Psychosis In Bipolar Disorder


Bipolar disorder is a mental health condition that affects millions of people worldwide. It’s characterized by fluctuations in mood, including episodes of depression and mania. While many people with bipolar disorder can manage their symptoms with medication and therapy, some people with bipolar disorder experience psychosis, which can complicate their condition even further. In this article, we’ll explore what psychosis is, how it relates to bipolar disorder, and what treatment options are available.

What is Psychosis?

Psychosis is a term used to describe a mental state where an individual has lost touch with reality. It’s a symptom of many different mental health conditions, including bipolar disorder, schizophrenia, and severe depression. The symptoms of psychosis can vary but often include delusions, hallucinations, disordered thinking and speech, and bizarre behavior.

Why Does Psychosis Occur in Bipolar Disorder?

The exact cause of psychosis in bipolar disorder is unknown, but it’s thought to be related to chemical imbalances in the brain. During a manic or hypomanic episode, the brain produces an excess of dopamine, a neurotransmitter that plays a role in regulating mood. This excess dopamine can cause the brain to become overstimulated, leading to symptoms of psychosis.

How Common is Psychosis in Bipolar Disorder?

Psychosis is relatively common in bipolar disorder, with estimates suggesting that up to 70% of people with bipolar I disorder – the most severe form of the condition – experience it at least once in their lifetime. Psychosis is less common in bipolar II disorder, which is characterized by less severe manic episodes.

What Are the Symptoms of Psychosis in Bipolar Disorder?

The symptoms of psychosis in bipolar disorder can vary, but some common symptoms include:

  • Delusions – false beliefs that are not based in reality
  • Hallucinations – hearing, seeing, or feeling things that are not really there
  • Disordered thinking and speech – difficulty organizing thoughts and expressing ideas coherently
  • Bizarre behavior – acting in ways that are unusual or out of character

How is Psychosis Diagnosed in Bipolar Disorder?

If you’re experiencing symptoms of psychosis, it’s essential to speak with your doctor or mental health professional. They’ll likely perform a thorough evaluation to determine if your symptoms are related to bipolar disorder or another condition. This evaluation might include a physical exam, blood tests, and other diagnostic tests. They may also ask you about your medical and psychiatric history and conduct a mental status exam.

What Are the Treatment Options for Psychosis in Bipolar Disorder?

There are several treatment options available for psychosis in bipolar disorder, including medication, therapy, and hospitalization. The most common treatment is antipsychotic medication, which can help reduce symptoms of psychosis. These medications work by blocking dopamine receptors in the brain, reducing the excess dopamine that’s thought to be responsible for psychosis.

Therapy can also be helpful in treating psychosis in bipolar disorder. Cognitive-behavioral therapy (CBT) has been shown to be effective in reducing symptoms of psychosis in people with bipolar disorder. CBT can help you identify and challenge negative beliefs and behaviors and learn coping skills to manage symptoms.

In severe cases of psychosis, hospitalization may be necessary. Hospitalization can provide a safe and supportive environment where you can receive intensive treatment and have your symptoms closely monitored.


Psychosis can be a challenging symptom to manage in bipolar disorder, but it’s a treatable condition. If you’re experiencing symptoms of psychosis, it’s important to speak with your doctor or mental health professional to determine the best treatment options for you. With the right treatment, many people with bipolar disorder can manage their symptoms and live healthy, fulfilling lives.


FAQs about Psychosis in Bipolar Disorder

What is a psychosis in bipolar disorder?

Psychosis is a condition where a person loses touch with reality. It is a possible symptom of bipolar disorder and can occur during bipolar mania or depression. Psychosis can involve delusions, hallucinations, or other forms of disturbed behavior.

What are the risk factors for psychosis in bipolar disorder?

The risk factors for psychosis in bipolar disorder can vary from person to person. Some factors that may increase the likelihood of experiencing psychosis with bipolar disorder include a history of psychosis in the family, substance abuse, stress, sleep deprivation and certain medications.

How is psychosis in bipolar disorder treated?

Psychosis in bipolar disorder is a serious condition that requires prompt medical attention. Treatment options may include medication, therapy or a combination of both. Antipsychotic medications are effective in reducing symptoms of psychosis but should only be used under the supervision of a healthcare provider. Therapy may involve cognitive-behavioral therapy or family-focused therapy which focuses on reducing stress and improving coping mechanisms. Support from family members and healthcare professionals is also essential in managing and preventing future episodes of psychosis.


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