I have schizoaffective disorder, and right now I am going through a major depressive episode. It has gotten to the point that all I think about is death. I have been taking 80 mg of Prozac as well as olanzapine, which I started a few months back. I am stuck in a pit. I hallucinate all the time, and I can't shake this depression. I am at my wit's end. Do you have any advice?

Lysa

First, please be sure to let your psychiatrist (whom I assume is prescribing your medication) know of your depression, hallucinations and preoccupation with death. He or she may want to adjust your medication, or try other drugs if the ones you are currently on are not helping or are possibly even making some of your problems worse.

Second -- but actually, in my opinion, possibly of more importance -- is to thoroughly discuss what you're experiencing with your therapist. If you don't have a therapist, GET one.

Good psychotherapy can be extremely helpful in reducing stress, increasing coping skills, and even addressing the underlying factors associated with psychotic conditions. Some things to consider discussing with your therapist can be what was happening in your life when your symptoms worsened, and what's going in your life right now. It's been my experience that most people focus on death because something about their lives feels overwhelming, intolerable or hopeless. If that's the case in your situation, a therapist may be able to help you make changes to improve the quality of your life. Good luck.