Does having psychotic depression mean you have to be institutionalized?

It means you need: treatment STAT. If this condition causes you to feel suicidal or homicidal, or if you get into trouble because of severe interference with normal mental functioning, then hospitalization would be indicated. There are minor version of psychosis that might be more manageable at home with meds, for example, but go to a psychiatrist right away to assess.

Usually until better: If a person is so mentally ill that she is psychotic, that means her brain has trouble telling what is real or not real, trouble interpreting what others say or do, and trouble separating right from wrong, important from unimportant, trouble thinking or planning... she basically is not functional. We would not want someone like that driving down the street alongside us... thus, it's hospital time.