Have you been told you have bipolar psychosis? What does that mean?
Bipolar disorder is a mental health condition that affects a person’s mood, energy, and activity levels. It causes mood swings that include extreme highs (called mania) and deep lows (called depression).
Bipolar psychosis is a more serious part of bipolar disorder. It can happen during these extreme mood swings. People with bipolar psychosis may have schizophrenic symptoms. They may have hallucinations (seeing or hearing things that are not there), delusions (false beliefs), or feel disconnected from reality. This can make life very hard for them.
At Empathy Health Clinic, we aim to raise awareness about bipolar disorder, a condition that is far more common than many realize. The World Health Organization says approximately 40 million people worldwide are affected. But even though it’s that common, many people don’t understand it. This is why taking the time to learn more about it is so essential.
Here’s what we’ll talk about:
- What causes mood episodes in bipolar disorder
- What are depressive episodes?
- What are manic episodes?
- What are hypomanic episodes?
- Bipolar psychosis explained
What Causes Mood Episodes in Bipolar Disorder
Mood episodes in bipolar disorder are caused by a mix of biological, genetic, and environmental factors. While the exact cause isn’t fully understood, scientists believe it’s linked to imbalances in brain chemicals like serotonin, dopamine, and norepinephrine, which affect mood.
Biological Factors
Brain scans show that people with bipolar disorder may have differences in brain areas that control emotions, decisions, and impulses. Hormonal changes and disruptions in sleep patterns can also trigger mood episodes.
Genetic Factors
Bipolar disorder often runs in families. If a parent or sibling has it, the risk is higher, but genetics alone don’t cause the condition—other factors matter too.
Environmental Triggers
Certain life events can spark mood episodes, such as:
- Stress: Job loss, financial problems, or relationship struggles.
- Trauma: Abuse or losing a loved one.
- Substance use: Alcohol or drugs can worsen symptoms.
- Sleep problems: Poor sleep can trigger mania or hypomania.
These triggers don’t directly cause bipolar disorder, but they can bring symptoms to the surface in those at risk.
Good Read: What is a mental breakdown?
How to Manage Triggers
Knowing your triggers can help you manage bipolar symptoms better. Here’s how:
- Stick to routines: Regular sleep, meals, and exercise help balance mood.
- Track moods: Use a journal or app to spot patterns.
- Handle stress: Try meditation, yoga, or therapy.
- Take medications: Follow your doctor’s plan without skipping doses.
- Get support: Talk to friends, and family, or join a support group.
By staying consistent and working with healthcare providers, people with bipolar disorder can reduce mood episodes and improve their daily lives.
Next, we’ll dive into the types of mood episodes, starting with depressive episodes. Stay tuned!
What are Depressive Episodes?
Depressive episodes are a core feature of bipolar disorder, marked by extended periods of low mood and energy. During these episodes, individuals may experience extreme sadness, fatigue, and a lack of interest in activities they once enjoyed. This isn’t about having an “off day” or feeling a little blue; it’s a profound and often debilitating experience.
We’ll be expanding more about these bipolar depression symptoms later.
How Bipolar Depression Differs from Major Depression
Bipolar depression and major depression can look very similar. Both can cause deep sadness, tiredness, and changes in sleep or eating. But bipolar depression is different because of other phases. People with bipolar disorder also have manic or hypomanic phases—times when they feel very excited, full of energy, or act without thinking.
For instance, a person with bipolar disorder may experience days of extreme fatigue, feeling unable to even get out of bed—this is known as a depressive phase and resembles symptoms of major depression. However, what sets bipolar disorder apart is the sudden shift to a manic phase, where they might feel unstoppable and act impulsively, such as recklessly maxing out credit cards on unnecessary purchases.
Common Symptoms of Bipolar Depression
Bipolar depression can manifest in unique ways, but some symptoms tend to overlap across cases.
To meet the criteria for a depressive episode, a person must experience at least five of the symptoms below, with one being either a depressed mood or a loss of interest in activities.
These symptoms must persist and significantly disrupt daily life:
- Persistent Sadness or Hopelessness: Feeling sad, worthless, or empty, often without a clear reason.
- Extreme Fatigue: Exhaustion so severe that even simple tasks, like showering or cooking, feel impossible.
- Loss of Interest: Hobbies, socializing, or favorite activities lose their appeal. For example, someone who loved painting may stop entirely.
- Sluggishness or Agitation: Feeling “stuck” and slow-moving or restless and unable to sit still.
- Sleep Changes: Sleeping too much or struggling with insomnia.
- Appetite Fluctuations: Significant changes in eating habits, leading to noticeable weight loss or gain.
- Guilt and Shame: Intense guilt over minor issues or an unwarranted sense of shame.
- Difficulty Concentrating: Trouble making decisions or remembering things, even with simple tasks.
- Thoughts of Death or Self-Harm: These can range from passive thoughts like “I don’t want to be here” to active planning or attempts.
Important Note: There are also cases of functional depression, where someone can still look normal outside and continue with their life with an underlying condition.
According to the National Institute of Mental Health (NIMH), depressive episodes in bipolar disorder usually last at least two weeks but can continue much longer without treatment. These episodes often disrupt relationships, work, and basic self-care.
You might be interested: Signs You Should Consider Rehab for Depression
Now that we’ve covered depressive episodes, let’s look at the other side—manic episodes.
Understanding Manic and Hypomanic Episodes in Bipolar Disorder
What Are Manic Episodes?
A manic episode is when someone’s mood becomes unusually high, excited, or irritable for at least a week, making daily life harder. It’s a key part of bipolar I disorder.
During mania, a person might feel unstoppable, full of energy, or easily frustrated. They might stay awake for days, spend too much money, or have big ideas they think are amazing. While it may initially seem exciting, it can lead to problems like debt, strained relationships, or accidents.
Symptoms of a Manic Episode
Mania can affect emotions, behavior, and thoughts. Common signs include:
- Feeling Overconfident: Thinking you’re super special or can solve huge problems.
- Not Needing Sleep: Sleeping very little but still have lots of energy, like staying up all night and starting projects.
- Racing Thoughts: Having so many ideas at once it’s hard to focus or stay on topic.
- Talking Too Much: Speaking fast or nonstop, making it hard for others to follow.
- Easily Distracted: Losing focus quickly because of noises or random thoughts.
- Overdoing Projects: Taking on big tasks like writing a book overnight or reorganizing everything at once.
- Taking Risks: Doing dangerous things like reckless driving, gambling, or spending too much money.
If at least three of these signs last for a week or more, it’s considered a manic episode. If the mood is more irritable than excited, four signs are needed. Mania can disrupt relationships, work, and overall health.
What Are Hypomanic Episodes?
Hypomania is a milder version of mania and is a key feature of bipolar II disorder. While it shares many symptoms with mania, it is less intense and doesn’t cause the same level of disruption or require hospitalization. Hypomanic episodes typically last at least four days and bring about noticeable changes in mood and behavior, but these changes might seem more manageable or even beneficial at first.
How Hypomania Feels
Picture this: You’re unusually productive and full of energy, juggling multiple tasks with ease. You feel more confident, outgoing, and creative than usual. To outsiders, you might seem like you’re just having a great week. However, these shifts in mood and energy aren’t sustainable and can lead to poor decision-making or burnout.
Key Traits of Hypomania
- Elevated Mood: Feeling unusually happy, confident, or energetic, often with a heightened sense of optimism.
- Increased Productivity: Tackling tasks with enthusiasm, sometimes taking on more than you can realistically handle.
- Social Behavior: Being more talkative, outgoing, or assertive than usual, which might come off as charming or overwhelming.
- Impulsivity: Making snap decisions, like splurging on expensive items or starting risky ventures without much thought.
While hypomania might seem less concerning than full-blown mania, it’s still important to pay attention. For some, hypomania can spiral into a manic or depressive episode if left unchecked.
The Impact of Manic and Hypomanic Episodes
Both manic and hypomanic episodes can significantly affect someone’s life. During mania, the consequences may include financial problems, damaged relationships, or even legal issues due to risky or reckless behavior. Hypomania, while less severe, can still lead to poor decisions or strained relationships if warning signs are ignored.
It’s also worth noting that what goes up must come down. After these elevated moods, individuals often crash into depressive episodes, resulting in exhaustion, guilt, or feelings of hopelessness.
Understanding manic and hypomanic episodes is essential for managing bipolar disorder. Whether you’re experiencing these episodes firsthand or supporting someone, education, and empathy go a long way in navigating this condition. By recognizing the symptoms and seeking appropriate care, it’s entirely possible to minimize the challenges and focus on living a balanced, meaningful life.
Bipolar Psychosis Explained
What is Psychosis in Bipolar Disorder?
As for our main topic, let’s expand on what is bipolar psychosis.
Psychosis is a serious symptom that some people with bipolar disorder may experience during manic or depressive episodes. It happens when a person loses touch with reality, which can lead to seeing or hearing things that aren’t there (hallucinations) or believing things that aren’t true (delusions).
For example:
- During a manic episode, someone might believe they have superpowers or are destined for greatness.
- During a depressive episode, someone might feel intense guilt or think they are worthless.
Psychotic Symptoms
Psychosis typically manifests as:
- Hallucinations: Seeing, hearing, or feeling things that aren’t real. Auditory hallucinations, such as hearing voices, are common.
- Delusions: Strongly held false beliefs that are not based in reality. For example, someone in a manic episode might believe they have extraordinary abilities or are being followed by government agents.
These symptoms can be both unsettling and confusing, not only for those experiencing them but also for their loved ones. Since the intensity and frequency of symptoms vary from person to person, developing a tailored treatment plan is essential for effective care.
Important note: Not everyone with bipolar disorder will have psychosis, but for those who do, it can be very upsetting. About 1 in 5 people with bipolar disorder may experience psychotic episodes at some point in their lives (source: American Psychiatric Association).
Psychosis During Manic vs. Depressive Episodes
- Manic Episodes: Psychosis during mania often involves grandiose or paranoid delusions. For example, someone may believe they are uniquely powerful or that others are trying to harm them.
- Depressive Episodes: Psychosis during depressive episodes tends to align with feelings of worthlessness or hopelessness. Individuals may have delusions about being gravely ill or causing harm to those around them.
Early Warning Signs of Psychosis
Recognizing the early signs of psychosis is crucial for early intervention and preventing escalation. Common signs to watch for include:
- Increased paranoia or suspicion of others
- Difficulty communicating or expressing thoughts clearly
- Social withdrawal or avoiding interactions with others
- Decline in performance at work or school
- Neglecting self-care or hygiene routines
- Reduced emotional expression or appearing emotionally flat
- Hallucinations, such as hearing, seeing, or feeling things that aren’t real
- Delusions, like believing you have special powers or are someone famous
- Distrust of others or feeling constantly threatened (paranoia)
- Confusion, jumbled thoughts, or difficulty focusing (cognitive fog)
- Acting impulsively or engaging in risky behavior
Spotting these signs early allows for intervention, whether through medication, therapy, or other supportive measures.
Treating Bipolar Psychosis
Psychosis can be managed with the right care. Treatment often includes medications like antipsychotics and therapy. If you or someone you know is showing signs of psychosis, it’s important to get medical help right away. With the right support, psychosis can be treated effectively. Key approaches include:
- Medications: Antipsychotics are often prescribed alongside mood stabilizers to manage psychotic symptoms.
- Psychotherapy: Therapy, such as cognitive-behavioral therapy (CBT), helps individuals process their experiences and develop coping strategies.
- Hospitalization: In severe cases, hospitalization may be necessary to ensure safety and stabilize symptoms.
It’s also crucial to address any underlying factors that may worsen psychosis, such as substance abuse. Detoxification and substance use treatment might be necessary before an accurate diagnosis and treatment plan can be established.
Bipolar Psychosis vs. Schizoaffective Disorder
While psychosis can occur in bipolar disorder, it’s important to distinguish it from schizoaffective disorder, which involves a combination of mood symptoms (mania or depression) and schizophrenia-like psychosis. The key difference lies in the timing:
- Bipolar Psychosis: Occurs only during manic or depressive episodes.
- Schizoaffective Disorder: Includes psychosis even when mood symptoms are not present.
Accurate diagnosis is essential, as these two conditions require different treatment approaches.
Managing Life with Bipolar Psychosis
Living with bipolar psychosis can be challenging, but with the right support, individuals can lead fulfilling lives. Open communication with healthcare providers, adherence to treatment, and building a strong support system are all critical steps. Family and friends also play a key role in offering understanding and encouragement.
If you or someone you know is struggling with psychosis, don’t hesitate to seek help. Professional resources, such as the National Alliance on Mental Illness (NAMI) or the Depression and Bipolar Support Alliance (DBSA), can provide guidance and community connections. Psychosis is a complex symptom, but with proper care, it can be managed effectively.
Final Thoughts
Bipolar depressive episodes can feel overwhelming, but understanding the condition is the first step toward relief and recovery. If you recognize these symptoms in yourself or someone you care about, remember that help is available, and healing is possible. With the right treatment, support, and coping strategies, it’s possible to regain balance and rediscover joy.
If you or someone you know is struggling with thoughts of self-harm or you sense dire danger, don’t hesitate to seek help.
Contact a trusted mental health hotline, such as a Prevention Lifeline at 1-800-273-TALK (8255) in the U.S., or reach out to local crisis services in your area. Your life matters, and there is always support available.
Disclaimer: This is not a diagnostic article. This is purely a general article for informational purposes. If you or someone you know may be experiencing symptoms of bipolar psychosis, please consult a qualified mental health professional for proper evaluation and support.
