How Do You Know If
You Have Psychotic Depression?

by Dani

I am taking fluoxetine and quetiapine, but only in the last few months, I have been hearing voices which are not actually there.

I think people are talking to me, but they aren't. I get very paranoid and anxious.

My psychiatrist has diagnosed me with Dysthymia, and also Generalised Anxiety disorder. However I have severe episodes of depression which end with me being admitted to hospital. When these diagnoses were made though, I didn't have the psychotic symptoms.

Is there such a thing as pychotic dysthymia?

What else could be causing all this?

Do you think this is psychotic depression?
It really annoys me.

Thank you in advance for any ideas you may have.

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No, dysthymia is a mild form of depression and psychotic features such as paranoia, hearing voices, etc. would not be present.

Since these psychotic symptoms exist you may very well have a form of psychotic depression. You can read more about psychotic depression here on my site. The way to determine if you have it is to get formally diagnosed. You should speak to your psychiatrist about your new symptoms so that a proper diagnosis can be made.

Also, it could be the combination of meds and/or the dosage of the meds that are causing the psychosis. If that's the case, a simple change in your medications should remedy the situation.

Something to note as well, if you are experiencing severe depression, that is not a symptom of dysthymia either. Dysthymic depression is when one feels "flat" so to speak. They don't feel really depressed but they never really feel happy either. Rather, they just feel "there". They usually live a normal, functioning life although, not necessarily a happy one.

I'd recommend talking to your psychiatrist about the new sypmtoms you are having. Together you can put a treatment plan in place so that you can feel better in the very near future! I'm certain you're conidtion is treatable and that you can life a happy, fully funtioning life!

I wish you all the best. I hope that this helps and thanks for reaching out.


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You Have Psychotic Depression?

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Correcting some false information...
by: Anonymous

"No, dysthymia is a mild form of depression and psychotic features such as paranoia, hearing voices, etc. would not be present."

Regarding the response above, dysthymia is another term for Persistent Depressive Disorder, which is not a mild form of depression. In addition, psychotic features can be present with dysthymia. In fact, the DSM tells practitioners to specify dysthymia with "mood-congruent psychotic features" or "mood-incongruent psychotic features" if psychotic features are present.


You raise a good point for clarification. Dysthymia is a mild form of depression that often gets unrecognized as depression and is usually considered just part of the personality. Most who have it can experience symptoms for much longer period of time - sometimes a couple of years or longer until it is accurately diagnosed.

With that said, there is a form of "double depression" where someone with dysthymia has bouts of major depression. Which, to your point, could include psychotic features.

Important to note that the dysthymia symptoms are similar to major depression. However, the symptoms are less intense.

Thanks for the points of clarification!

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