Psychotic depression is a subtype of major depression that occurs when a severe depressive illness includes some form of psychosis. The psychosis could be hallucinations (such as hearing a voice telling you that you are no good or worthless), delusions (such as, intense feelings of worthlessness, failure, or having committed a sin) or some other break with reality. Psychotic depression affects roughly one out of every four people admitted to the hospital for depression.
Because these symptoms happen with many conditions, people with depression may never get help for them. They don't realize that their physical problems might be caused by their mental illness. A lot of doctors miss them, too.
Depression seems to be related to improper regulation in nerve cell networks or pathways that connect the brain areas that process emotional information. Some of these networks also process information for sensing physical pain. So many experts think that depression can make you feel pain differently than other people.
Tell your doctor about any physical symptoms: Don't assume they'll go away on their own.
Sometimes, treating your depression -- with therapy or medicine or both -- will clear up your physical symptoms. Medicines for depression "tweak" the chemicals your nerve cell networks use communicate, making them work more efficiently. Some antidepressants, such as Cymbalta, Effexor, and older tricyclic antidepressants like Elavil or Norpramin, may help with chronic pain, too.
But you may also need something else. For example, your doctor may suggest an anti-anxiety or sleep aid medicine for insomnia so you can relax and sleep better.
Since pain and depression can sometimes go together, easing your pain may lift your depression as well. You could try cognitive behavioral therapy. It can teach you ways to deal better with pain.