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Depression is not a symptom of psychosis but people who have psychosis often are depressed as well. Also, psychotic symptoms can be part of depression.
How a person might act:
A person might talk about feeling helpless or hopeless
The person seems depressed most of the day and spends a lot of time crying
They don't seem to be interested or feel pleasure in activities. The person may not move much at all but just sit staring into space
The person may be tired and not have much energy
Weight loss or gain
Difficulty sleeping and early waking (usually between 2 and 4 am)
The person may feel worthless or guilty. They may have the belief that they have done something terrible and need to be punished
Having a hard time concentrating and thinking. Having a hard time putting sentences and thoughts together, and may give very short responses and need prompting
Thinking about death a lot
Skin may become coarse and dry, and hair limp and greasy or sparse.
Helpful things to do:
Be aware that depression is a very real condition reflecting changes in the chemicals of the brain and that it is not a reflection of being weak. You cannot cheer the person up out of this state
Be aware of suicide risk. If you are concerned, do not be afraid to talk to the person about suicide – this will not make them act on possible thoughts of suicide. Talk with their treating team about this issue. This issue may be a reason for hospitalisation
If the person seems unexpectedly happy and begins to give possessions away and organise their affairs, be aware that this is a risk factor for suicide and get help immediately
Be aware that poor concentration from depression can cause safety issues e.g. if someone works with knives or drives
Be aware of whether the person is drinking enough water or eating properly. Again, these issues may need to be attended to in hospital
Connect with how the person is feeling rather than trying to change their mind eg 'It must be very hard feeling so low'
Let the person know that your care about them
Try to sit beside and be in the person's space – often people who are depressed do not like to make demands on others but they appreciate company. Likewise, you will need to do the talking rather than expecting the person to do so
Let the person know where you are going even if there is no response
This information is adapted and reprinted with the permission of the Mental Illness Fellowship of Victoria (Australia)
