I have psychotic depression (depression for 5 years, psychotic features for 2 1/2 years) but I've managed to avoid the hospital so far. It doesn't always end up in a hospital stay. I think what's kept me out of the hospital is that I learnt pretty quickly that doing what the voices said (hurt myself) wouldn't shut them up, so there was no point. Also I understand that my voices are really my own thoughts that I am not able to discern as thoughts at the moment.

Standard treatment for psychotic depression is an antidepressant + an antipsychotic. I've found an antipsychotic really helpful for reducing the voices and the paranoia. I'm currently on aripiprazole/abilify as risperidal made me really out of it. So far they haven't really helped my strange thoughts/delusions. I still feel that people can read my thoughts and are judging me, which makes me paranoid (although I can leave the house now on meds). I am also experiencing all this guilt for things that aren't my fault i.e. world dying, people dying around the world etc. I'm going to ask my pdoc when I next see her if increasing the aripiprazole will help with that as all I do is sob when I hear the news and feel guilty for everything every day.

Basically as long as you eat & drink, aren't harming yourself or others, they will have no need to hospitalise you just because you're experiencing psychotic symptoms. (Though this is in the UK where they seem to avoid hospitalising people at all costs as it costs the NHS too much money. From reading these forums I hear of people going into hospital in the US when they wouldn't in the UK, so it may be different wherever you are.) My pdoc barely batted an eyelid when I told him so don't worry about telling a pdoc about this. You deserve to get help.

All the best,

*Willow*