Bipolar Delusions and Delusional Thoughts (as a Result of Psychosis or Otherwise)
A delusional thought is symptomatic of a psychotic state, which is when you have an altered perception of reality.
Most bipolar delusions are grandiose, involving exaggerated feelings of power, wealth, sexual attractiveness, luck or insight. Many of these thoughts have religious connotations and beliefs about God.
Delusional thoughts can be very dangerous and may lead to reckless behavior, including overspending or hypersexuality.
Who Can Experience Bipolar Delusions?
Bipolar psychosis, and subsequent delusional thoughts, is usually a feature of severe mania in bipolar type 1 — it can also be associated with bipolar depression, but this is less common.
Studies have shown that approximately two-thirds of bipolar patients will experience at least one psychotic symptom over a lifetime.
When Did I First Experience Bipolar Delusions?
I vividly remember experiencing bipolar psychosis for the first time in 2008. However, I had no knowledge or education about mental health, so I had no idea what was happening to me at the time. It was absolutely petrifying.
The first time was hearing a man’s voice coming from inside the bedroom where I was sleeping, telling me he was coming to get me. His voice was low and threatening.
I ran into my friend’s bedroom, but when she woke I refused to tell her what I had heard. I knew there was no man in my bedroom, but I could hear a man’s voice.
I thought I had gone completely mad. After the second time, I was inconsolable and told my friend to call an emergency helpline, which told me sleep and food deprivation may be the cause.
‘I Was Convinced I’d Lost My Mind’
My delusional beliefs came on slowly and were impossible to rationalize as clearly as recognizing there was no man in the room. I remember making my mum take me to an emergency clinic because I was convinced I’d lost my mind and needed serious help.
I sat with her and started talking about the family tree and how everyone interconnected. I believed I had a clear understanding of why every one of us behaved the way we did and how we forged relationships with each other.
I talked endlessly about my findings to my mum; looking back, she must have been very concerned. At this point I was undiagnosed and starting to behave irrationally.
I was over-exercising, being creative, irritable, suicidal, high, low, every which way you could imagine. I learnt at a later date I was rapid cycling with undiagnosed bipolar.
As time went on, my thoughts became grander. I was looking at life as this big wondrous place that I could understand implicitly.
I felt as though life was like a chessboard and every person was merely a piece being moved around by God. I believed I understood deeply what was happening and therefore had a unique relationship with God.
At the same time, I believed I was invincible and could jump across busy roads. I was also shoplifting.
I don’t remember telling anyone about my relationship with God because it felt so special and personal that it wasn’t information to share with others. In my eyes, they didn’t understand like me and they wouldn’t get it.
I’m not even sure I told my psychiatrist in-depth about how I felt. I just explained that everything felt worldly, big and I was having ‘special’ thoughts.
After diagnosis, I was admitted into a psychiatric hospital, and in the throes of mania, other things were happening to me.
I spent days scouring fashion magazines and carefully constructing outfits that I used to parade around the wards confidently. I stopped wearing underwear and felt above everybody else.
It was another string to the bow of feeling invincible. Nothing felt like it could touch me.
Bipolar Delusions and Paranoid Thoughts
While some delusional thoughts can feel wonderful and enhancing, others can be detrimental.
Not only was I taking risks, but I was also feeling as though people were against me or talking about me. I was convinced at times that everyone was discussing my life and I was isolating myself from my family because of it.
I remember having to organize the return of my company car from the hospital and only liaised with my uncle and aunt. I told them to keep the seemingly unimportant issue top secret, making them promise they wouldn’t tell a soul.
Unfortunately, my aunt told someone else, who then contacted me in hospital. I freaked out, cried, self-harmed and became completely paranoid.
My psychiatrist had to recommend phone calls be vetted to make sure they didn’t upset me. This period was really hard; I had never felt so alone and misunderstood, with no control over what people were thinking and saying about me.
What Helped Me?
Throughout my first manic outbreak, where I experienced psychosis and delusional thoughts, very little helped me. I was uneducated with no insight and every friend and a family member was learning alongside me.
I have now learned that with the proper treatment, experience and practice, symptoms can certainly be relieved.
Therapy Does Work!
In my first hospital admittance, I was on a trial-and-error program with mood stabilizers and anti-psychotics, and it took four months to slow down my rapid cycling and treat the mania and psychosis.
While medication is crucial in a crisis, therapy and support are just as effective in different ways.
The first thing I learned in hospital, is that you need to be surrounded by professionals and a support network that understands. If you trust someone, you can tell them you are experiencing strange thoughts and you doubt yourself and your reality.
My family and friends have been on a steep learning curve, but now know they need to listen, be kind and empathetic, help to distract me or maybe double-check I’ve taken my medication as well as signpost me to my community psychiatric nurse, therapist or psychiatrist.
From my years of therapy, I know there is a lot I can do for myself. I can keep a diary and write down any thoughts or feelings I’m having, which I can then check with a doctor or psychiatrist if I’m concerned.
I can also be honest and tell friends and family my thoughts and allow them to rationalize what is reality and what may be an altered perception.
I know I need to do my deep breathing when I have anxiety that people are talking about me, and challenge myself with questions, such as have I actually done anything wrong or could that person’s facial expression be because they are having a bad day and nothing to do with me?
As much as I can learn and help myself, there are times, particularly in mania, where we lose complete insight. It is therefore important we have plans in place with trusted people around us.
I have sat down and told my family what to watch out for symptom-wise when I become ill. My community nurse has a written plan of the things I think and act when my mood is changing. They play a part in managing my state when I become psychotic or delusional.
I will say one thing. Apart from my first manic episode when I was undiagnosed, I have only experienced psychosis and delusional thoughts when I have had medication altered.
It is very rare for me and I take solace that in managing my condition with medication, a good support network, balanced diet, exercise, therapy and doing things I enjoy, the chances of any significant mood changes, which can trigger psychosis and delusional thoughts, are radically reduced.