Those with depression with psychosis meet the criteria for diagnosis of depression but also experience psychotic symptoms. When individuals with major depressive disorder (MDD) experience delusions, hallucinations, or catatonic symptoms, it is referred to as MDD with psychotic psychosis, also known as psychotic depression. The nature of the psychosis in those with depression is usually mood-congruent somatic, pessimistic, or guilt-related delusions. It is crucial for healthcare providers to diagnose psychotic depression early due to its high risk of suicide and poor response to antidepressant treatment alone. Additional antipsychotic medication is typically necessary, in addition to the antidepressant, for an effective response. Electroconvulsive therapy is more commonly used in those with severe depression with suicidality, catatonia, and those with psychotic depression. Studies have shown a response rate of 70-90% with electroconvulsive therapy in those with severe depression.