Psychotic symptoms

If you are suffering from severe depression, you may get psychotic symptoms. With a psychotic depression you also have negative thoughts. But your thoughts are unrealistic and difficult for others to understand.

You may have thoughts of guilt, taking the blame for serious accidents and catastrophes that have nothing to do with you. You may also be convinced that you are a bad person, and you may feel so condemned that you believe you deserve to die or be punished severely.

Your appetite and thirst can become so reduced, and in some cases people stop eating and drinking altogether. This is potentially life threatening and would usually require medical intervention and hospital admission.

Can become dangerous

When you are suffering from a psychotic depression, you have no perception of reality. You are not fully capable of taking care of yourself - and this can become dangerous. With a psychotic depression you always need to be admitted to hospital, in order to be protected and treated. If the situation becomes critical or dangerous, the doctor always needs to be called in. Either a GP or the mental health team should be called in for an assessment. If necessary, you may be admitted to psychiatric care against your will.

Paranoia

With a psychotic depression you can become paranoid and feel persecuted. You may convince yourself that certain people or secret organisations are out to hurt or punish you. You may believe that you are an innocent victim. But often your depressive thoughts cause you to believe that you deserve to be persecuted and punished.

Hallucinations

With a psychotic depression you also get hallucinations. You may hear voices that speak derogatorily about you or tell you that you must be punished. The voices can also encourage you to punish yourself - perhaps commit suicide. With a severe depression you may also have serious suicidal thoughts without having hallucinations. Severe depression is therefore a very serious illness, which require admission to hospital

An example

One autumn an elderly man was admitted to a psychiatric ward with severe depression. He was anxious, restless and had psychotic symptoms. He was unable to sit still due to the unrest. He told his story rather incoherently and was interrupted by self-criticism and sighing. This is his story:

"During the summer months, we spend most of our time in our allotment. We grow vegetables there for our own use. We have a little house and a shed. We cook food on a little gas hob with a gas cylinder. In the spring, we prepared for the summer. I therefore cleared out the shed as usual.

In the shed I found a gas cylinder. There was still a little gas left in it. I decided that it was dangerous to keep it there. I therefore took a screwdriver and pressed on the valve. The gas was let out this way. Afterwards I put the gas cylinder back. Later I wanted to exchange it for a new one.

The summer was warm and dry. There was a watering ban but we watered secretly. But the soil dried out anyway. It cracked. The leeks and all the other vegetables withered. I know I caused the drought by letting out the gas. I destroyed the ozone layer.

Not only have my vegetables and the harvest in my country failed. I'm also to blame for the drought and hunger catastrophes in the world. I saw a program about the hunger in Africa the other day. Children were dying. It's my fault, and I feel that I no longer have the right to live."

Its obvious that this man was not in touch with reality. Luckily his wife quickly arranged for him to be admitted to hospital and to start appropriate treatment in a safe environment.