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Bipolar Psychosis: 7 Things To Know

Medically reviewed by Paul Ballas, D.O.
Updated on April 11, 2024

If you’re living with bipolar disorder, you’ve likely experienced mood swings between mania (elevated mood) and depression (low mood). But bipolar disorder can come with other symptoms, including bipolar psychosis — periods when it’s difficult to tell what’s real and what’s not.

Experiencing bipolar psychosis can be scary, both for you and your loved ones. “One thing that scares me is not having control over these episodes,” shared one member of MyDepressionTeam.

Read on to learn more about bipolar psychosis, including what it feels like, and the steps you can take to manage it.

Around 63 percent of people with bipolar 1 disorder have experienced bipolar psychosis.

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1. Many People With Bipolar Disorder Experience Psychosis

According to the National Institute of Mental Health (NIMH), the term “psychosis” refers to times when a person can’t tell the difference between what is real and what is not. Psychosis can happen during the mood swings caused by bipolar disorder. Both depressive and manic episodes can cause psychosis. Bipolar psychosis is typically linked to bipolar 1 disorder. Around 63 percent of people with bipolar 1 disorder have experienced bipolar psychosis.

2. It Helps To Be Aware of Common Symptoms of Psychosis

Symptoms of bipolar psychosis vary, but some common ones include:

  • Delusions — False beliefs
  • Hallucinations — Seeing or hearing things that aren't there
  • Paranoia — Feeling like everyone is “out to get you” or that you’re being watched
  • Disorganized thinking or speech
  • Catatonia — Immobility or repetitive movements

The range of symptoms a person experiences during psychosis is often influenced by that person’s mood when they enter psychosis.

3. The Cause of Bipolar Psychosis Is Unknown

Scientists are still working to figure out the exact cause of bipolar psychosis. Bipolar psychosis may be related to differences in how your brain works, genetics, or triggers such as stress or substance abuse.

4. Your Doctor Will Ask About Your Mental Health History To Diagnose You With Bipolar Psychosis

Several mental health conditions can cause psychosis. For this reason, your doctor will consider your mental health history and symptoms to diagnose you with bipolar psychosis. They may ask you questions such as:

  • How often do you experience symptoms of psychosis?
  • How do you feel when you experience psychosis, including recent mood changes?
  • Does anyone in your family have a history of psychotic episodes?


The best way to manage psychosis is to recognize the early signs and get help.

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The answers to these questions will help your doctor decide whether your psychosis is a symptom of bipolar disorder or another related disorder.

5. You Can Learn To Recognize the Warning Signs of Psychosis

Psychosis is linked to a high risk of self-harm, suicidal thoughts, and harm to others. For this reason, you need to act quickly if you think you or a loved one may be entering a psychotic episode.

The best way to manage psychosis is to recognize the early signs and get help.

Early signs of psychosis include:

  • Isolating oneself from others
  • Having difficulty focusing or racing thoughts
  • Experiencing problems at school or work
  • Feeling paranoid or suspicious
  • Feeling strong emotions or no emotions at all
  • Paying less attention to self-care, such as not sleeping enough, showering, or brushing one’s teeth

If you think you or a loved one are experiencing psychotic symptoms, seek help right away. You can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

During an episode, try to reduce your fear and stay calm by challenging your thoughts. After the episode, follow up with your health care provider to prevent future episodes.

6. You Can Live a Full Life With Bipolar Psychosis

Although you cannot prevent bipolar psychosis, there are strategies you can use to improve your symptoms and decrease the risk of future episodes.

Treatment

Like many mental health conditions, treatment options for bipolar psychosis include both medication and talk therapy. Antipsychotic medication is prescribed to help manage symptoms such as delusions and hallucinations, while mood stabilizers can help prevent future episodes.

Keeping a record of when you experience psychosis can help you manage your symptoms.

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Talk therapy can also help manage symptoms and prevent relapse. This could include cognitive behavioral therapy (CBT) or psychotherapy.

Lifestyle Changes

Managing bipolar psychosis can be difficult, but there are several lifestyle changes that can help improve your quality of life. These include:

  • Getting regular exercise
  • Maintaining a healthy diet
  • Avoiding alcohol and substance use (other than drugs prescribed by your doctor)
  • Seeking support from family members and friends

It’s also important to get enough sleep. Adults 18 and over should get at least seven hours of sleep each night, according to the Centers for Disease Control and Prevention (CDC).

Track Your Symptoms

Keeping a record of when you experience psychosis can help you manage your symptoms. Write down what you were doing, how you felt, and how you managed your symptoms during and after the episode. If you can't remember what happened, ask someone who was with you to help you record it.

Recording this information will help you:

  • Identify what triggers your psychosis.
  • Recognize the early signs of psychosis.
  • Find which strategies help manage how you feel during an episode.
  • Help your doctor understand your symptoms and find the right treatment plan for you.

7. Your Health Care Professionals Are Your Best Resource

Be sure to talk with your doctor or a mental health professional if you have symptoms of bipolar disorder, including bipolar psychosis. They can help you find a treatment option that helps you cope.

If you or a loved one is experiencing symptoms of bipolar psychosis, it is important to seek help right away. Contact a mental health professional or emergency services for immediate help.

Remember, with treatment and support, it is possible to manage bipolar psychosis and lead a fulfilling life.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and their loved ones. On MyDepressionTeam, more than 146,000 members come together to ask questions, give advice, and share their stories with others who understand life with depression.

Have you been diagnosed with bipolar psychosis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Updated on April 11, 2024
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    Paul Ballas, D.O. is an attending psychiatrist at Friends Hospital in Philadelphia, Pennsylvania. Review provided by VeriMed Healthcare Network. Learn more about him here.
    Catherine Leasure, Ph.D. is a Ph.D. candidate currently studying at Vanderbilt University in Nashville, Tennessee. Learn more about her here.

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