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Re: depression with psychotic features Diane E.

Posted by shellie on July 20, 2000, at 18:56:46

In reply to depression with psychotic features, posted by Diane E. on July 20, 2000, at 15:24:05


" Her examples were the fact that when he is really doing poorly he is convinced that he will never get better and that he believes he has a character flaw rather than a mental illness (on better days, he understands that this is an illness). I always thought that this type of thinking was sympotmatic of depression and not a delusion (i.e., low self-esteem, tons of self-blame, feelings of hopelessness). She said that it is a tricky distinction, but that she and the psychiatrist believe these are delusions. Can some one help me to explain this better? When does depressed thinking become delusional? How can the two be distinguished?"

Hi Diane. It must be a "tricky" distinction, because everything you've written seems like major depression to me. The only thing I can think of is the "tons of blame" part. Like if he not only thinks he is bad because he is depressed (common for depressives), but also believes he is depressed because he is bad, that would be delusional to me.

Maybe Noa's correct in it helps his doc chose his medications. Unless it is used in his treatment strategy (either for therapy, or meds), the diagnosis doesn't really change anything. And his therapist is saying it's a tricky (or perhaps a subtle) distinction. I do hope she's not writing that on the insurance forms though: my therapist's belief is that you always give the least harmful diagnosis on any forms. Like for me, both my therapist and pdoc write "major depresson"; not "major depression with dissociative disorder" Shellie


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