When Bipolar Disorder Leads to Psychosis

Understanding and Managing Bipolar Psychosis

Bipolar PsychosisIn the world of psychology and mental illness, bipolar disorder stands out from the crowd. Compared to many other conditions, bipolar disorder is more complex, more confusing, and more frustrating to sufferers and clinicians alike.

A major contributor to the complexity is that one person’s presentation and symptoms of bipolar disorder can vary greatly from those of another. Additionally, the complications increase because bipolar symptoms can fluctuate regularly, which means the symptoms of today may not match the symptoms of tomorrow.

Bipolar is pervasive. It has the ability to negatively impact all phases of your life, including your mood, energy levels, relationships, and work status.

In the best situations, bipolar disorder can be managed well with effective treatment. In the worst situations, symptoms are rarely controlled, leading to many hardships that affect you and your loved ones.

In the best situations, symptoms are mild; but in the worst situations, they swing wildly and include bipolar psychosis.

Not everyone with bipolar disorder will experience bipolar psychosis, but some will experience the condition that leads to flawed perceptions of reality. This situation can be challenging to identify if you are unfamiliar with it and difficult to manage if you are unprepared to take the needed steps.

By learning all you can about the condition, you can improve the outcome of bipolar disorder if needed in the future.

Defining Bipolar Disorder

For all the media coverage and common use in everyday language, there continue to be multiple misconceptions about what bipolar disorder actually means. If you are in a “good mood” one minute and a “bad mood” the next, you do not have bipolar disorder, contrary to popular conceptions.


Instead, you have normal emotional changes that come with reactions to stressful situations. If your child refuses to go to school, it does not mean they are bipolar — it only means they are engaging in an unwanted behavior.

To be diagnosed with bipolar disorder, you must be evaluated by a mental health professional. Avoid any self-diagnosis measures or online tests that claim to offer a diagnosis — these can be flawed and often make false claims.

A professional will ask many questions about your life, the history of your symptoms, and the mental health of your family members, since bipolar disorder has a strong familial component.

Your evaluator will look for symptoms of a major depressive episode that include:

  • Depressed or irritable moods.
  • Lower interest or pleasure in activities.
  • Significant weight loss or weight gain.
  • Changes in sleep habits.
  • Feeling slowed down or sped up.
  • Low energy.
  • Feeling worthless with low self-esteem.
  • Lower concentration and decisiveness.
  • Thoughts of death or suicide.

If you meet the minimal criteria for having a major depressive episode at some point in your life, the evaluator will begin looking at symptoms of a manic or hypomania episode.

These symptoms include a mood that is persistently elevated or irritable, behaviors that are hyper-focused on achieving goals, and a combination of the following:

  • Very high self-esteem.
  • Lower need for sleep.
  • Being very talkative.
  • Bouncing from ideas quickly.
  • Being distractible.
  • Spending a lot of time with potentially dangerous activities, like spending money, using drugs, or having promiscuous sex.

Before the term bipolar disorder was used, manic depression was the common term for this mental health condition. It was a descriptive name because the individual must have both manic and depressive symptoms in their lifetime to qualify for the diagnosis.

The rate and intensity of the episodes will vary, as will the periods of low or absent symptoms. Some people are diagnosed with bipolar II disorder because their symptoms are only intense enough to meet the criteria for a hypomanic episode rather than manic.

Study the Specifiers

Once the bipolar diagnosis is given, your mental health clinician may ask more questions about the course of the illness, other symptoms, and developing trends and patterns of the condition.

For example, if someone with bipolar disorder consistently has depressive episodes in the fall and winter, and manic episodes in the spring and summer, they might qualify as having bipolar I disorder with seasonal pattern.

The “with seasonal pattern” is called a specifier. It is a way to fine-tune the disorder and tailor it to the individual.

Next page: a closer look at bipolar specifiers.

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