Will it ever get better? Psychotic depression

[NotQuiteUsual]

Thought I was doing really well. Functioning, feeling ok. But then I went to the psychiatrist and found out I'm in the middle of a massive relapse. Things I thought were totally normal and others I'd repressed really deeply. Turns out its all delusions and hallucinations and all that nonsense.

I'm getting help, see my MH nurse this week. Meds being again reviewed next week. But when does this get better? It's been 2 years of slow, crawling progress followed by rapid, all encompassing decline. Its exhausting. My kids need me, so I've learnt to mask my symptoms and not to talk about certain subjects infront of them. But I'm not the mother I used to be. I can't take them out as much or do as many activities. I'm a shit wife now too. I can sometimes cook dinner and I can make the packed lunches. But that's about it. I used to keep the home to a high standard, but it's nothing like that anymore.

I miss who I was before this took over my life. Has anyone experienced psychotic depression and got better? Should I taper my expectations and accept life is just going to be this way from now on? I don't know what to do anymore. I just want my brain to stop racing.

Hi Notquite,
I remember your previous posts and am really sorry that you are experiencing this again. My DD is going through something similar, although different diagnosis.
I have no advise but just wanted to bump your thread. Hopefully with your meds review, you will see an improvement.
Best wishes

I'm bipolar and had psychotic depression after having my daughter and had psychosis as part of a mixed episode (symptoms of low and high moods simultaneously) and it got better both times but it took time.

After having my daughter it became treatment resistant and I ended up in hospital for 10 weeks where I had my medication overhauled. I ended up on 4 medications 3 at quite high doses, the game changer for me was lithium.

It took 2 years to recover from that episode and during that time my partner did pretty much everything in terms of house work and cooking. I did the washing and online food shop and I think that was it. For a while I did have to taper my expectations and get to a stable place but once I had some stability I could let more of life in. It was 1 year of being continuous acutely unwell and unfit for work (luckily on maternity leave), 6 months of being quite unwell but able to start dipping my toe back into work and life with a young toddler. The 18 months of trying to rebuild a life where things could still be quite shaky at times.

When I was first diagnosed with bipolar it was 4 years of not gaining much stability between episodes and I was quite vulnerable to relapse and outside pressures. I was doing a PhD at the time and it was not an environment conducive to good mental health. When I was finishing I had to have a good hard look about what my life could look like that would potentially give me stability so I prioritised a career that was lower on stress, with better work life balance, better hours, lower pressure and the difference was immense. I went from 2-3 episodes a year to 2 in 8 years, one triggered by the birth of my daughter.

I've seen a few threads where people with severe debilitating treatment-resistant (i.e. anti-depressants and antipsychotics) psychotic depression were advised to look into ECT. Although it's not looked fondly upon due to it's poor portrayal in films etc, it can carry much less risk and can be much more successful and faster acting than meds, and is preferred by some psychiatrists. I think it's hard to function at all with psychotic depression - but you are actually having proper delusions and hallucinations?

Thank you for the replies. Sorry I took so long to respond. My psychiatrist has changed my diagnosis to Psychosis of undefined cause or something like that and moderate depression. Apparently I've been in psychosis for a little while. But I mask very well. I know what things I say that make people upset or uncomfortable so I just keep them internal. Its not like telling anyone matters, they're not proper humans anyway. Psychiatrist says the noises I hear from the tv/radio are symptoms and not dh messing with me. I don't know though.

The smells dh says he can't smell are apparently symptoms too but I'm not convinced it's not dh messing with me again. I'm so tired. Nothing makes sense yet everything is clearer than ever. It's so weird. I just want to up my meds cos they quieten my thoughts.

Except when I'm manic, my psychosis is often internal and it has to be quite acute to be obvious to everyone else. My partner didn't pick up on it with my daughter. I had it for about 7-8 weeks before it was picked up by my treatment team despite seeing them weekly. It was during a psychiatrist appointment where she asked a question. I can't remember what but in the resulting answer I spoke about how I frequently had thoughts that my daughter wasn't real. I went on to have thoughts that she wasn't mine or had been swapped. As no one else was bringing it up I assumed they were in on it so couldn't be trusted so I kept everything inside. I keep a lot inside, I never had people to trust in my formative years with inner most thoughts and the psychosis is an extension of that.
It's hard when there's distrust, there's a world that feels so real and when the real world disagrees with the world that feels real to you there's either conflict or you retreat inside.

@Superscientist I can really relate to your post. It feels pointless talking to people because when I do they clearly feel uncomfortable and don't understand anyway.

I've decided to play my part today for Father's day. Then Monday I can drop the facade a bit. Its weird celebrating in a hiuse of strangers, but it's liberating too. Like what they think of me isn't important so I can play my role without feeling self conscious.