If, like me, you have experienced psychosis, then you know it is not easy to talk about it with other people. I’ve done a lot of research on bipolar disorder to understand my condition and learn to manage it, and I’ve found very little information about bipolar psychosis. I’ve had one major psychotic episode, and I know that about 60% of people with bipolar disorder experience psychosis at least once in their lifetime, so I decided to do some research and gather some thoughts about this topic.
Currently, I am not actively psychotic or having an episode. And at this point in my life, I feel I know myself better than I ever have, and I am learning how to make this life work for me. Here are some facts I’ve gathered to help me make sense of this condition. What is bipolar psychosis? It is a distorted or nonexistent connection with reality. A person with psychosis cannot distinguish between the external, objective “real world” and their own subjective perceptions, distorted and characterized by delusions and/or hallucinations. In bipolar psychosis, this loss of contact with reality is usually a feature of the severe mania experienced in Bipolar Type I. However, it can also be associated with bipolar depression, but this is far less common. People with bipolar I can share a broader range of symptoms than those with bipolar II, but both can go through psychosis. It is characterized by grandiose delusions involving exaggerated feelings of power, wealth, sexual attractiveness, luck, or insight. It is also characterized by hallucinations which include hearing, seeing, feeling, smelling, or sensing things that are not really there. There is a great deal of information about bipolar disorder and psychosis on the Black Dog Institute Factsheet and Psychology Notes. > The psychotic episode I had had delusions and hallucinations, and I recount parts of that episode in the earlier posts of this blog. I’m still processing that episode as I am shocked that my mind could lose its footing severely and put me in danger. It’s something I often revisit in therapy. What to do during bipolar psychosis? Here are three things that have helped Pippa L. when experiencing psychosis. #1 Deep breathing Count to ten and let your breathing settle down. Sometimes the correct breathing pattern can be enough to settle or even stop the psychosis. Make sure your breaths are even deep and continue until you feel calm and safe. #2 Safe place You may not be able to prevent psychosis, but you can lessen its effect on you. Get yourself to a safe place, or at the very least, to a quieter place. If you can, grab someone you trust and take them with you, or go alone if that makes you more comfortable. #3 Anchoring objects You can find things around you that you can focus on. Some great apps are available for further help if necessary, but just find something still and focus your attention on that object as much as possible. Psychosis can only affect you to the extent you are concentrating on it. > I found these grounding strategies helpful as I was lost and confused while experiencing my psychosis. Some moments were panic-inducing, so I’m adding them to my toolbox in case this happens again. How to treat bipolar psychosis? You have to treat psychosis with antipsychotics immediately because it can be dangerous to lose touch with reality. People with bipolar disorder who are experiencing psychosis are usually prescribed what are called atypical antipsychotics, or second-generation antipsychotics, according to the NIMH. They work by affecting various neurotransmitters in the brain, including dopamine. Antipsychotics begin to treat some symptoms, like hallucinations, within days, while it may take weeks for delusions to fully recede. The duration of treatment is highly variable, depending on the patient. Some people with bipolar disorder only take antipsychotics when symptoms appear and stop a few weeks or months after they feel normal again. Others may stay on a low dose of antipsychotics for a year before tapering off to prevent another episode. And sometimes, people stay on them indefinitely as a maintenance treatment. Most often, antipsychotics are just one component of the drug regimen used to treat bipolar disorder. > I’ve been on Abilify since October 2018, and my psychiatrist recently told me we will discontinue its use (which was the best news ever as I can’t take the weight gain anymore). The best way to manage psychosis is to prevent as many mood episodes as possible. The longer a person with bipolar disorder can stay stable early in their illness, the better their prognosis in the long term. Achieving that stability usually entails sticking to a treatment plan, including medication and therapy, and avoiding episode triggers like extreme stress, sleep deprivation, and substance abuse. It also involves checking in with a doctor often and adjusting that treatment plan as needed. While I am still processing my psychotic episode, I find that knowing is just half the battle and this information helps me make more sense of what I went through with the hope that work in therapy will allow me to dig deeper and really figure out what went down in that complex mind of mine.
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AuthorI was born in 1986 in Lebanon. I'm still trying to find my passion in life and in the meantime I'm learning to navigate my bipolarity and redefining stability. Archives
February 2024
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