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psychotic depression?


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My pdoc and I are still trying to figure out what's going on. Brief background for those who missed my first post: I was admitted to the hospital for 6 days after a manic/psychotic episode. Now obviously I'm home but I'm still experiencing hallucinations or psychosis or something. I don't feel like I was ready to be released. This was my first manic episode with psychosis. I was put on a new meds combo about 3 days ago so I still have a little while to go before I start seeing real results from them. My problem is I've changed from being angry at everyone, being convinced they've stollen something from me, thinking they're trying to gas me in the shower, was convinced my husband was cheating on me and that the person he was cheating on me with was trying to poison him so I wanted to kill her, etc to seeing myself dead/dying/being killed, hearing my kids screaming as if they're being tortured, hearing and seeing demonic beings that tell me to go away and that no one wants me here, feeling as if my internal organs are melting away, and other gruesome things included in my nightmares which are also awful and scary. I get confused, frantic and disoriented when it's happening. I feel constantly panicked but I have moments where I'm feeling better, kind of like right now. I'm assuming and hoping that it's my medication starting to kick in. I don't really remember doing this (but I have the lump on my head to prove it) I was banging my head on the wall last night evidently in attempts to make it stop and when my husband stopped me I begged him to take me back to the hospital. I'm not against that if they can make this go away. I feel like crap. :( I don't know what's going on. Someone mentioned schizoeffective disorder on one of my last posts. Could my diagnosis have changed to that or could this be psychotic depression? I don't feel manic anymore. I don't really know how I feel right now. I just know I don't feel good. :( I keep sobbing and apologizing to my sister and my husband for making these last few weeks hell on them. Help please? :(

Edited by littlemisschaos
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I'm so sorry you're suffering. :( This sounds really, really hard. I hope your head feels better, too. 

 

Is it possible that you've flipped into a mixed state? 

 

We can't really diagnose you here, but you should definitely talk to your pdoc about your symptoms and what they mean for your treatment. 

 

You are on 400 mg of Seroquel, if I remember correctly? You have a lot of room to go up on the Seroquel, the max dose is 800 mg. So, if this dose still isn't addressing your symptoms after a few days, you could ask to have your dose raised? It would obviously be up to your pdoc, but I'm sure they don't want you suffering needlessly. 

 

I have also had very macabre hallucinations and delusions. I used to also see demonic creatures, specifically people's faces turning into demon's faces and staring at me. I have also seen a demon that looked like a headless, bloody man. I know how stressful and terrifying these kinda of hallucinations can be. Just know that you have support here, for sure. 

 

Feel free to keep posting if you feel stressed out, or start a blog. 

 

I would recommend possibly printing this post off and reading it to your pdoc. That way they'll get a full picture of what you're going through. 

Edited by Parapluie
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I'm not expecting anyone to diagnose me. I'm just looking for clarity I guess. I've told my pdoc some of this but printing it out is also a good idea. I hadn't thought of that. I thought she would move my Seroquel dose up but I guess she's waiting to see how these new meds work first. She is putting me on 200mg twice a day instead of 400mg once a day so maybe that will make a difference. It apparently takes 7 weeks to get me to the Lamictal dose that she wants me at. Hopefully things get better before then. I'm not a very big person so she's always worried about putting me on higher doses of things that might turn me into a zombie. 

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There is such a thing as depression with psychosis. And from my quick conversation with Dr. Google, it looks like you can have repeated depressive episodes (either MDD or BP) *without* psychosis, then develop psychosis. It then pretty much follows that a lot of your depressive episodes in the future will include psychoses.

 

It isn't necessarily going to be that way for you, but it is something you should keep an eye on.

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There is such a thing as depression with psychosis. And from my quick conversation with Dr. Google, it looks like you can have repeated depressive episodes (either MDD or BP) *without* psychosis, then develop psychosis. It then pretty much follows that a lot of your depressive episodes in the future will include psychoses.

 

It isn't necessarily going to be that way for you, but it is something you should keep an eye on.

 

Awwww. :( My psychotic depression evolved into a full blown psychotic disorder. Since I'm on meds, I hope I don't become depressed so severely again that I become psychotic again. Though I have psychosis without depression too. 

 

Crtclms, You know how if you have three major depressive episodes, your chances of developing another one are 90%? Well, do you know if there's any research like that on psychosis? I've had 3 psychotic episodes... Chances are I'll have one again, but it'd be nice to know any research. I have been unable to find any. 

 

To the OP, I just want to say I'm thinking of you and I really sympathize with you. Psychosis is scary. 

Edited by Parapluie
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To me, it sounds like your mood has shifted from manic to depressed, not that your illness has changed from bipolar. Time will tell. It's not important right now. What is important is making the psychosis stop.

 

If the change to twice a day dosing doesn't stop the psychosis by Monday, I'd call you doctor to say as much and that you want help now. If twice a day dosing is going to work, it will by then. If it doesn't, your dose should be increased or another antipsychotic added or tried. You do not have to wait the seven weeks to go up on Lamictal to have the psychosis stop. That would be a ridiculously incompetent plan. But, your doctor cannot know that this plan is not working if you do not tell her that it isn't.

 

Also, while you are more lucid, tell your husband that if you again ask to go to the hospital that he takes you. Tell him not to fuck around, but maybe put it a little more nicely.

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I don´t think the exact diagnosis matters, whether is "psychotic depression" or "bipolar" or manic state. Usually they are all treated with similar meds: antipsychotics and antidepressants.

 

I know what you are going through is horrible and you probably feel scared and confused. With the right medication and a lot of patience, you will get out of this horrible experience.

 

I went through 2 psychotic breaks. Real horrible ones. After some time, I was able to go back to work and start a new "normal" life

 

Be patient

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I started the twice a day Seroquel today because I had already taken my medication yesterday by the time we decided to try it twice a day so I guess if it's not working by Tuesday I'll contact my pdoc and see if she'll up my dose or switch medications. I or my husband are in contact with her pretty much daily right now so she does know what's going on. Thank you everyone! It's nice to at least know that I'm not alone with this.

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Hmm, parapluie, I've never really looked into that, or heard anything about it. I know the depression statistic, but not one on psychosis.

 

But just pulling this out of my ass, our illnesses often worsen over time, it seems likely that you should be on the lookout. But we are all so different.

 

In my 20s and early 30s, I had depressive episode after depressive episode, 6 months to 2 years long. But while I have been dysphoric during manias and hypomanias, I haven't been actually clinically depressed since 2000. That doesn't mean it won't come back, but my symptoms are completely different than when I was getting depressed. Maybe the same thing will happen with you (this has to be the most dismal encouragement I have ever given).

 

Littlemisschaos, I hope you get some relief soon.

 

ETA: And I had my first psychotic feature last summer, 25 years after my initial diagnosis.

Edited by crtclms
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