Navigating bipolar disorder can involve more than just managing depressive and manic episodes; it also might include the potential challenge of psychosis.
This helpful guide explains how to recognize bipolar psychosis, outlines common questions, highlights risk factors that may lead to psychosis, and provides some examples of the types of support commonly offered to those who have been diagnosed with psychosis.
Bipolar disorder affects roughly 3 out of every 100 U.S. adults, with psychosis being an occurrence that can arise during a mood episode for some individuals.
Psychosis, more formally known as psychotic symptoms or psychotic experiences, refers to times when a person perceives or interprets things differently from those around them — essentially, a loss of contact with or change in beliefs about reality. It’s a feature that can manifest in both the manic and depressive phases of bipolar disorder.
Understanding what happens during a psychotic episode is pivotal to recognizing and managing it effectively. The experience can be disruptive, confusing, distressing, or even frightening. Here is a breakdown of key occurrences:
Safety should be a primary concern during a psychotic episode. The altered perception of reality can lead to increased risk including dangerous behaviors, self-harm, or harm to others. In such instances, immediate professional intervention is necessary.
There are two primary types of psychosis. These classifications help licensed prescribers and therapists tailor treatment approaches to the symptoms of bipolar psychosis.
This type of psychosis involves behaviors or thoughts that are consistent with depressive or manic mood states. For instance, during a depressive episode, someone may believe they committed an unforgivable sin.
On the other hand, mood-incongruent psychosis involves beliefs or experiences that don’t line up with the presented mood state. During depression, for example, someone may feel that they have supernatural abilities.
While both bipolar disorder and schizophrenia can involve psychosis, the experiences are different. Bipolar psychosis tends to be shorter and often related to severe mood symptoms. Schizophrenic psychosis is typically longer-lasting, with more severe disorganization in thoughts and behaviors, and often occurs outside of mood episodes.
The length of a psychotic episode can vary in those with bipolar disorder. Psychosis can last for as little as a day or several weeks. Understanding the typical length of an episode can help individuals prepare for the recovery period and take steps to prevent or lessen the impact of future episodes.
Diagnosing bipolar psychosis requires a thorough evaluation by a mental health professional. This assessment involves discussing symptoms, reviewing medical history, and, at times, conducting physical exams and lab tests to rule out underlying medical conditions that could be causing symptoms.
Understanding the triggers of a psychotic episode is crucial for management and prevention. What triggers bipolar psychosis? These are some of the common causes:
Managing bipolar disorder’s psychotic episodes typically involves a combination of medication, therapy, support, and self-care.
During a psychotic episode, medications may need to be adjusted or added, and one may need to check in with or see their prescriber often. Antipsychotic medications are often used to manage the symptoms of psychosis. Like all medications, these have risks and benefits, and it's important that you consider those with a healthcare provider.
Cognitive behavioral therapy (CBT) can also be effective in helping individuals manage and prevent psychotic symptoms by providing tools to challenge and reframe irrational beliefs.
Having a strong support group is really important for people who experience psychosis — those trusted individuals can help distinguish reality from imagined perceptions. Support and education programs for loved ones can also be a valuable resource to help them become more informed and prepared to provide help through the recovery process.
Maintaining a balanced lifestyle that includes regular exercise, a healthy diet, and adequate sleep can help stabilize mood and reduce the risk of psychotic episodes. Additionally, identifying and avoiding personal triggers such as stressful situations or substance use is crucial.
Be prepared: Fill out this free mental health emergency plan so you have a roadmap for action if your symptoms escalate.
After experiencing bipolar psychosis, it’s crucial to regroup and reestablish a sense of stability. Many of the same interventions that are recommended during an episode apply in the recovery process, which may also involve adjusting treatment, seeking support, and focusing on self-care. It’s also essential to have open and honest communication with a trusted mental health professional.
Following a psychotic episode, it may be beneficial to:
Psychotic symptoms, though common in bipolar disorder, vary in how they impact the condition's progression and outcomes. With support and management strategies that work for you, you can regain balance and continue to lead a fulfilling life.
Supporting someone in the midst of psychosis requires sensitivity and patience. You’ll want to:
You could risk making things worse if you try to convince them that their beliefs are false, dismiss or belittle their experiences, argue with them, or encourage dangerous or impulsive behaviors, potentially leading to increased distress, isolation, or even harm to themself or others.
People experiencing a psychotic episode have a higher risk of suicide. If someone demonstrates severe symptoms — such as expressing suicidal thoughts, showing intense paranoia or agitation, or acting abusively or violently — contact local emergency services immediately.
The complexities of bipolar disorder and psychosis may present challenges, but you don’t have to face them alone. With the right knowledge, support, and strategies in place, you can find stabilization and greater control over your life.
Support groups, education, and therapy are just as essential for those who care for individuals with bipolar psychosis as they are for the affected person themself.
From online therapy to medication management, Cerebral can deliver a tailored approach to address these mental health needs. Discover how we’re different from other online mental health providers.
Images by vecstock and tirachardzon Freepik.
The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.
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