Psychotic Depression

What is Psychotic Depression?

Psychotic depression, also known as major depressive disorder with psychotic features, is a severe form of clinical depression. It's associated with psychosis, which involves experiencing and interpreting reality in a distorted way.

Typically, psychotic depression is marked by depressive symptoms (e.g., intense sadness, anhedonia, changes in appetite and sleep) combined with psychosis, which can manifest as hallucinations or delusions. Hallucinations are sensory disturbances that involve seeing, hearing, feeling, or smelling something that isn’t actually there. Delusions are false beliefs maintained despite clear evidence to the contrary.

Factors Associated with Psychotic Depression

Although the exact cause of psychotic depression is unknown, it may be related to several factors, including:

  • Genetics: People whose family members have a history of mental illness, such as major depressive disorder or schizophrenia, may be at higher risk for developing psychotic depression.
  • Brain chemistry: the neurotransmitters dopamine, serotonin, and norepinephrine are thought to regulate mood and thought. Some studies suggest that psychotic depression is associated with an imbalance in one or more of these brain chemicals.
  • Drug or alcohol abuse: Excessive alcohol or drug use can increase the risk of developing psychotic depression.
  • Certain medical conditions: Illnesses such as stroke or trauma can impact brain functioning and lead to psychotic depression.


Psychotic depression is often treated with a combination of medication and psychotherapy. Medication such as tricyclic antidepressants, serotonin reuptake inhibitors, and antipsychotics may be prescribed to help improve mood and reduce the symptoms of psychosis. In addition, psychotherapy, such as cognitive-behavioral therapy (CBT), can help people identify and manage problematic thinking patterns and behaviors.

With proper treatment, people with psychotic depression can find relief from their symptoms and improve their quality of life.