# "Psychotic Depression?" Me? No way!



## Fiver (Jun 9, 2009)

Except uh huh, yup. It fits, I will begrudgingly admit. My foray into mental illness began around a year ago after being diagnosed with acute PTSD. I'd been rather violently assaulted under semi-random circumstances (meaning that while I knew him personally, if I hadn't been conveniently available, another woman would have suited his purposes just as well.) I ended up with a therapist that not only knows her stuff, but is always two steps ahead of me, constantly keeping that light bulb over my head illuminated. Yeah, she's good. Really good. And I trust her completely under most circumstances.

During the month of April I went through the trifecta of blows; I was already dreading the anniversary date of the assault at the end of May and wondering how I would handle it, and I had a trial at which my testimony would likely be required, also toward the end of May. It was a draw which one was the more frightening event, the anniversary or his trial, but in the midst of these, my home life deteriorated when some extremely bad decisions based on naive trust left me emotionally stunned and financially bankrupt.

Something snapped. Regardless of how intuitive Pat the Wondertherapist was, there were things going on in my head that I simply could not share nor could I allow her to even suspect. Suicidal ideations have frequently popped up during this last year, but being a woman of logic I'm usually able to recognize that this is not the way "healthy" people think, and because I trust Pat, I'm willing to hang in until I can exhale again. This time it was more than illogical thoughts of suicide, though. My thoughts were just plain nuts -- things like being convinced that there was some kind of conspiracy among my friends to have me assaulted because of past transgressions in our friendships -- among others, but that one was probably the least logical. And I knew it wasn't logical, yet I believed it anyway, even though I also believed it couldn't possibly have any basis. And yet, I knew it was true. Very dichotomous thinking, and very confusing. 

And humiliating. These are not things I tell other people, even a trusted therapist, because I know they aren't true and I know my thinking is skewed. So if I know these thoughts are not part of reality, I can't be that bad, right? Evidently not right.

The part where Pat realized how delusional I'd become was on April 25, when I'd made the choice to end my life, had it planned to the very detail and felt such a sense of relief that I was nearly euphoric. My intent was not to tell her, but to at least try to cryptically convey that she'd not failed with me; that I'd chosen the most logical and well thought-out option available. I didn't want Pat or anyone else to feel guilty for something that was giving me the glorious relief I'd been seeking.

But remember, Pat is smarter than me. Her thirty years in the biz trumps my zero years. And I'm apparently much more transparent than I thought. It took about ten minutes for her to tell me I was full of it if I was going to sit there and tell her I felt fine, and only five minutes of my illogical rationalizations for her to realize how delusional I was regarding my recent decision. That was the day I went kicking and screaming into a locked unit.

I did two weeks of lockup and two weeks of partial day hospitalization. I suppose the lockup kept me safe and I left realizing how irrational my logic had been. Day hospital helped with getting through the trial and anniversary, and it boosted my self-esteem at the time. But when I was discharged I read my formal diagnosis: Major Depressive Episode with Psychotic Features.

What?! "Psychotic?" What the hell is that supposed to mean? I went between being offended (certain that the diagnosis was wrong) and freaked out that I was worse than I thought. I thought back to the very irrational paranoid beliefs I'd been experiencing and gave it some thought... Finally about two weeks ago I owned up to them in a session with Pat. After she got done bluntly telling me how these are Things I Am Supposed To Tell Her, she also assured me that I'm not nearly as far gone and hopeless as I'd been thinking. But since then she has been having me come in two to three times a week instead of just once.

I've done some research, and apparently psychosis with major depression isn't all that uncommon at times, which makes me feel a little bit better, I guess, because the extreme paranoia and guilt, irrational as I know it is, hasn't completely left. Nor has the suicide desire. I never knew depression could cause psychosis. For that matter, I never thought of myself as someone who could get so severely depressed.

I guess it's the label that freaks me out. I like to at least give the impression that I'm in control of myself, regardless of the truth. And I don't see myself getting much better right now. In fact, as I'm heading out the door here soon to see Pat, I still feel like it's a wasted effort because I seriously doubt I can be helped. I suppose this is another delusion, because if I were anyone else I'd assure them that they're not the first to feel this way, and that life does not stay at this end of the spectrum forever. But this is me, and I know myself, right?

It's just that "psychotic" adjective. I hate it. I wish I understood why everything I read about "depression psychosis" has so many different definitions and interpretations. Most of all I wish none of this had ever happened. But I've been wishing that for more than a year.


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## NicNak (Jun 9, 2009)

Fiver said:


> I've done some research, and apparently psychosis with major depression isn't all that uncommon at times, which makes me feel a little bit better, I guess, because the extreme paranoia and guilt, irrational as I know it is, hasn't completely left. Nor has the suicide desire. I never knew depression could cause psychosis. For that matter, I never thought of myself as someone who could get so severely depressed.



My diagnosis is Major Depressive Illness. I also have psychosis "episodes".  My Psychiatrist refers to them as "episodes".  As well I have suicidal idealization.  

On ocassion I also think people are conspiring to manipulate me too.  I may have what is classified as an "episode" a few times a month.  

With the suicidal ideation I often have to keep reminding myself that they are only thoughts, as disturbing as they are, and that tomorrow is another day. 





Fiver said:


> It's just that "psychotic" adjective. I hate it. I wish I understood why everything I read about "depression psychosis" has so many different definitions and interpretations. Most of all I wish none of this had ever happened. But I've been wishing that for more than a year.



I agree about the "psychotic" adjective being disturbing.  I think that is why my Psychiatrist refers to them as "episodes" but on paper writes the clinical terms.  

When hearing the diagnositc terms that upset me, I try to remind myself that I am the same person I was the day before, before learning this new information.  It doesn't make me a bad person and the term doesn't suddenly make me a monster.

I also agree, telling your therapist everything is important.  I always make sure I tell my psychiatrist everything that I think might be a bit off.  Sometimes they can catch us laying down a "trail" and bring us back quicker.

I hope this helped a bit :support:


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## Fiver (Jun 9, 2009)

It does help, thank you. One of my major stumbling blocks in dealing with PTSD and the aftermath of violent sexual assault is my lifelong need to maintain control no matter what. It's bad enough when control is ripped away during assault, but when my thoughts become out of my own control and into some bizarre head place, _ and I recognize it without being able to fix it,_ it just becomes way more than my mind can grasp right now.

I have never felt so absolutely confused and unable to comprehend the simplest of things, ever. This is what makes it all feel so hopeless. It's out of my realm of life experience. 

It is, however, a relief to hear I'm not alone. Thanks again.


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## Jazzey (Jun 9, 2009)

I'm sorry Fiver.  I don't know what to say other than to offer you my support.  The 1 year anniversary is approaching for me and I don't think that there's ever a day, lately at least, that I don't think about it. :support:


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## Fiver (Jun 9, 2009)

Believe me, I appreciate the support, Jazzey. The good news that _I_ can offer _you_ is that first anniversaries happen only once, and then they never happen again. That, and I am living proof that it's not only possible to live through the anniversary, it's not nearly as bad as the original event. However, prior to May 23rd I wouldn't have believed it.

Pat the Wondertherapist just gave me explicit permission to feel incredibly confused about the simplest of concepts, not just involving my life. She also told me it was time to give myself credit for completing basic daily tasks instead of beating myself up for not being able to do them without a great deal of effort (if I do them at all.) This is so foreign to me, this whole thing where I can't even get up the energy to feel emotions unless they're directed harmfully at myself.  This isn't who I used to be. And I need to know WHY this has happened.

Unfortunately, she also said, "Stop trying to figure out why things are. Concentrate on just feeling what you know is trying to break through." Man, I'd hate having me for a patient. It's like she has to keep slapping me upside the head to make it stick. It just so happens that this is the method that tends to work (when I let it.)


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## Jazzey (Jun 9, 2009)

Thank you Fiver...You've certainly understand this process...And now, I'd like to actually support you instead of inviting you to support me :lol:

I've understood everything you've posted Fiver.  And thank you so much for sharing with all of us.  I think there are quite a few of us here who relate to your post.  So I hope that you'll lean on us too. 

And this is the sentence that really struck a chord for me:


> One of my major stumbling blocks in dealing with PTSD and the aftermath of violent sexual assault is my lifelong need to maintain control no matter what. It's bad enough when control is ripped away during assault, but when my thoughts become out of my own control and into some bizarre head place, and I recognize it without being able to fix it, it just becomes way more than my mind can grasp right now.
> 
> I have never felt so absolutely confused and unable to comprehend the simplest of things, ever. This is what makes it all feel so hopeless. It's out of my realm of life experience.



One thing that's worked for me, for the most part is not fighting those moments. But to calmly remind myself that I'm ok now.  With time, I find the duration and intensity have lessened a little.  I think for the time being, we just have to accept that it's part of the process and do exactly what you're doing - informing ourselves, caring for ourselves by seeking therapy (this is not something we can resolve on our own - I'm finally getting that) and give ourselves a little slack when things don't make sense.  I don't think any of this kind of experience is supposed to makes sense.  

and I'm a control freak too - I analyze, over-analyze everything because it's hard to not see a rational point to everything.  But there's nothing rational about sexual assault.  It's unfortunately one of those sick things in life that I'm now finally grateful to not understand (if that makes sense?)  I'm slowly letting go of this need to understand how and why it all happened.  Why he chose me...etc...


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## NicNak (Jun 9, 2009)

Fiver said:


> .......but when my thoughts become out of my own control and into some bizarre head place, _ and I recognize it without being able to fix it,_ it just becomes way more than my mind can grasp right now.
> 
> I have never felt so absolutely confused and unable to comprehend the simplest of things, ever. This is what makes it all feel so hopeless. It's out of my realm of life experience.



I so relate to the confusion.  I also have the bouts of confusion too.  Some days not even being able to string proper sentances together and even type properly.  



Fiver said:


> It is, however, a relief to hear I'm not alone. Thanks again.



For sure, you are not alone :support:  You are most welcome.



Fiver said:


> Pat the Wondertherapist just gave me explicit permission to feel incredibly confused about the simplest of concepts, not just involving my life. She also told me it was time to give myself credit for completing basic daily tasks instead of beating myself up for not being able to do them without a great deal of effort (if I do them at all.)



WonderTherapist is very smart!  This is so important. That we give ourselves credit for the things we are doing well.  Even though most people may not see them as big things, like doing the dishes or getting groceries, some days it is a very difficult task for those of us coping with mental illness.



Fiver said:


> Unfortunately, she also said, "Stop trying to figure out why things are. Concentrate on just feeling what you know is trying to break through." Man, I'd hate having me for a patient. It's like she has to keep slapping me upside the head to make it stick. It just so happens that this is the method that tends to work (when I let it.)



Is it possable it doesn't "stick" cause of the confusion you are coping with?  I know with my Psychiatrist he has to frequently repeat things through out the session so they "stick"

I use to try to figure out why things are, but for me there is no rhyme or reason for it, except to blame myself thinking I was weak.  To my Psychiatrist it is as clear as glass. ( I guess that is why *he* is the Psychatrist and not me :lol: ) Previously he would talk about the complexity of my diagnosis.  He constantly tells me how well I am doing with managing my symptoms and using my coping skill tools.  

I trust him, like you trust your Therapist, so I focus on conveying how I feel to him, my change of symptoms (if any) and allow him to guide me.


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## Fiver (Jun 9, 2009)

Jazzey said:
			
		

> and I'm a control freak too - I analyze, over-analyze everything because it's hard to not see a rational point to everything.  But there's nothing rational about sexual assault.  It's unfortunately one of those sick things in life that I'm now finally grateful to not understand (if that makes sense?)  I'm slowly letting go of this need to understand how and why it all happened.  Why he chose me...etc...



Exactly. Until recently I felt that if I could understand the motivation behind such a heinous act, perhaps I could let go of some of whatever is making me a potential time bomb. But I think I've mostly accepted that there will never be a suitable answer to this particular question.

Now my need for knowledge extends to why my own mind is working against me by taking PTSD -- something I was truly conquering with small, painstaking steps -- and creating a new monster of major depression with a delicious creamy center of psychotic features. I need to understand why my mind has allowed me to get this far. Why and how did I let this happen when I was doing so well? And why the hell is depression so filled with guilt?

My therapist suggested I stop trying to find my answers on the Internet, legitimate sources though they might be. I see her point, because it just confuses me even more. But I'm not a patient woman. I want answers.  Now.

I suppose this is why we've gone from meeting once to meeting three times a week (that, and because I'm doing my best to stay out of any form of psych hospital, locked or partial, no matter what. Been there, done that. No tee-shirt, just a huge bill.)

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NicNak said:


> Is it possable it doesn't "stick" cause of the confusion you are coping with?  I know with my Psychiatrist he has to frequently repeat things through out the session so they "stick"



Absolutely. It's not just the repeating of the same things; it's having to specifically tell me what I'm supposed to concentrate on when I get home. Tell me, tell me exactly and be quite literal about it, otherwise I'll lose the concept. That's not who I used to be, not even in the beginning of therapy. But then, my diagnosis has changed since then.



> I trust him, like you trust your Therapist, so I focus on conveying how I feel to him, my change of symptoms (if any) and allow him to guide me.



For the most part, I do this. When my thoughts had leapt the bounds of logic I was afraid to say anything more out of denial than lack of trust, but now my basic distrust of my own ability to judge makes me sometimes not trust Pat the Wondertherapist. However, I was smart enough to point this out to her today and surprisingly, she understood exactly what I was poorly articulating. (I told you she was good.) I believe this is the "fake it til you make it" method and since logic tells me she has no nefarious agenda, I'll continue to trust her even during my less-than-lucid moments.

You know, walking into a hornets' nest while battling a horrible case of shingles would still be preferable to dealing with major depression.


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## Jazzey (Jun 9, 2009)

> Now my need for knowledge extends to why my own mind is working against me by taking PTSD -- something I was truly conquering with small, painstaking steps -- and creating a new monster of major depression with a delicious creamy center of psychotic features. I need to understand why my mind has allowed me to get this far. Why and how did I let this happen when I was doing so well? And why the hell is depression so filled with guilt?



Ah, a woman after my own heart...and I'm not convinced that's a good thing! :lol:  I do the same.  I let myself go down the path of 'I thought I was strong', 'I thought that I was rationale'  and yet that major depression and dissociation (in my case) doesn't mesh with this idea.  I've always thought that I was this person that needed no one - that could do for myself.  I just had to keep to a good schedule: eat right, exercise and sleep well.

But now I think I give myself a big of slack - it's my brain's way of dealing with stuff that I've been ignoring for so long (I think  ).   Yes, I admit it -  my strength came mostly from setting aside important issues and 'forging ahead' as if unfazed...but i finally get that it always catches up to you.  And diet and exercise aren't good enough to change that. 

As for the internet - I've read everything I can on PTSD, on major depression, dissociation etc...I don't think there's anything wrong with a bit of research to understand your condition. With the caveat that you do need to appreciate that some sites are not necessarily reputable for their information - but it's a good way to draw up questions you may have on your diagnosis, I think.


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## Fiver (Jun 10, 2009)

Sometimes information through a layperson's filter can be dangerous. I suspect this is why I'm being told to stop applying the criteria from the DSM-IV to myself without the aid of some educated perspective. However, the very fact that I no longer feel like a secluded freak, that others have experienced what I'm going through and come out on the other side, has made a big difference. 

And now it's time to make the attempt to shut off my brain and get some sleep. Thank you all very much for being with me today. It means a lot to me.


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## NicNak (Jun 10, 2009)

Hi Fiver.  I agree, it is dangerous.  When I read articals on diagnosis, I tend to read them out of "general interest" the rest I will read to maybe see if I can apply certian coping skills to my symptoms, but that is the extent of it.

So many symptoms overlap from one condition to the next, but it doesn't necessarly mean we have all of them.  

My Psychiatrist had always told me to be careful, he always says "your diagnosis is very complex".  I leave that sort of thing up to him, as I said in an above reply, that is why he has the degrees and I don't :lol:


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## David Baxter PhD (Jun 10, 2009)

Fiver said:


> Sometimes information through a layperson's filter can be dangerous. I suspect this is why I'm being told to stop applying the criteria from the DSM-IV to myself without the aid of some educated perspective. However, the very fact that I no longer feel like a secluded freak, that others have experienced what I'm going through and come out on the other side, has made a big difference.



That's in part why (1) we emphasize the support aspect of this forum, and (2) we discourage any attempts to diagnose anyone online - it's neither accurate nor ethical, in my opinion.


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## Fiver (Jun 10, 2009)

No kidding. It's bad enough that I've tried to diagnose myself based on what I've read on the Internet -- I can't imagine giving credibility to someone diagnosing a mental illness based on anything other than the intuition and education of someone who is actually sitting in front of me.

And don't get me started on telephone therapy...


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