“How to Help Someone Who Is Experiencing Bipolar Psychosis” by Natasha Tracy

25 Feb
As Natasha Tracy writes, psychosis is most commonly associated with schizophrenia, but it can also manifest in people with bipolar disorder. People with bipolar I are at risk for psychosis during manic episodes; however, those of us with bipolar II aren’t off the hook. Tracy notes that while hypomania cannot cause psychosis (it can, however, result in delusional perceptions and thoughts),  severe depression puts us at risk as well. I can personally attest to this: during my worst moments, I’ve had visions of wraiths floating over my bed, seen my face turn into a skull in the mirror, and heard God’s voice telling me I was evil and should kill myself.
As there’s evidence that depressive episodes are more frequent and durative in bipolar II, those of us with that diagnosis shouldn’t make the mistake of thinking that we’re immune to psychosis. Considering the overlapping and symbiotic symptoms of bipolar disorder and PTSD, those of us with a comorbid diagnosis should be especially cognizant of the risks.
Reblogged from Answers.com

While psychosis is normally associated with schizophrenia, psychosis is also a dangerous mental state that can occur in people with bipolar disorder. A person experiencing psychosis may feel they are a deity and try to fly or they may feel like they can talk to animals. They may see, hear, taste, smell, and feel things that aren’t there. They may become highly agitated when these beliefs or experiences are questioned. Here’s how to help a person suffering from psychosis in bipolar disorder.

What is Psychosis?

Psychosis is a mental state personified by the presence of delusions and hallucinations. Delusions are false beliefs that may be held even in the face of direct evidence to the contrary. Delusions of grandeur are common wherein the person believes themselves to be extremely special in some way such as being a genius or a god.

While most people think of hallucinations as seeing things that aren’t there, that’s only part of it. Hallucinations can actually manifest through any sense although the most common is to see and hear things that aren’t real. Someone suffering from psychosis often hears people who don’t exist talking about him or her and this can be very distressing.

Other symptoms of psychosis include changed feelings, changed behaviors, and confused thinking. See: What is psychosis?

How Does Psychosis Manifest in Bipolar Disorder?

Typically, psychosis manifests as part of mania or a mixed episode. Bipolar mania is a highly elevated mood experienced by those with bipolar type I (or possibly Other Bipolar and Related Disorder). According to Medscape Reference’s information on bipolar disorder, it’s estimated that up to 75% of people who suffer from mania, also suffer from psychosis. By definition, psychosis does not occur in hypomania.

Psychosis can also occur during bipolar depressions. It’s less clear how many people experience psychosis in this mood state.

No matter how psychosis is experienced, however, it is typically considered a medical emergency and help should be sought immediately. See: Psychosis and bipolar disorder

How to Help Someone Experiencing Bipolar Psychosis

According to the British Columbia Schizophrenia Society, there are many ways to help someone experiencing psychosis. Helpful things to do include:

– Stay calm and protect the safety of all involved.
– Be aware that unusual behavior during this state is a symptom of an illness and is not about you.
– Avoid arguing with the person about their delusions. Delusions are extremely difficult change.
– Connect with the emotion behind the delusion. For example, it’s easy to understand that some psychosis symptoms would be very scary, so you could say, “It must be very frightening to believe that you are Jesus Christ.”
– Calm down the environment and remove stimulation such as people and noises
– Show compassion for how the person feels and give him (or her) the help he asks for. For example, if he thinks the television is trying to kill him, turn it off.
– Show him you are on his side with your body language. Sit next to him, rather than across from him.
– Speak slowly, clearly, and calmly and allow plenty of time for the other person to understand and respond.
– Give step-by-step instructions, if needed.
– Be aware that even if the person suffering from psychosis isn’t expressing much emotion, they still may be experiencing a lot of feelings.

And above all else, it’s critical to get professional help for anyone experiencing psychosis. If his doctor cannot be located in a timely fashion then an emergency healthcare team should be called or a visit to the Emergency Room should be arranged. See: What to do about psychosis symptoms

People with bipolar disorder can experience psychosis during the manic, mixed, and depressive phases of the illness. How psychosis is manifested varies but it can include hallucinations, delusions, confused thinking, and changed feelings and behaviors. Psychosis is typically considered a medical emergency so professional help should always be sought. Until the help arrives, however, it’s important to be calm, protect everyone’s safety, not argue, and remove excess stimuli from the environment.

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