and give people a safe place to discuss their problems.

  • A big part of therapy is getting better at coping and getting along with other people. Because of this, they will have the skills to improve their relationships with others.

  • Prescribed medicines are meant to make symptoms less painful. It makes people's lives better.

  • ECT is a choice for people with severe psychosis who haven't gotten better from taking medicine.

  • Holistic therapies can be used to help deal with stress. Patients learn how to bring themselves back to the present moment at any time through this method.

  • Living arrangements that help the patient get better might be good for him or her. This home provides a safe place for the patient to make the slow but steady transition back to normal life.


Schizophrenia, bipolar disorder, and other psychotic diseases are serious mental illnesses that lead to distorted thought processes and altered perceptions. Patients suffering from psychoses are often detached from reality. Delusions and hallucinations are two major indicators.

Delusions are erroneous ideas, such as suspecting a plan against you or seeing hidden messages on your television. Hallucinations are erroneous experiences of sensory stimuli such as hearing, seeing, or experiencing an object or event that is not there.

The treatment of psychosis is condition-specific and depends on the underlying reason. Medication for symptom relief and psychotherapy are also potential components. Serious circumstances when a person poses a risk to herself or others may need hospitalization.