Psychotic depression

Posted , 6 users are following.


NB: cross-posted on 'Mirtazapine' forum.

I've had clinical depression for 30 years. I have a severe depressive episode for about 6 months of every year, successfully treated with medication so far. The last few years the depression has escalated into psychotic depression. I am currently on the maximum dosage of 45mg Mirtazapine which seems to reduce the depression enough to prevent any major psychotic episodes until I get better.

During the current episode (2 months in), the medication is not holding back the psychosis and I am becoming very agitated and confused (got lost walking home today!) and hearing children singing "Stephen is ill again, Stephen is ill again,..." in my head all day. I am also getting paranoid. I took a chemical cosh (sedative) last night and slept a good 12 hours but still have the voices in my head all day.

Has anyone transitioned from the medication for depression to anti-psychotics and have any advice? I am seeing my doctor tomorrow (by the way has been the best GP I've ever had) and have my 'annual' psychiatric assessment next week.

I am just anxious on what the next stage of treatment may be...


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  • Posted

    Hey, your situation sounds tough, I've been rowing on my cousin's rowing machine and found it helps. I suppose it biochemically compliments the Sertraline and quetiapine. I've found the quetiapine helps with bad thoughts. It suppresses them, so helps with my OCD. I have a friend who has psychotic depression, she seems to balance it well with creative outlets like art, music (dancing/learning an instrument) Maybe just realising the thoughts are just over-vamped mental noise which your brain confuses with physical stimuli? (hence the auditory hallucinations) I know I don't have the same illness, but I thought this might help? CBT is meant to be good, meditation might help with dismissing the voices. I hope this is of some help. Sometimes the best answers are the simple ones eg being open to new drugs is the current cocktail isn't working (Obviously only prescription, cannabis etc is likely to worsen worse your symptoms) Going private is advisable if you can afford it, as NHS waiting times can be colossal, as I'm sure you're aware.
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    • Posted

      Thanks allycats,

      Yes - I do quite a lot of exercise at the moment and you are right does help.  I also do some art... again helps me relax.  I am cr@p at CBT and end up arguing with the Psych. and 'bored' with the other patients if group-based! I know, sounds bad...

      I have found NHS OK - I have a very good GP... I am classified as 'at risk' and can get an appointment within the hour and fast-tracked into the local Psych. dept within 24 hours. 

      I am quite experienced though (30 years of this...), and know the signs and when to 'knock' myself out (legally with prescribed drugs)... which probably prevents 99% of all emergencies... I think the doctors appreciate my insight and capability to act as nurse/patient.


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    • Posted

      No I understand. You feel like you can't relate to anybody right? Like all you see is another professional. I think sometimes it's difficult to explain what goes on in your head to people. I know from experience that medication can be the way to go and that it's essential to both you and myself, but I don't really see it as any different from taking any other sort of pill. People stigmatise mental issues so much, buy 1 in 6 people are suffering from one at any given time and 1 in 4 will become mentally ill at least once in their lifetime. I can vouch for meditation, I'd really recommend it. I didn't initially really believe in it until I had an amazing feeling of calm during one session. MRI scans have found frequent meditators demonstrate physically altered brain structures than those of no meditators. It seems to me that a lot of therapies focus on aspects of meditation now-mindfulness especially
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