Psychosis and the Bipolar Mind

When I was first diagnosed with bipolar disorder, I was not familiar with the term “psychosis” or “psychotic break.” My guess is that my doctors did not want to explain it to me while I was full-blown manic and right in the middle of a psychotic break.

How can you tell someone who has lost touch with reality that what they are experiencing is, in fact, not real? It is impossible to explain away a hallucination or delusion to someone experiencing them. At least, that has been my experience.

In hindsight, this all makes sense.

My Experience With Psychosis

Symptomatically, some of us diagnosed with bipolar disorder type 1 have experienced psychosis, or will in the future. I for one fall into this group.

Generally speaking, and looking back over the course of my life, I tend to have faith-based or spiritual psychosis.

Let me give you some examples of psychosis from my own experience.

Psychosis 2015

When I revisit the memories of my past manic episodes, it is hard to comprehend how I believed some of the things I did and how I acted during an episode.

My mind basically turned on me. I made decisions based on what my mind perceived.

During my manic episode in 2015, I believed I was best friends with the Pope. I sincerely thought I had an important idea that would positively change the face of all Christianity.

Looking at this situation now, I can see the absurdity of that notion. However, during that time, I trusted in this truth like I do the air that I breathe into my lungs right now.

This is an example of being delusional.

Having a delusion, is by definition, having a belief, opinion, or judgment that is contradictory to reality. These delusions can be anything – again, mine tend to be faith-based.

Psychosis 2016

Most people perceive mania as a fun and exciting state of mind. In reality, a full-blown manic episode is completely different.

In September and October of 2016, I experienced a large amount of stress in my life, all at once and in a short period of time. This increased stress level resulted from a barrage of triggers. I did everything in my power to manage the stress and maintain my stable frame of mind. However, it just was not enough. A full-blown manic episode ensued.

At first, I felt a sort of inner peace and extreme clarity with the world around me. My energy level increased, creative ideas flowed, and I started channeling this new energy into projects.

The first few days were fantastic and extremely productive – but this was short-lived.

I slept less and less but felt more refreshed than I could remember. Most people when they do not get enough sleep feel tired and draggy the following day. The less need for sleep helps to fuel mania.

My thoughts were flowing so fast that I could not remember them from one moment to the next. With such disorganized thinking, paranoia took over, and I felt like people could read my mind. I felt out of control.

Dark shadows followed me. In my mind, I had opened the gates of a spiritual dimension that only my manic mind could fully comprehend. Those dark shadows turned into demons, and I glimpsed the true nature of the spiritual warfare going on around me. I needed to protect my family from this evil.

Hallucinations

One of the hallmarks of having a psychotic break is a hallucination, and there different types of hallucinations: auditory, olfactory, tactile, gustatory (taste), kinesthetic, and visual.

Auditory: Hear sounds and noises that are not real.

Olfactory: Smell an aroma or odor that is not present.

Tactile: Feel something crawl all over your body when nothing is there. Some people feel pressure, like someone is touching them, but no one is really there.

Gustatory (Taste): Have a strong taste that is not there. For example, some individuals will have a metallic taste in their mouth. It can mean something different, and the possibility of other ailments needs to be ruled out.

Kinesthetic: Think your body is in motion when it is not. For example – flying, walking, running, or falling.

Visual: See shapes, colors, objects, and/or people that are not there.

Those living with bipolar disorder type 1 are more likely to have auditory hallucinations as opposed to visual hallucinations.

Memory

Bipolar mood episodes are episodic in nature – meaning, they have a distinct beginning and ending. The time frame of a mood episode varies from person to person but can be weeks, months, or even years. Many times a mood episode does not follow any pattern.

Memory and its relationship to a mood episode is a topic that I feel needs more research and attention.

During a manic episode, my thoughts race so fast that I do not have enough time to remember them past that instant. I feel, from my personal experience, that this is the primary reason I do remember my manic episodes. My thoughts do not stay in my mind long enough to get stored in my long-term memory bank.

I do not blackout during a manic episode, but my memories are fuzzy, and it is hard to recount anything, if at all. However, I can remember my feelings during an episode of psychosis. With the help of my loved ones, I am able to piece together these memories and determine what exactly happened.

I know this is not the experience for everybody living with bipolar disorder, but it is in the most severe cases – like myself. I find the link between memory and bipolar disorder intriguing, especially in the case of a full-blown manic episode, accompanied by psychosis.

Treatment Plan for Psychosis

Experiencing a psychotic break is extremely scary and unnerving. What I thought was real and the truth completely contradicted reality. Losing control of my thoughts, memories, and actions has been one of the scariest experiences I have endured.

One of the ways I prepare for psychosis is to write a protocol into my treatment plan. If you have not already, I highly suggest you create one.

When writing up my treatment plan, I speak with my loved ones and my medical care team. We discuss what steps they should take when I get manic or experience a depressive episode. It is extremely important that all parties involved agree to the plan of attack. There should be no questions once the treatment plan is finalized.

When I reach the threshold of psychosis, it is at this time when others must intervene. During psychosis, you cannot use anything to reason with me. If my loved ones have any questions about how to help me during this time, they simply need to look at my treatment plan.

My personal plan describes that my loved ones can admit me to a hospital or other psychiatric facility if they feel it necessary, and the same goes for my doctor and therapist.

Trust me, it is easier to make a plan now than it is during an extremely stressful situation, such as a mood episode.

Last Thoughts

Remember to always speak with your doctor if you have any questions.

Psychosis is a symptom of more than just bipolar disorder. Symptoms overlap among different mental illnesses. A doctor is the only one who can properly diagnose bipolar disorder and other mental illnesses.

There are treatments for psychosis. A class of medications called antipsychotics can help alleviate psychotic symptoms. Again, speak with your doctor.

With bipolar disorder, psychosis is something that can show up with no warning. Prepare before it strikes.

It may seem like you do not have much control traversing along the road of your life, but you have more control than you think.