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Can Severe Depression Cause Hallucinations

How Do You Know If Youre Having A Nervous Breakdown

In treating schizophrenia, a balancing act between drug and talk therapy

“Nervous breakdown” is not a medical term, but it is often used colloquially to mean intense mental and emotional distress.

In terms of major depressive disorder, symptoms of psychosis, including hallucinations and delusions, can occur. When this happens, it is called MDD with psychotic features, or psychotic depression.

Can Depression Cause Psychosis

The short answer to this question is, Yes. Depression can cause psychotic symptoms, including delusions and hallucinations. These symptoms will most often reflect depressive themes like personal inadequacy, guilt, disease, death, punishment, and worthlessness. For example, a person who is experiencing depression with psychosis may develop false beliefs that he or she is afflicted with a physical illness or hear ridiculing, criticizing voices. In addition to these types of symptoms, people experiencing depression with psychosis might experience other symptoms typical of depression such as agitation, anxiety, hypochondria, insomnia or excessive sleep, poor concentration and lack of energy or motivation.

Psychosis is more common in severe depression, affecting roughly one in four people who are admitted to the hospital for depression. Those who have experienced one episode of psychosis with depression can be at an increased risk of recurrent depressive episodes, bipolar disorder, and suicide. For these reasons, accurate diagnosis is important.

A person who is experiencing depression with psychosis may develop false beliefs that he or she is afflicted with a physical illness or hear ridiculing, criticizing voices.

Psychotic Depression And Bipolar Disorder

Psychotic depression is more likely than nonpsychotic depression to have a bipolar outcome , and episodes of bipolar depression are more frequently associated with psychotic symptoms than are episodes of unipolar depression . Indeed, a strong predictor of psychosis in the course of a mood disorder is bipolarity . Of adults with psychotic depression in community samples, 48.5% have received a diagnosis of bipolar I, and 10.5% a diagnosis of bipolar II, mood disorders . An eventual diagnosis of bipolar disorder is especially common in early-onset psychotic depression . Relatives of patients with psychotic depression have a higher rate of bipolar disorder than relatives of patients with nonpsychotic depression, and depressed relatives of patients with bipolar disorder are more likely to have psychotic features than are depressed relatives of controls . As in unipolar depression, psychosis accompanying bipolar disorder is associated with an earlier age at onset of the mood disorder, more affective symptomatology and chronicity, a greater number of admissions, longer hospitalizations, more psychiatric comorbidity, and a poorer prognosis .

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The Dangers Of Psychotic Depression

While all forms of severe depression can have a significant impact on quality of life and complicate prognosis, psychotic depression presents heightened risks. Grace Rattue writes, The course of the disorder is linked to elevated rates of relapse and higher long-term psychosocial impairment, as well as higher mortality rates than . Although this can be explained in part due to the fact that people with psychotic depression tend to be clustered in the more severe end of the depression spectrum, it may also be attributed to the unique symptomatology of psychotic depression.

Psychotic symptoms can be deeply disturbing and functionally disruptive, impairing the ability to participate in positive, meaningful social relationships and vocational activities. People with psychotic depression are also more likely to experience symptoms such as rumination, insomnia, psychomotor disturbances, and cognitive dysfunction than people with non-psychotic depression, further compromising emotional wellbeing and functional ability. Additionally, psychotic depression is associated with a higher risk of developing bipolar disorder.

The widespread under-recognition of psychotic features in major depression may be the result of a variety of factors, including:

Whatever the reasons, the result is that many people who have major depression with psychotic features do not receive the care they need to heal and remain at heightened risk for poor outcomes.

Can Anxiety Cause You To Feel Things That Arent Real

Can Major Depression Cause Psychosis?  BrightQuest ...

Anxiety stresses the body, and stress can cause hallucinations. Hallucinations can affect any of our senses, including the sense of touch. So, yes, anxiety can cause you to feel things that arent real, such as a crawly skin feeling, feeling like someone touched you when no one did, burning, itching, etc.

Visit our Anxiety Skin Symptoms article for more information.

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Psychotic Depression Treatment And Prognosis

People with psychosis may require emergency hospitalization before entering an inpatient or outpatient treatment program. During their hospitalization they may be administered antipsychotic medications such as Zyprexa, Seroquel, or Risperdal, which can stabilize their conditions by halting the progression of their hallucinations and delusions.

In formal inpatient or outpatient treatment programs for psychotic depression, psychotherapy in individual, group, and family formats will be combined with appropriate medications, which generally includes a mixture of antipsychotics and antidepressants. Treatment and rehabilitation may be further advanced through the addition of holistic healing practices, life skills classes, educational offerings, and any individualized services recommended by members of a patients treatment team. If a dual diagnosis for substance abuse has been made, treatment programs may include services specifically tailored to assist in the detox and recovery process.

Because of the disabling nature of the disorder, long-term treatment for psychotic depression is usually necessary. That may include an extended stay in residential inpatient treatment programs , plus participation in aftercare regimens that continue for several months following the cessation of formal treatment.

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Symptoms of depression can occur along a spectrum both in duration and severity. Mild depression can occur during periods of stress but resolve with time and may not require any specific treatment. Moderate to severe depression causes chronic symptoms and usually requires at least one form of treatment, if not multiple treatments.

Generally speaking, severe depression requires some type of treatment to find some relief. Additionally, depression severity can change over time, growing increasingly worse or alternating between mild and severe during the same depressive episode.

If someone has severe depression, they may self-harm, have suicidal thoughts, or be at risk for attempting suicide. If you are severely depressed, help is available to help you manage your symptoms and ensure your safety and well-being.

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Prevalence And Risk Factors

It is estimated that about 3% to 11% of all people will experience severe depression during their lifetime. Of those who experience severe clinical depression, about 14.7% to 18.5% will develop depression with psychotic features. This type of depression also appears to become more common as people age.

It is, however, impossible to predict who exactly might be prone to psychotic depression, as not enough is known about the conditions causes.

The definitions and measurement tools for depression evolve and change, meaning that these statistics are always shifting. From what we know now, some of the factors that may make you more prone to depression, in general, include:

  • Being a woman: Women are twice as likely as men to develop depression about two-thirds of those who develop severe depression are women.
  • Having a difficult childhood: People who experienced adversity as children are more predisposed to depression.
  • Having a parent or sibling with depression: A propensity toward depression, especially severe depression, tends to run in families. If you have a parent or sibling who has had depression, you are more likely to develop it yourself.

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Can Extreme Stress Cause Dementia

Yes, Gluten & Autoimmunity Can Cause Severe Depression, Psychosis, OCD, Anxiety and More

The current evidence indicates that while prolonged stress may play a role in development or progression of dementia, having chronic stress does not necessarily cause dementia. Hopefully further research can begin to uncover what role, if any, stress does play in a person’s risk of developing dementia.Farvardin 26, 1396 AP

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When To Contact A Medical Professional

If you are thinking about hurting yourself or others, call 911 or the local emergency number right away. Or, go to the hospital emergency room. DO NOT delay.

You can also call the National Suicide Prevention Lifeline at 1-800-273-8255 , where you can receive free and confidential support anytime day or night.

Contact your provider right away if:

  • You hear voices that are not there.
  • You have frequent crying spells with little or no reason.
  • Your depression is disrupting work, school, or family life.
  • You think that your current medicines are not working or are causing side effects. Never change or stop any medicines without first talking to your provider.

Hallucination In Neurological And Organic Mental Disorders

Formed and unformed visual hallucinations occur as a result of cortical lesions involving the occipital and temporoparietal areas. Olfactory hallucinations and gustatory hallucinations are usually associated with temporal lobe lesions and lesions in the uncinate gyrus. Crude auditory hallucinations are more common in these conditions than formed ones. Peduncular hallucinations produce vivid, non-stereotyped, continuous, gloomy or colorful visual images that are more pronounced in murky environments. These complex visual hallucinations arise due to lesions that straddle the cerebral peduncles or involve the medial substantia nigra pars reticulata, bilaterally. Hallucinations have been reported in sleep disorders such as narcolepsy. Systemic lupus erythematosis , which involves the central nervous system, may present as hallucinations. In the above conditions the modality and content of hallucinations depends on the area of the brain involved.

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Treating Anxiety Disorders With Psychotic Features

Arriving at an accurate diagnosis is the first step in determining how to treat someone who has both severe anxiety disorder and exhibits psychotic features. Taking all aspects of the illness into consideration will assist clinicians in arriving at a specific diagnosis. Because different types of anxiety require slightly different treatment approaches, this initial assessment phase is key.

Treatment for the condition will likely involve an integrated approach, including:

Psychotherapy: Psychotherapy will include both individual therapy and group therapy. The individual cognitive behavioral therapy sessions allow the therapist to help the individual identify irrational thoughts and fears and maladaptive emotional responses. CBT is highly effective for treating PTSD, OCD, generalized anxiety disorder, and phobias. A recent study published in Dialogues in Clinical Neuroscience concluded with the statement, the research on CBT in anxiety disorders supports the efficacy and effectiveness of these methods, with most of the current research demonstrating the usefulness of providing exposure therapy in the treatment of anxiety disorders.

Group therapy: Group sessions provide opportunities for small groups to discuss and share their anxiety issues while being facilitate by a therapist who guides the topics. These intimate group settings provide a safe environment for sharing and foster peer support in the process.

What Causes Psychotic Depression

Can Depression Cause Hallucinations

The cause of psychotic depression is not fully understood. It’s known that there’s no single cause of depression and it has many different triggers.

For some, stressful life events such as bereavement, divorce, serious illness or financial worries can be the cause.

Genes probably play a part, as severe depression can run in families, although it’s not known why some people also develop psychosis.

Many people with psychotic depression will have experienced adversity in childhood, such as a traumatic event.

Treatment for psychotic depression involves:

  • medicine a combination of antipsychotics and antidepressants can help relieve the symptoms of psychosis
  • psychological therapies the 1-to-1 talking therapy cognitive behavioural therapy has proved effective in helping some people with psychosis
  • social support support with social needs, such as education, employment or accommodation

The person may need to stay in hospital for a short period of time while they’re receiving treatment.

Electroconvulsive therapy may sometimes be recommended if the person has severe depression and other treatments, including antidepressants, have not worked.

Treatment is usually effective, but follow-up appointments so that the person can be closely monitored are usually required.

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Different Views On Psychosis

You may feel that a mental health crisis linked to your psychosis is part of a spiritual crisis. It may have encouraged spiritual growth. You may find support from others who share your views helpful. For example, within faith communities.

Some people feel that their mental health crisis has been positive and has caused growth in their personal lives.

You may believe that psychosis can be caused by a deeper psychological distress, which can be worked through. For example, if you feel as though your life is being controlled by outside forces, this might come from feelings of lack of control in your life.

You can find more information about Spirituality, religion and mental illness by clicking here.

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A Transdiagnostic Psychosis Trait

Although the association has been questioned , a family history of diverse psychotic disorders including schizophrenia, psychotic bipolar disorder, and psychotic major depression is more common in psychotic than nonpsychotic depression . Furthermore, there is some evidence that the content of delusions and hallucinations may be similar in psychotic relatives of psychotically depressed patients, regardless of the actual psychotic disorder , suggesting a transdiagnostic psychosis phenotype that overlaps affective and nonaffective psychotic syndromes . This phenotype may be more strongly expressed in bipolar disorder, in which a family history of schizophrenia occurs in 14% of patients, while 15% of schizophrenia probands have a bipolar family history . The transdiagnostic property of psychosis is supported by a Danish birth cohort study showing that subclinical psychotic experiences at age 1112 were associated with a family history of psychosis, but no particular psychotic disorder diagnosis .

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Managing Hallucinations: When To See Your Doctor

Hallucinations in bipolar disorder can be managed. As with any physical or mental illness, its important to seek the advice of your doctor. Both of you can work together to find the right medication to stabilize your mood, or work to adjust your medication.

Hallucinations may be the result of your bipolar disorder, but it could also be caused by something else. Other causes of hallucinations include:

  • side effects of medications
  • drug or alcohol abuse or withdrawal
  • certain eye conditions

Effects In Children And Teenagers

Introducing the Evidence that Trauma Can Cause Psychosis

Sleep deprivation can affect both children and adults. Children need more sleep, and not getting it may lead to behavioral and growth problems. They can even hallucinate.

Adolescents who are night owls with delayed sleep phase syndrome may have difficulty meeting their sleep needs due to a delay in the onset of sleep and required wake times for school.

Falling asleep late, and waking too early, may lead to a cumulative sleep loss. This may be compensated for with excessive sleeping on weekends or even nappingor lead to problems.

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Physical Effects Of Depression

Depression can appear physically via symptoms felt in the body. Examples of physical effects of depression include sleep disturbance, appetite changes, poor concentration or memory, and a loss of interest in sex. Some people with depression may also feel chronic pain, experience gastrointestinal issues, or have a higher level of fatigue.

Postpartum Mental Health Disorders

Many new parents struggle with postpartum depression and anxiety. Less commonly, some experience postpartum psychosis, which can cause hallucinations.

An example is if a mother believes she is hearing her baby crying when the baby is not doing so. In more extreme cases , a mother may hear a voice telling her to kill her child.

Because postpartum psychosis can endanger the baby and disrupt the relationship between parent and child, prompt treatment is vital. Therapy, medication, and social support can help.

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What Mental Health Conditions Are Linked With Psychosis

Psychosis can be:

  • a one-off experience,
  • part of a long-term mental health condition. You may only experience psychotic symptoms as part of your condition. Or you may experience other symptoms too, such as depressive symptoms.
  • part of a neurological condition such dementia, Alzheimers or Parkinsons,
  • caused by a brain injury,
  • a side effect of medication,
  • an effect of drug abuse, or
  • an effect of drug or alcohol withdrawal.

Hallucinations can also happen if you are very tired. Or if someone close to you has recently died.

On this page we use the term symptom instead of experience. This is because symptom is a medical term. And here we are describing mental health conditions from a medical view.

If you want more information about psychosis linked to neurological conditions or brain injuries look at the Useful Contacts section at the end of this section.


You may get a diagnosis of schizophrenia if you experience a mixture of what medical professionals call positive symptoms and negative symptoms.

You can have a combination of negative and positive symptoms.

Positive symptomsPositive symptoms are something you experience in addition to your normal experience. Such as psychosis. They include the following.

  • Hallucinations. Such as hearing voices.
  • Delusions. Such as believing something that isnt factually correct.
  • Disorganised thinking. Such as switching from one topic to another with no clear link between the two.

Bipolar Disorder

Schizoaffective disorder

Psychotic Depression And Trauma

Can stress cause psychosis?

Since depression is a common feature of PTSD, psychotic depression in a patient with a history of trauma can be very difficult to differentiate from PTSD with psychotic features . Whether or not symptoms of comorbid PTSD are present, it is not known whether psychotic symptoms that directly reflect traumatic experiences in a depressed patient have different therapeutic or prognostic implications than mood congruent psychotic symptoms. The speculation that some of the relative treatment resistance reported with psychotic depression may be due to unrecognized PTSD has not been studied. It is not yet clear whether treatment of the combination of posttraumatic symptoms, depression, and psychosis should be similar to the treatment of psychotic depression in the absence of a significant trauma history.

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