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Psychotic Depression...really?


Positivenegative

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So I learned, but somehow I always knew (maybe because I used to be a psychologist myself) that I have psychotic depression, or Major Depression with psychotic features. Mine is caused by pre menopause and prolonged chronic depression. I am not big on labels, because whatever the diagnosis, I just care about feeling better. When I am severely depressed, or fatigued, or experience long depressive episodes, I have always had some psychotic symptoms (minor delusions and hallucinations) but they didn't bother me too much because I knew they weren't real even though they felt real. But lately, I have been doing a little research on psychotic depression, and it appears the only real way to treat this 'successfully' is through meds or ECT. Both of those aren't options for me. I'm trying not to let this get me down. But it feels like I have two brains. One that is self aware of what is going on, and the other one that is just not controllable because of the wacky neurological stuff going on. I have another appt with a psychiatrist, but she has been stumped since all she can do is suggest non medical interventions, which have not been successful for years and years. I'm just really ****ing p*****. I really am. This diagnosis makes perfect sense to explain things, but I don't care about diagnoses. I'm just really angry because there is nothing that can be done to control the psychotic part as of now, without meds, and ironically, the even crappier part of all this is that most people with true psychosis aren't as self aware as I am. So I know what is happening, but can't do about it. Just when I thought it couldn't get worse....it did. I guess it's back to radical accepting and praying that something will put me out of my misery. How can one change their psychotic thoughts with no help? It's like trying to grow another arm just by thinking about it. Sorry to rant. This is a real horrible realization.

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PosNeg,

Only getting way out of my comfort zone, making new friends, taking new chances boldly, ripped me out of a similar path.

 

You know everything there is to know, every treatment, every best and worst case scenario of the cold, clinical world.

 

I'm cheering for you to take enormous chances this week, hold eye contact longer and say hi, re-engage at life

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Oh PN, I am so sorry about that.  Considering this isn't full on schizophrenia you might want to do some research on neuroplasticity.  I am not sure if it would cure you completely but if you only began to hallucinate after prolonged depression if you address how being depressed changes the neural pathways of the brain and work to rewire them it may help alleviate the psychosis end of things.  It may take a lot of long term concerted effort on your part to remap your brain but things like daily meditation can do wonders to help the brain start to access more positive feelings and emotions over the negative ones your brain is trapped in.  Our brains are creatures of habit but habits can be broken and they are learning that brains can be remapped and new neural pathways can be created so I honestly don't think all hope is lost for you so do check into meditation and mindfulness practices.  Sounds True has a whole library of helpful podcasts course you might want to check into or even check out YouTube.  There is all sorts of free insights on there.    I am starting to get into mindfulness and meditation myself and it has helped me to start to take a conscious part in shifting my thoughts and moods.  You are incredibly strong to resist the over arching need to get out but I do believe there is still something you can do to take your life back.  It could take a long time, possibly years but I would think that if things started to shift for you even a little you could gain your hope back.  My thoughts are with you.  Hugs.

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I'm with Michelle. There's more ways to treat this than just meds or ECT. I don't see why there being psychotic features being there changes that,

as compared to regular depression. I know this isn't about schizophrenia, but even in there, in many cases people have gotten better without medication. 

How can one change their psychotic thoughts with no help? It's like trying to grow another arm just by thinking about it.

 

 

I know I couldn't deal with severe depression without help, and although a personal choice, I don't think trying to deal with these things alone is the best choice. And I imagine focusing on depression itself and improving it would also improve those thoughts. I have also read stories of schizophrenic people that noticed their psychotic thoughts weren't random, that they were able to connect them to other things like fears or other emotions. Additionally that getting distressed over them can make them worse. Not sure if this applies in your case.

 

But, mostly, I think you should see someone that actually helps, whether another psychiatrist or look into therapy.

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Hi positive 

 

Really sorry to hear that.  :(

 

I have had depression with psychotic symptoms too and although meds never really helped the depression that much they did help those symptoms at the time. I have to say though that for me I have thought the symptoms were an expression of how severe the depression was and I do believe there are other ways of lessening depression. That probably means nothing to you right now from where you are - drowning in the middle of depression - but I do believe it. 

 

If you break this down then it sounds like you are aware that the psychotic symptoms are not real and they arent causing you too much disruption. The important part is getting back to a little more stability. Could you work on self comfort and getting comfort and soothing from others at present? When I am really bad then sometimes thats all I can cope with. 

 

Sadly Ive realised that my brains ability to process theory doesnt usually help me much. 

 

Hugs if Ok. 

Edited by Fizzle
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You should never read anything online or self diagnose yourself. I did this a lot in the past and came up with so many unbelivable things that I thought I could have, it was unreal. All it does is stress you out and the likelyhood of you having any of those things is probably slim.

Sometimes when we over analyze our brains we can trick ourselves.. I experienced some mild self aware hallucinations when I was at my worst with depression. I was nothing more than that..

I would suggest seeing an endocrinologist and being tested for any underlying medical issues... Have them check out your thyroid levels as well.

Edited by Elicia
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I appreciate what you all are saying....I have tried everything mentioned above. Therapy, different psychiatrists, etc....I am not trying to self diagnose, but that is difficult for me since I am a psychologist myself. Sometimes having all the knowledge I have is not a positive for me.

I am aware that I need help, which is why I ask my friends and family, but they have told me they have no idea how to help me. And many professionals have 'fired' me, because they couldn't help. I'm tired of trying. I am open to suggestions. I try to be very grateful for the things I do have. But my brain feels like its splitting in half now. I have periods of not even being aware of who or where I am.

Oh well...I don't like even posting much, although it does help a little, because I don't want to frustrate others. When people are willing to help, and can't, it does get tricky for everyone.

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I appreciate what you all are saying....I have tried everything mentioned above. Therapy, different psychiatrists, etc....I am not trying to self diagnose, but that is difficult for me since I am a psychologist myself. Sometimes having all the knowledge I have is not a positive for me.

I am aware that I need help, which is why I ask my friends and family, but they have told me they have no idea how to help me. And many professionals have 'fired' me, because they couldn't help. I'm tired of trying. I am open to suggestions. I try to be very grateful for the things I do have. But my brain feels like its splitting in half now. I have periods of not even being aware of who or where I am.

Oh well...I don't like even posting much, although it does help a little, because I don't want to frustrate others. When people are willing to help, and can't, it does get tricky for everyone.

Hmm, this may go without saying but have you had a brain scan or been tested for other brain illness like early Alzheimer? You are way more educated on mental health issues and their symptoms than I but to suddenly lose track of who you are or where you are seems to me that other avenues other than just a mental health disorder should be ruled out. In the absence of headaches it very well isn't a tumor but I would push the cognitive and memory issues with a regular doctor and get yourself fully evaluated for things outside the mental health arena just to be sure.  There are other illness that can affect mood not just mental health illnesses.  

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I had a nervous breakdown due to stress and was diagnosed with bipolar with psychotic features during my three month period of insanity. They gave me Depakote and Lamictal and haven't had one symptom since. However, I had never had symptoms of being bipolar before, so I actually think that we might have similar issues. I was originally diagnosed with dysthymia and GAD which makes me think that, like you said, it was the prolonged depression and then my added stress that caused it. I might try to be switched from my current meds just to see if I really need to be on the bipolar ones and not one for depression/anxiety.

 

If the meds help, then take the meds. Most people these days are on at least one medication. It's not worth the suffering without trying at least once.

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No frustration with you/ your situation here positive. Just feeling for you. I wonder if looking for a new t might at least allow you a holding place of sorts. You could vet them to find someone who is going to be able to hear unjudmentally and work with acceptance I certainly know what it feels like to loose sense of who or where I am. I suspect you have the ability to sound rational even when very unwell and I know from personal experience that can be a double edged sword. What do you think would help you now? I know you cant take meds because of health issues, 

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When I was younger I was in fierce denial about my depression and suicidal tendencies.  I knew something was up but chose to ignore and hide it even from myself and it worked to some degree but showed up in some pretty intense fear and anxiety that I also fought really hard to deny until I got a job that was overwhelming with a boss that was over bearing and began to have physical health issues I headed straight towards a nervous breakdown but oddly one day when I was just about to completely break down my brain snapped but instead of heading into the psychotic end of things I wound up finding myself at total peace with the world and myself.  I still had issues but none of it mattered.  I felt completely depression free and instead of wanting out I actually was at a place of wanting to live.  I really thought I had somehow beat depression.  And I did for 10 years until some issues with my heart brought all the fear and anxiety back and in the aftermath caused me to crash into a severe outwardly suicidal depression that was worse than any I had experienced before because I could no longer contain my emotions like I had before.  Needless to say i was quite devastated by it all because the peaceful state was heaven.  Then I found myself here and happened upon a post about Transcranial Magnetic Stimulation and the person who had it done said that afterwards they felt like they were zenned out.  It kind of clicked with me that was where I was when my brain snapped under high duress, into a zen like state.  I honestly can't say how it happened except that I was prone to reading a lot of self help books but I didn't conscious do anything to get there, I wasn't on meds, so I suppose I am just lucky in the sense that my brain at the breaking point snapped in a positive zen state as opposed to negative psychotic state but it also says to me that there may be something to the TMS treatment.  From what I understand it may take quite a few sessions for it to work and I believe it would have to be repeated before a years time to avoid something like what happened to me shifting back into a worse depression but it may be something you want to check into if you haven't.  I looked it up and they seem to use it for migraines, strokes, schizophrenia and treatment resistant major depressive disorder.  I am not sure the long term effects but there is so much we don't know about the brain and how it operates it might be worth checking out if you haven't already.  

Edited by Michelle38
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Thanks all for the suggestions... TMS unfortunately gave me a manic episode and the doctor discontinued it. I would love if a medication could help, but they give me intolerable side effects and I had genetic testing done with indicated that my liver can't process medications very well. I have heard a million times that I'm just not trying hard enough or that I don't give things a try, which isn't true. I will try anything ..I just know my body very well and if something is gonna make me worse, then I get scared. Has any one tried just going for a long vacation? I don't have that much money and I know I would take my problems wherever I go, but sometimes a change of scenery can help reset things at least temporarily. Not sure.

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Positive, You need to start each thread with a paragraph describing the situation. Or put it in your signature! The med, ect, therapy types and TMS  situation.  ;-) 

 

Im not sure what will help you of course. I do know that for me little things can sometimes shift things. Not cure but shift. I have found that if I get a little shift when I am really bad then it can allow other things in and that can ease the situation. It tends to be slow but starts going in the right direction. The same goes for some things setting me on a downward trend.

 

 A holiday did help my husband once. Obviously different situation. Undiagnosed and the only time he had a problem. I think it just allowed a different perspective. We had no money but I did it anyway as I made an educated guess that it would help. 

 

What are your most prominent symptoms? You obviously have the delusions, hallucinations. Do you have psycho motor retardation? Anxiety? Hypervigilance? Interpersonal sensitivity? Ruminations? Insomnia? Is the depersonalisation worse? Im assuming so. What is happening when you loose track of who and where you are? 

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Fizzle...yes that's a good idea. I feel silly repeating myself over and over. I don't like making people feel like I don't care about their suggestions. Because I really do appreciate all of them, even if I have already tried most of them.

To answer your question, my prominent symptoms are severe depression with periods of dissociation that have become way worse then before, confusion, anxiety, suicidal thoughts of course, a lot of physical stuff like dizziness and headaches and fatigue, ruminations and insomnia, and more. I get worse because now when I try to talk with loved ones about my issues, it feels like beating a dead horse. They tell me sorry, they don't know why else to do. And I don't either or course. My tendency when I get confused is to ask alot of questions over and over hoping something will make sense. So I repeat myself alot I guess. Every little thing bothers me. The world seems very harsh and like a sensory overload. I get frustrated but not at anyone specific... Just at the world.

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Thanks all for the suggestions... TMS unfortunately gave me a manic episode and the doctor discontinued it. I would love if a medication could help, but they give me intolerable side effects and I had genetic testing done with indicated that my liver can't process medications very well. I have heard a million times that I'm just not trying hard enough or that I don't give things a try, which isn't true. I will try anything ..I just know my body very well and if something is gonna make me worse, then I get scared. Has any one tried just going for a long vacation? I don't have that much money and I know I would take my problems wherever I go, but sometimes a change of scenery can help reset things at least temporarily. Not sure.

No one here thinks that and even if anyone or the whole planet did who cares.  You know in your heart how hard you are trying.  It's honestly just between you and god.  And it's ok to be scared.  When you keep hitting a wall it is normal to feel scared and defeated but there is a side of you that is not giving up.  That is the side you want to nurture.  I know I spoke to you before about mindfulness.  I found an article online about its possible effectiveness in depression when traditional cognitive approaches have failed. 

 

Here is the article.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303604/ 

 

Like I said before it isn't a quick fix.  It is something that takes time but may help you shift your relationship with your mood which may in turn help you feel better.  I know for me simply going for a walk in the woods was helpful in me walking through my emotions from a mindful and just getting away or lost so to speak perspective so a trip some place you deem peaceful may be of help.  Is there a place that speaks to you from an inspirational perspective?   There is some truth to a change of circumstances helping us shift our thoughts.  I wanted to quit smoking but was struggling.  I smoked like a fiend in the car because it was the one place where i was free to smoke without anyone telling me no but when I bought a new car I made a decision that I would not smoke in the car and to my surprise it was not that hard to not smoke in it.  I did occasionally because no one is perfect but the point is I realized that changing my environment and my relationship with my car helped me to shift my smoking habit a bit when I didn't have any faith I would be able to.  Enough of a shift for me to see I did have a little more control over it than I thought.  So go with your gut on this.  If it feels like a good thing there is no harm in doing it.   But use it as a starting point.  Let go of any expectations about it fixing you and go to be free for a moment.  To experience the feeling of being free that you can reference moving forward.  The one important thing about mindfulness is that we learn to let go of control of trying to fix the situation instead learning to walk through it and change our relationship with the negative in our life so it doesn't have the upper hand and rule our world.  Little shifts help get us towards bigger shifts.  It is a process with time that may help lead us to a tipping point and a new way of life. 

Edited by Michelle38
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Hi :)

Ive  noticed that. You ask open ended questions which then opens things to people doing suggestions. Which I think possibly then fuels your feelings of hopelessness as obviously each time people wont know your whole story or the nuances of what is happening for you. I,m guessing the questions are because you are asking those questions yourself and do genuinely want help. Im just wondering if there could possibly be a way to help you feel more heard and understood. 

 

I totally understand needing to try to make sense of things and questioning as a result. I thik its hard when we usually rely on logic a far amount and then find that isnt enough.  This may not work but I wonder if it might help pre stating that you are exploring something rather than wanting answers from others. I know you would like answers from others and yourself of course. Im just not sure its helping you to approach it from that stand point,  But what do I know! These things are never ever solved in that sense anyway in my experience. Its rather a bit like finding a blanket that gives a little comfort and then working your way up from there. And removing as many sharp instruments from your environment as is possible!

 

I will say that if I was constantly wording things in terms of a solution it would fuel my hopelessness a lot. For me. 

 

Are you agitated and anxious as well? Or more on the slowed down spectrum? Does grounding work at all for you? 

 

You dont repeat yourself by the way so dont worry about that. You always express yourself very well. Are you ever able to just share your emotions and take comfort from others? How are you with accepting your emotions? I hear your hopelessness, pain, frustration and despair. 

Edited by Fizzle
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You guys are better then therapy :-) I realize that being believed is hugely important for me. I am sure this is because I haven't felt believed or understood for a long time. In one way, I'm glad no one understands completely because that means they would have to experience this pain. However, it still feels good when I can talk with people and I don't have to say much because they just know. I wouldn't care about being believed so much if I didn't realize that I need help right now. And I feel like how can people help if they don't understand. I am aware enough to know that it all comes from inside and I have to heal myself with the help of my higher powers. It's just difficult right now when I feel utterly separate from myself and everyone. I keep asking for guidance, but not much is appearing because right now I believe I'm a little too confused to see it. It's there. I just have a block and can't see it or feel it. I went to see a spiritual healer since Western medicine hasn't been helpful, and she told me that I am extremely empathic but refuse to accept it. So I can practice acceptance. But even when I feel like I'm practicing acceptance, I still get confused and things get even tougher. Now im just rambling.

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I say keep rambling.  It is the rambling that helps me sort out my head confusion.  I still run around in circle sometimes from one idea to the next.  I know not the same type of confusion you are talking about and I know a lot of doctors caution against rumination but for me allowing the thoughts to flow helped me to see what was there.   I have some 20 plus odd journals with all my ramblings lol but it was a way for me to clearly see what was on my mind about myself and my world.  So let yourself ramble and see what falls out.  And mindfulness may help still your mind enough to hear the guidance.  I don't just use it for my mood but more so for my racing thoughts and rumination.  I allow my thoughts to be what they are and just try to reel them in when they go dark and astray.  That is what happened a lot with my walks in the woods.  Sometimes I was brought to tears during it because I couldn't stop the negative thought train but after a while my brain would have enough and I would move onto a more positive perspective and feeling as well.  The mood shifts were not grand and all freeing but enough for me to see that I did have subtle shifts in mood.  Seeing that helped me to see that I could begin to sense what times in life triggered me to feel worse which gave clues to where my painful thoughts lived.  But the point is I spent most of my life trying to not be depressed or suicidal and trying to be all put together when I wasn't.  Once I became severely depressed though it seemed to be out of my control I went with the loss of control of my emotions and gave myself a free pass to whatever was going on.  I did things in a responsible way in a private setting or with people I trusted but I stopped putting limitations on how I was supposed to behave and feel and said this is how it is like it or not.  It was liberating and though the experience was initially very intense I found the fact that I stopped running from myself was helping me free myself from the pain I had carried with my my whole life. Not immediately but it is lessening in intensity and I hope one day to be on the other side.   Anyways, it is a process and one that is very personal for each of us.  If there was a one sure fire way to fix things there would not be so many different ways to approach depression recovery.  So honestly just keep asking.  I have lived my whole life without really realizing it, from the ask and you shall receive perspective always constantly asking why or how.  The receiving may not come immediately or even soon sometimes but keep asking and asking and asking and something will shake out. 

 

You have a coach side that you know.  The rational side that you are aware of that knows that there is something there for you to help you even if you can't find it yet.  Keep asking that side of you for help.  I honestly feel like two different people, one who wants to do me in and one that is trying super hard to get rational and positive, but I don't care if that sounds crazy or strange because going with it has helped me and though initially my enemy side was winning out the coach side was ever so quiet but persistently telling me that there is a way out even if I didn't believe it and now it is starting to have a stronger voice than the enemy side. So as they say feed your rational side and keep turning back to it when the enemy side wants to run the show.  You are aware of so just remind yourself that it is just as much a part of you as your enemy side is.  Just because the enemy side has a strong pull right now doesn't mean the rational side is any less a part of who you are.  From a spiritual perspective they say it is more so who you are. But regardless you have proof that you are not only negative thoughts even if they have more power right now.  You do have a part of you that you can turn to.  Remind yourself that when the confusion steps in. And mindfulness may help you feed that rational coach side.     

Edited by Michelle38
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I hear you and believe you that things are extremely painful and hopless right now. 

I hear you and believe you that you are very dedicated and hard working and try to get better. 

I hear you and believe you that you have tried many things that havent helped. 

I hear you and believe you that you know you need help and that you are reaching out for it. 

 

I think sometimes a lot can feel invalidating and isolating when we are in so much pain. Even our own thoughts. 

Edited by Fizzle
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I'm sorry for your pain. I've been there many times and without meds I'm pretty sure I'd be dead now. Are there any meds that you might take that are easier on the liver? Maybe even a benzo for acute anxiety? I had a nervous breakdown last week and those benzos really helped calm me down. I was very suicidal and had terrible nightmares about ******* myself. I'm feeling better but I needed those meds to calm my nervous system down. I hope you find relief soon. Are you working now? Do you have any hobbies? My hobbies can help me by giving me something else to focus on. I wish I could just talk with you because it really sounds like you need people to talk to that really understand the true pain that depression and anxiety can cause. Feel free to PM if you need to.

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