All You Need To Know About Bipolar Psychosis

Reviewed by Aaron Horn, LMFT

Published 06/27/2022

Bipolar disorder affects about six million people in the United States every year. In fact, almost three percent of Americans have bipolar disorder. The median age of diagnosis is 25, but the disorder can happen to anyone at any time. That is why it is important to know all you can about the symptoms.

The Symptoms Of Bipolar Disorders

There are several different types of bipolar disorder, so the symptoms can vary quite a bit. According to experts, there are three types of bipolar disorder. These include bipolar I disorder, bipolar II disorder, and cyclothymic disorder.

Bipolar I Disorder

This condition includes those who have had at least one manic episode. Only one is needed for the diagnosis, but those with this disorder will often have several episodes of mania a year. Those who have bipolar usually develop the disorder in their late teens or early adulthood. However, some have their first symptoms as early as childhood.

Bipolar II Disorder

The depressive symptoms of bipolar disorder type II are the same as bipolar I, but they typically do not have full-blown manic episodes. What they do have are episodes of what is referred to as hypomania. The symptoms to look for include:

  • Having more energy than usual
  • Not needing as much sleep
  • Talking faster than usual
  • Risky behavior
  • Taking on too many tasks or ideas
  • Having periods of anger or rage

The differences between mania and hypomania are that the symptoms are not as extreme, and they usually last only about a week or so. Mania typically lasts for weeks or months. Bipolar II disorder is more difficult to diagnose because you may only notice the depressive symptoms.

Cyclothymic Disorder Or Cyclothymia

This disorder includes having short periods of hypomania with longer periods of depressive symptoms. The depressive symptoms are usually more noticeable than the hypomanic phases.

Symptoms In Children Are Different

With children, it is sometimes called pediatric bipolar disorder. Since children are not usually able to describe their symptoms, it is a bit different when trying to diagnose them. The signs of mania in children typically include:

  • Acting happier or sillier than usual for an extended period
  • Not being able to sit still
  • Talking fast
  • Not being able to focus on one thing
  • Having trouble sleeping or staying asleep but still feeling energized
  • Racing thoughts
  • Acting out of character
  • Having a short temper
  • Risky or reckless behavior

Children express their feelings are different from adults, so it is important to know what you may need to look for. Depressive symptoms in children are usually seen as:

  • Not wanting to get out of bed all day or for several days
  • Eating less or more than usual
  • Refusing to do anything social
  • Trying to stay home from school
  • Avoiding friends and family
  • Crying for no reason
  • Not having any energy to do anything
  • Older children may use drugs or alcohol
  • Talking about death or suicide

It may be hard to notice these signs in some children. There is an online bipolar disorder test you can take to help figure things out, though. But it is a good idea to know the symptoms so that you can recognize them in yourself or someone you love:

Symptoms Of Mania

  • Talking faster than usual
  • Not being able to concentrate on one idea at a time
  • Having way more energy than usual
  • Not needing any sleep, often staying awake all night
  • Believing that you are better than everyone else
  • Impulsive or careless spending
  • Reckless or risky behavior like hypersexuality or using drugs
  • Having angry outbursts or fits of rage
  • Eating less than usual and losing weight

Symptoms Of Depression

Chronic fatigue no matter how much you sleep

  • Sleeping for days without getting out of bed except to eat and use the bathroom
  • Feeling worthless or hopeless
  • Crying episodes for no obvious reason
  • Eating more or less than usual
  • Gaining or losing weight
  • Having no interest in activities that you usually enjoy
  • Isolating yourself from others
  • Speaking and moving slower than usual
  • Random aches and pains
  • Suicidal ideation or thoughts of death

A manic episode may last for a couple of days, a couple of weeks, or even last a few months. If left untreated, mania or mixed symptoms typically worsen and may be life-threatening due to the risky behavior. That is why anyone with bipolar disorder must get treatment.

Bipolar Disorder With Psychotic Features

Anyone who has bipolar I or bipolar II disorder can also have bipolar with psychotic features at any time. Over 50% of those who have bipolar disorder have at least one psychotic episode. You need to be aware of the signs and understand what you can do to treat it if it happens.

Psychosis And Bipolar Disorder

The definition of psychosis is described as losing all contact with reality and not being able to tell the difference between what is real and what is not. Although the symptoms can vary depending on the severity and type of bipolar disorder you have, there are some common signs to look for.

Bipolar Psychosis Symptoms   

Bipolar with psychosis often comes in waves. The symptoms start mild but may get worse without treatment. Early symptoms include withdrawing from friends and family, inability to concentrate, being suspicious of people, extreme worry about job performance, and not bathing, sleeping, or eating. If left untreated, the symptoms may get worse. Some of the signs of psychosis include:

  • Delusions like believing something that is not real
  • Bipolar hallucinations such as feeling, hearing, smelling, or seeing something that is not there.
  • They may believe they are on a secret mission or some other untruth
  • Bipolar paranoia such as thinking people are following them or are out to get them
  • Involuntary movements
  • They may believe that secret messages are coming from the television or radio
  • Extreme jealousy and believing their partner is cheating
  • Believing they are dying of some major disease
  • Thinking that someone they do not know (like a movie star) loves them
  • Inability to speak clearly

Treatment For Psychosis

Psychosis usually has to be treated in the hospital with medication and therapy. This is because those who have psychosis sometimes hurt themselves or others. There are some ways you can help a loved one who has had bipolar psychosis. Helping them keep track of their symptoms and getting them treatment are two good ways to help. Here are some others:

  • Plan A Schedule. Having a daily routine is good for anyone, but it is essential for those with any kind of mental illness. Let them help you with the scheduling not to feel like you are treating them like a child unless they are a child. 

Help Them Keep Track Of their Medication. It is best to put this on the schedule so they do not miss any medication. Missing a medication time can set off a bout of psychosis.

  • Make Sure They Get Enough Sleep. Sleep deprivation can be a cause of psychosis. Help them plan their day so that they go to bed and wake up at the same time every day. This will make it easier for them to get the sleep they need. But do not try to force them to sleep. Instead, if they are having trouble sleeping, sit up with them and have them try some warm milk or melatonin.
  • Give Them A Journal To Write In. This is an excellent way for them to keep track of their symptoms and feelings. Encourage them to write in it whenever they want to. Let them know they can write whatever they want in there and that nobody will read it unless they want to share it.
  • Do Not Threaten Them Or Set Consequences For Their Getting Treatment. What they have is an illness, and it is not easy for them to live that way. Nobody wants to have bipolar disorder or psychosis. Just let them know that you are there to help them if they need it.
  • Ask Them Questions Instead Of Assuming You Know What Is Going On.Do not assume that they want help all the time. Sometimes they may need to de-stress on their own. As long as they are not a danger to themselves or others, let them be.
  • Try to stay positive. Even though this disorder is difficult and can turn your lives upside down, remaining positive is important for you both. Give them comfort and encouragement as much as you can. 

Psychosis Is Treatable

The good news is that psychosis is treatable. Often, those who have psychosis are afraid to ask for help, or they do not even know they need help. With the right treatment and medication, they can get their life back on track. Once they have stabilized and are not experiencing psychosis anymore, online talk therapy is a good way to help.

To take the first steps to discover if you have any potential bipolar symptoms, take this online bipolar disorder test to find out more.