Delusions: A Symptom of Psychosis

Understanding Delusions as a Symptom of Psychosis in Bipolar Disorder

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Delusions are false beliefs that a person firmly holds to be true, despite what other people may think or say. They are usually a part of or a symptom of psychosis in bipolar disorder. 


Delusions are described as being "bizarre" or "non-bizarre," depending on whether or not they could potentially occur in real life.

Some common non-bizarre delusions include:

  • Delusions of grandeur: Believing that you're famous or publicly important or that you're a god.
  • Delusional jealousy: Believing a spouse or partner is unfaithful when it is not true.
  • Persecutory or paranoid delusions: Believing you are being followed, spied on, secretly listened to, or the like.
  • Somatic delusions: Believing that you have some medical condition or physical defect.
  • Delusions of referenceThinking that random events contain a special meaning for you alone.

Bizarre delusions include believing in things that are impossible, such as thinking you're a werewolf, that your spouse is an octopus, or that giant worms make subway tunnels.

Delusions are one aspect of the psychotic features of bipolar disorder, schizophrenia, and schizoaffective disorder, as well as some other psychiatric and medical conditions.

Delusions may also occur in people with delusional disorder. Unlike psychosis, though, people with delusional disorder can usually function and behave normally in their daily lives.

Psychosis in Bipolar Disorder

Psychosis occurs when you lose touch with reality. In other words, your thinking and beliefs become distorted and not based on what's really happening around you. It's not an illness in and of itself, but a symptom of something else.

Signs that you're having a psychotic episode include delusions or hallucinations, which are seeing and/or hearing things that no one else does.

In bipolar disorder, psychosis typically occurs during a manic episode, but can occur during a depressive episode as well. 

Warnings Signs

Psychosis doesn't normally happen suddenly. There are often warning signs that can let you know that it's coming. These warning signs include:

  • Suddenly losing interest in the things you used to enjoy
  • Strong, unreasonable emotions or feeling no emotion at all
  • Extreme changes in your sleeping patterns
  • Being unable to do things you normally can
  • Isolating yourself more than normal
  • Your grades or work performance suddenly dropping
  • Becoming suspicious of others
  • Bizarre behavior or speaking that do not reflect reality 
  • Not bothering to invest time in personal hygiene
  • Having trouble focusing and concentrating
  • Beginning to be unable to tell what's real and what's not
  • Problems communicating like changing topics rapidly or speaking incoherently


Roughly three percent of the U.S. population will experience psychosis during their lifetime, according to the National Institute of Mental Health. Remember too, you don't have to have bipolar disorder or schizophrenia or any other mental health disorder to develop psychosis.

Other Causes

Along with mood disorders like bipolar disorder, depression, and schizophrenia, there are other conditions or illnesses that can cause psychosis, including:

  • Being sleep deprived
  • Drug use
  • Head injury
  • Temporal lobe epilepsy
  • Thyroid disorders
  • Bad reactions to medications
  • Vitamin B12 deficiency
  • Huntington's disease

Treatment Options

Psychosis is treatable and most people who experience it can live fulfilling, normal lives. Early intervention makes a big difference in recovery. Treatment may include antipsychotic medications and psychotherapy, such as cognitive-behavioral therapy (CBT), supportive psychotherapy, and cognitive enhancement therapy.

If your safety is in question, hospitalization may be necessary for a time. If you are hospitalized, you will be evaluated to make sure there are no physical reasons for your psychosis.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing. 

Bressert, S. (2016). Delusional Disorder Symptoms. Psych Central

Early Assessment & Support Alliance.( 2016). What is Psychosis?

National Alliance on Mental Illness.(2016). Psychosis.

National Institute of Mental Health (2016). RAISE Questions and Answers.

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