,

5 Things You Should Know About Psychotic Depression

psychotic depression symptoms and treatment

Image courtesy of Pixabay.com

Psychotic depression (also known as major depression with psychotic features) is a very serious form of disorder characterized by delusional thinking affected by mood swings and observable changes in cerebral tissue. It is estimated that 10 to 15 percent of people with severe depression will eventually develop symptoms of psychosis. It is considered to be underdiagnosed and undertreated, though scientific knowledge and awareness regarding this form of depression have been on the rise in recent years due to advances in research.

Psychotic depression is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM)-V as a subclassification of major depressive disorder. One key optic the disorder exhibits is a combination of depressed mood with psychosis, typically in the form of persistent and morbid hallucinations or delusions.

Psychosis: the Lowdown

What is psychosis? Psychosis can occur in the form of an episode or a condition in which an individual cannot clearly distinguish between what is real and what is imagined.

A “psychotic break” occurs when an individual experiences an episode of acute psychosis after a significant symptom-free period, though more typically for the very first time. This psychotic break may or may not be related to depression. Similarly, a psychotic disorder, or delusional disorder, can occur independently of or in relation to a depressive disorder.

Psychotic, or psychosis, symptoms typically develop after the patient has had several bouts of severe depression without psychosis. Once psychotic symptoms have manifested themselves, they tend to reappear with each future depressive episode.

Anyone who has been diagnosed with major depressive disorder should become educated in psychotic depression to better understand what they might need to be on the watch for. Here are five things to be aware of.

  1. Misdiagnosis of psychotic depression is often a result of clinicians’ lack of recognition of pertinent psychotic symptoms, according to the National Institute of Mental Health (NIMH). Close to one-third of observed misdiagnoses in one study most commonly misdiagnosed psychotic depression as major depressive disorder without psychotic features. Other misdiagnoses included depression not otherwise specified (NOS), or mood disorder Surprisingly, none of the misdiagnosed individuals were considered to have any psychotic disorder whatsoever. This appears to suggest that the diagnosing mental health professionals were completely missing the psychosis rather than the mood disorder.
  2. Major depressive disorder (including psychotic depression) and dysthymia (persistent depression) can “play off” of one another to create what is known as “double depression.” When dysthymia is present, a major depressive or depression-related psychotic episode can end, but an individual will revert to his or her normal, chronic level of persistent depression. Without proper treatment for double depression, the individual is likely going to continue relapsing into double depression.
  3. Psychotic depression and bipolar disorder have shown signs of being interrelated. A family history of bipolar disorder has been shown to be a risk factor for psychotic depression but not for non-psychotic depression. Research has indicated that individuals with psychotic depression (particularly those diagnosed at an early age), may have a higher risk than non-psychotic depressed individuals of later developing bipolar disorder. Those related to individuals with psychotic depression are also at higher risk of developing bipolar disorder than relatives of those with nonpsychotic depression.
  4. Hallucinations vs. Delusions. Hallucinations are more typically visual or auditory, though they may also be olfactory (smell) or tactile (touch). Delusions may or may not be tied in with an individual’s depressive mood (mood-congruent delusions vs. mood-incongruent delusions). Mood-congruent delusions might involve overwhelming feelings of inferiority, illness, severe guilt, or deserving of punishment. Mood-incongruent delusions might involve heightened, artificial feelings of grandeur, despite a depressive mood (you may have heard the term “delusions of grandeur”). About half of those coping with psychotic depression experience more than one kind of delusion, usually without any hallucinations.
  5. It is common among those with psychotic depression to also experience severe anhedonia, or the inability to take pleasure in activities that are commonly considered to be pleasurable. Social anhedonia is a pronounced lack of interest in social contact, and decreased pleasure in social situations. Physical anhedonia is an inability to feel sensory pleasures in regard to eating, touching, or sex. Psychomotor retardation (a slowing down of cognitive processes and significantly slowed physical movements) is another common symptom of psychotic depression.

Needless to say, psychotic depression can be dangerous to someone. If you suspect that you or someone you love might be having a psychotic episode, or worse, might become suicidal or exercise poor judgment that could end up being dangerous for anyone, get help as quickly as possible. If you are protecting a loved one, avoid a confrontation and secretly hide car keys, guns, alcohol, and any drugs, prescription or illegal, that could possibly result in an overdose. If a situation becomes urgent, you may need to call 911 and request a “mental health check.”

Are you or someone you know dealing with hallucinatory experiences in addition to depressive symptoms? It doesn’t have to get into crisis mode before professional help is sought. Arrange a visit to talk to someone about mental health issues that seem overwhelming. Consider reaching out to our expert team at Solara Mental Health at 844-600-9747.

,

Am I Bipolar? Top Indicators of Bipolar II Disorder (2nd Article in a Series of Two)

 

Bipolar II Disorder

Image courtesy of Pixabay.com

 

Bipolar II Disorder symptoms are very similar to Bipolar I Disorder. A bipolar disorder treatment program requires an accurate diagnosis in order to be effective. Bipolar disorder is a frequently misunderstood diagnosis.

In a previous article we discussed some of the top indicators of Bipolar I Disorder . In this article we will discuss some of the top indicators of Bipolar II Disorder.

All types of bipolar disorder (cyclothymic disorder (or cyclothymia) and other specified and unspecified bipolar and related disorders are other, less common types of bipolarity) are distinctly marked by episodes of extreme highs (mania, or manic episodes) and extreme lows (depressive episodes).

Depressive episodes are very much alike with both Bipolar I and Bipolar II disorders, and there are few surprises in this regard. The primary difference between the two types of disorder is found in the extremity of the manic episodes that are the result of each. The mania is significantly greater with Bipolar I, while Bipolar II exhibits a condition known as “hypomania,” which is essentially a much lesser degree of mania. What does that mean? Manic behaviors are typically more severe, and are considered to be “out of character,” or even dangerous for the manic individual. Hypomanic behaviors might seem “out of character” for the individual, but would not necessarily be considered “abnormal.”

Bipolar I Disorder

To be properly diagnosed with Bipolar I Disorder, you need to have experienced at least one manic episode (so severe that hospital care was required), preceded or followed by a depressive episode.

Manic episode symptoms are generally so intrusive and poignant that there is little room for doubt that something is “off.” Such episodes are typically characterized by recognizable bipolar disorder symptoms such as:

  • state of euphoria (unexplainable happiness, elation)
  • disturbed sleep
  • restlessness
  • high energy levels
  • compulsively “explosive” temper, argumentative, and confrontational
  • disturbed concentration
  • risky behaviors (including promiscuity, substance abuse, excessive gambling, compulsive shopping, etc.)

 

Bipolar II Disorder

Bipolar II is commonly misdiagnosed as depression. Granted, it often involves major depressive episodes lasting at least two weeks, as well as at least one hypomanic episode. Note that Bipolar II mania is usually not severe enough to require hospitalization.

When the mania that would indicate bipolarity is dormant, the focus naturally falls on the individual’s depressive symptoms.

Bipolar Disorder Causes

We still don’t know exactly what the root cause of bipolar disorder is. Popular beliefs include: abnormal cerebral characteristics (physical), an imbalance in cerebral chemicals, and certain genetic characteristics.

Like other medical conditions, bipolarity is often passed along through families. Those with parents or siblings who have bipolar disorder run a greater risk of developing it themselves. The genetic source of bipolar disorder also continues to be a mystery.

It’s commonly acknowledged that substance abuse, acute stress, and/or emotionally traumatic episodes may trigger bipolarity. Such triggers include childhood abuse, the loss of a loved one, PTSD, etc.

Bipolar Disorder Treatment

Bipolar disorders are usually treated with a combination of medications and psychotherapy. You should discuss side effects and interaction effects of any medications prescribed by your mental health professional with him or her.

Mood stabilizers are generally the first go-to pharmaceutical for treatment, and these can be taken for an extended duration. Lithium has been a widely used mood stabilizer for several years. Though it does have several potential side effects, including decreased thyroid functioning, indigestion, and joint pain. An antipsychotic medication (sometimes more than one) can be carefully selected and prescribed in an appropriate dosage by your health care professional to treat manic episodes.

Regarding psychotherapy, often talking about your experiences openly and honestly with someone you trust can give you valuable insights into your mental illness, as can journaling. Pay attention to your moods, sleeping and eating patterns, and significant life events to help you and your mental health professional understand how the medications and psychotherapy are working. If overall symptoms don’t show an improvement or decline, your doctor may suggest changing up your medications, or may try a different psychotherapeutic approach.

Moving Forward

There is no cure for bipolar disorder, at least not yet. Proper treatment and support from your family and friends will help you manage your symptoms and quality of life. Be sure to keep your family and friends in the loop regarding your treatment, and follow your mental healthcare professional’s directions in regard to medications and lifestyle choices, including:

  • Diet
  • Sleep
  • Alcohol and/or drug use
  • Stress management

Learn as much as you can about bipolar disorder, as the more you know about your condition, the more in control you will feel as you manage your mental illness. You may gain insights to help you repair damaged or strained relationships. Helping those in your life better understand your condition can help them be more understanding regarding past hurtful interactions.

Always remember that this is a manageable condition, and that you are not alone. Talk to your mental health professional or contact local hospitals about local resources and support groups.

Are you concerned about the possibility that you or a loved one may have bipolar disorder? Don’t fret! It’s treatable and manageable! If you or someone close to you need to talk to someone about mental health issues that seem overwhelming, we can help. Consider reaching out to our expert team at Solara Mental Health at 844-600-9747.

,

Bipolar Disorder – Signs, Symptoms, & Definition

bipolar disorder girl tied up on railroad tracks

 Image courtesy of Pixelbay

Bipolar Disorder: How to Recognize It

Some sort of bipolar disorder test may have appeared on your radar at some point, either for yourself or for someone you love. Unfortunately, though we can easily recognize many common bipolar symptoms, there is no such thing as a quick and easy fail-proof medical test (or X-ray, brain scan, MRI) that can result in a reliable bipolar disorder diagnosis.

In fact, it is not uncommon for someone with bipolar disorder to be misdiagnosed as something else, such as Attention-Deficit/ Hyperactivity Disorder (ADHD).

What is bipolar disorder?

Let’s begin with a working definition. Bipolar disorder (also known as manic-depression or bipolar depression) has been classified as a type of mood disorder. Those who live with it are known to swing back and forth from feeling severely depressed and unable to muster the energy to get out of bed some days to feeling energized, creative, sleepless, and invincible (or manic) on others.   

In between bipolar depressive and manic episodes, people with bipolar can enjoy periods of relative stability and “normalcy,” though the extreme volatility in mood is much more serious for them than the common ups and downs that most people go through. The treatment and diagnosis of bipolar disorder requires the attention of a specialist with expertise in mood disorders.

Bipolar Symptoms

If you have ever experienced depression for two weeks or more, if that depression was so severe that it made normal daily activities almost impossible without a lot of effort, if you have lost interest for extended periods of time in activities that typically bring you pleasure (anhedonia), or if a mental health professional has ever suggested that you may have symptoms of bipolar…those are strong indicators that you may indeed have it.

If you have been diagnosed, or suspect that you may be living with it, following are some things you should know.

Recognizing bipolar can be tricky. When someone with bipolar symptoms is on a manic high or going through a “normal” stage, he or she might actually be enjoyable to be around. Or, some people never get too manic on their own, and are depressed more often than not. When antidepressants are prescribed without a mood stabilizer for such individuals, it can send them into a full-blown mania. Over time, the mania followed by the lows can become more noticeable and poignant.

There are more types of bipolar disorder than you might be aware of. The disorder is about more than just mood extremes. Bipolar disorder types are classified as bipolar I, bipolar II (more severe), cyclothymia (more mania with less depression), rapid cycling (four or more episodes within 12 months), or “mixed state” (when depression and mania happen concurrently).

Manic episodes can affect someone in the same way as psychosis. Mania in the context of bipolar are not always merely periods of mood “highs.” Along with the spike in energy and creativity comes less of an inclination to eat properly and get enough sleep, which can lead to delusional thinking or hallucinations, both of which are telltale symptoms of psychosis.

It is treatable, though there’s no known cure. This is a long-term condition with no fail-safe cure, at least not yet. The good news is that with bipolar treatment, the negative effects can be significantly reined in. Between medication (to treat depression and mania, as well as to stabilize the bipolar individual’s mood), lifestyle changes such as exercise, adequate sleep, and healthy eating, and treatment, there are plenty of approaches for someone with the disorder to take.  

When someone with bipolar symptoms begins to recognize the things and situations that trigger his or her mood swings, it becomes easier to map out a treatment approach. And then, coping and managing the disorder begins to become second nature, as does getting on with your life.  

Having trouble starting a hard conversation about yourself or a loved one having bipolar symptoms? If you or someone you love need to talk to someone about bipolar symptoms or feelings of being overwhelmed, we’d like to help. Consider reaching out to our expert team at Solara Mental Health at 844-600-9747.