Hello and welcome to Healthcare Magic. Thanks for your query.

I shall answer your questions in detail...

1) In simple terms, you have been diagnosed to have a very severe depression. MDD stands for Major Depressive Disorder.

MDD is further categorized, based on the severity, into: mild, moderate and severe. The severe type is further sub-categorized into:
- severe depression with "psychotic features"
- severe depression without "psychotic features"

Now, having "psychotic features" in severe depression, means that the depression is very severe and serious). What this means in plain English is that, sometimes, when people have a severe depression, they can also start having abnormal or false beliefs - called delusions (for example, that their body is rotting or that their XXXXXXX organs are missing or that people are trying to harm them, etc. ) or may they may start to hear voices - called hallucinations.

In terms of treatment, individuals with "severe depression with psychotic features", need not only anti-depressant medication, but also anti-psychotic medication. The medication which you have been put on seems to be corelating and appropriate for your diagnosis. That is, Celexa (Citalopram) is an anti-depressant medication and Risperidal (Risperidone) is an anti-psychotic medication. One more point in your diagnosis is that you seem to be having "recurrent" episodes of depression, which obviously implies that you have had depressive episodes in the past also.

2) The duration of treatment varies from individual to individual, depends upon various factors like the severity of the depression, the number and severity of past episodes, the past response to medication (i.e whether you have had any depressive episodes while taking treatment), the patient's level of social functioning and level of social support available, and of course, the patient's choices as well.

In your case, your depression is severe (with psychotic features also) and you seem to have had recurrent episodes in the past also. In such a case, a minimum of 2 years of continuous treatment would be the protocol. You may need the anti-psychotic medication, Risperidal, only for a short duration (i.e. till the psychotic symptoms subside), but you need to be on an anti-depressant for at least 2 years.

3) Regarding carrying guns, anyone who has "active" symptoms of depression or psychosis, will not be allowed to carry guns (epecially because having "psychotic symptoms" means that your thinking process has become clouded or could be compromised due to the delusions or hallucinations). However, if you have completely recovered from your depression, and on subsequent psychological assessments, are found to be completely free of depressive and psychotic symptoms, and your risk of developing a subsequent episode is minimal, then this should not be a hindrance to holding a police officer job.

I hope this has been informative and useful to you.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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