Psychotic Symptoms in Bipolar Disorder

Psychotic features are frequently present during the manic phase of bipolar I disorder. Psychosis may also manifest during extreme episodes of depression.  Psychosis is a loss of contact with reality.  They are also present in schizophrenia and schizoaffective disorder.

Severe episodes of mania or depression include psychotic symptoms. The most common symptoms are hallucinations hearing, seeing, or sensing the presence of things not actually there.

Hallucinations are most often associated with mental illness schizophrenia. However, they may also occur for those with bipolar disorder when either depression or mania has psychotic features.

Severe episodes of mania or depression include psychotic symptoms. The most common symptoms are hallucinations hearing, seeing, or sensing the presence of things not actually there.  Psychotic symptoms in bipolar disorder reflect the extreme mood state at the time.

Delusions are false beliefs that are firmly held. They are one aspect of the psychotic features of bipolar disorder, schizophrenia and schizoaffective disorder.

In depression, the psychosis is usually consistent with their depressed state (eg, thinking they have a terminal disease and are about to die). In schizophrenia, these thoughts are more bizarre and disorganized or paranoid

 When a person is manic delusions of grandiosity, such as believing one is the President or has special powers or wealth, may arise; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed a terrible crime, may exist during depression. Some, during their mania, believe they are more important, gifted or capable than they really are. As a result of their inflated thoughts, they often behave in ways that are not usual for them, and represent a severe change from the non-psychotic state. For example, people during a manic psychosis might believe: they are capable of superhuman feats can fly, drive at excessive speeds, gamble excessively though they are broke.   They have God-like qualities, and begin to preach to others.

Psychosis during a manic episode is a very severe symptom and needs to be treated. Today,  drugs called atypical antipsychotics that are used to treat mania with and without psychosis.