Bipolar Psychosis Symptoms

The features of psychosis associated with bipolar disorder

Bipolar Psychosis
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Approximately two-thirds of people with bipolar disorder will experience at least one symptom of psychosis over the course of their lives. Psychotic symptoms usually accompany the extreme mania experienced with bipolar I, although it is also possible for patients with bipolar II to experience these symptoms. 

While psychotic symptoms are often present in the mania of bipolar I disorder, they can also occur with depression and many other disorders.

 The same psychotic symptoms that can appear in bipolar mania may also occur with schizophrenia, schizoaffective disorder, and other mental disorders. Some physical illnesses that can mimic the symptoms of bipolar disorder may cause psychosis as well.

What Is Psychosis?

Psychosis is a loss of contact with or distortion of reality. A person with psychosis cannot distinguish between the “real world” and his or her own subjective perception of the world, which is not rooted in reality and often characterized by visual and auditory hallucinations.

Features of Psychosis

Psychotic symptoms can have a profound effect on the mood of bipolar patients and can make diagnosis and management trickier. Often, patients experiencing psychosis will be diagnosed with depression. While a patient with bipolar psychosis may not feel depressed, psychotic symptoms can be dangerous and must be managed carefully—often in a hospital setting.

These are some of the features of psychosis that warrant further evaluation and medical management.


Most people tend to associate hallucinations strictly with schizophrenia. However, hallucinations are often experienced by people with bipolar disorder when either depression or mania has psychotic features.


Simply put, delusions are false beliefs that a person is convinced are true. 


Paranoia can be present in a number of mental illnesses, including bipolar I disorder. Psychiatrists use the term paranoia to describe a disordered way of thinking or an anxious state that attains the level of a delusion. This article looks at—and what does not—fit the psychiatric definition of paranoia.


Catatonia is primarily a symptom of schizophrenia and schizoaffective disorder, but it can appear—though rarely—as a psychotic symptom of bipolar disorder as well. When most people think of catatonia, they think of catatonic stupor, where the affected person sits absolutely still and doesn't respond to anything. But there are many other symptoms and forms of catatonia.

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