Today I have the privilege of sharing Caz’s experience with psychotic depression. When I first started corresponding with Caz about sharing her story, I had no idea that psychotic depression was even a mental illness classification.
According to WebMD, “Psychotic depression is a subtype of major depression that occurs when a severe depressive illness includes some form of psychosis. Psychosis is a condition that affects the way your brain processes information. It causes you to lose touch with reality. You might see, hear, or believe things that aren’t real. Psychosis is a symptom, not an illness. A mental or physical illness, substance abuse, or extreme stress or trauma can cause it.”
Psychosis is frightening and widely misunderstood, so I am excited to share a new perspective today.
Hi, I am Carol, but I go by my nickname, Caz. After facing traumatic life events and going to counseling to heal from them, I felt the need for a change. At 36, I went back to school to study mental health nursing at my local university.
I qualified to become a mental health nurse three years later. Two years after that, they promoted me to Ward Manager on acute in-patient mental health wards. This position was rewarding on so many levels. Sadly, 10 years later, my career ended overnight, with the sudden onset of a rare neurological disorder called transverse myelitis, which is similar to multiple sclerosis.
Now that I am retired, I spend my days blogging about all things mental health. Researching and writing articles for my blog has given me a new lease on life. After being silenced for so many years, I finally feel I have a voice.
When I was around 30, my long-term relationship with the father of my children ended. I had what I would call a mental health breakdown because that’s just how I felt—emotionally and mentally broken. I couldn’t eat or sleep. I felt so sad and angry at the injustice of it all, and I started having panic attacks, which terrified me.
About a year after the split, on top of the constant anxiety, 24/7 panic attacks and sleepless nights, I started seeing mice scurrying across my wooden floorboards. I heard people talking behind my back—using foul language and making disparaging remarks about the things I’d done when I was younger.
I’d lie in bed wrapped tightly in my duvet waiting for sleep to take me away from what was a living nightmare. One night I shot out of the bed when I felt something strange—like tiny bugs—crawling under my skin. The bugs were not visible on my body or the duvet or my bed, but I felt sure they were there, and I clawed at my skin with revulsion.
Night after night, I sat on my kitchen floor drinking hot milk and smoking endless cigarettes. One night, I had a revelation that hit me like a ton of bricks—I remembered killing someone. My heart was pounding, and I couldn’t catch my breath. I knew where I buried the body, but I couldn’t remember who I had killed. Obviously, this was the psychosis talking to me, but this troubling thought wouldn’t leave me.
I carried on with life, as best as anyone could when they are in the middle of a living nightmare. This was madness, I was exhausted and I couldn’t take it anymore. I wanted to die.
Getting Professional Help
Eighteen months after my traumatic split, I took my boys to our general practitioner for their asthma, and I could see him frowning at me. Once he’d examined the boys, he sent them out of the room.
The doctor turned to me and said, “Tell me, what’s the problem? You’ve lost so much weight and though you smile, I think you’re very sad.” Snot mingled with salty tears flowed as I howled and sobbed and I poured out my sorry tale.
The doctor made a quick phone call, and he drove me to a local hospital to see his colleague, who was a psychiatrist. I was petrified. The only thing I knew about mental hospitals was when I saw my mum going into an asylum back in the 70s, and now I was terrified the same thing was happening to me.
The psychiatrist said I had psychotic depression brought on by traumatic life events. He said my problems were varied and complex and didn’t want to give me a diagnosis of anorexia nervosa too because he felt I might regain weight once my mental state improved.
The psychiatrist and his team couldn’t have been any nicer when they explained what was happening to me and why. So, although I was apprehensive about what that might happen next, what they told me made sense. It was a relief to know that all these odd things were part of an illness, albeit a dreaded mental illness.
Caz’s Treatment Protocol
The team agreed that although I had suicidal thoughts, I had no intention of killing myself. (I didn’t dare tell them about the one and only time I ever took an overdose about six months previously.)
They prescribed me atypical antipsychotics for the psychotic symptoms and antidepressants for the depression and anxiety. We didn’t have home treatment teams then, so I visited my general practitioner every two to three days to follow up.
I also went to the hospital’s psychiatric department each week for counseling. I am eternally grateful to that team for their kindness, compassion and understanding. I wouldn’t be here today if it weren’t for them.
Caz’s Life Today
Unfortunately, I still experience anxiety and depression and continue to take antidepressants. While it isn’t ideal, I can live with it because I have many good days too. I love spending time with my family, my sons, my husband, our gorgeous grandchildren and my best friends.
When I can’t sleep for two or more days because of the pain from transverse myelitis, I become fatigued and see things like mice or people’s faces sitting opposite me at my computer table. I still hear people talking to me.
I know that it is not real because I am the only one in my living room, and because of my insight into mental illness, I’m not so afraid anymore.
I want lay people to know that mental illness is real and often very painful. Psychotic depression is frightening for the person experiencing it. You can show your support by being present, listening without judgment and extending compassion, empathy and understanding.
Psychosis is one of the most feared and misunderstood symptoms of mental illness. I think it is important to remember that psychosis is a symptom, not a mental disorder. In most cases, psychiatrists can eliminate the symptoms with atypical antipsychotics.
We should treat people who struggle with psychosis—of any kind—with empathy and kindness instead of fear and revulsion.
For those living in the United Kingdom, The National Health Service (NHS) provides clear, up-to-date and easy-to-understand information about all mental illness diagnoses. Read their informative article on psychotic depression.
The charity Mind is based in the United Kingdom and provides assistance with all things mental health, helps you make choices about treatment, understand your rights and get the right support.
For more information on psychotic depression, read this helpful article from Verywell Mind.
To find professional help in the United States, visit Substance Abuse and Mental Health Services Administration’s (SAMHSA) website.