Hi Talanic,

There are a couple of conditions that include both bipolar and psychosis. There's bipolar with psychotic features, where psychosis occurs during bipolar episodes, and there's schizoaffective bipolar type, which is where symptoms of bipolar occur with psychosis outside of bipolar episodes.

I have been diagnosed with both (not at the same time) but I think my current diagnosis is bipolar with psychotic features. My first big psychotic break was when I was 23. I was manic and it switched into a mixed episode and while I was on the subway I could hear everyone's thoughs, and every time I met someone's eyes, they were telepathically telling me to die. I very nearly killed myself, but my therapist knew this kind of thing might happen, and made me promise to go to the psych ER if it did. So that's where I went.

The only other coping mechanisms I have are just practice. Practice recognizing them before they get too strong a hold on you, talk to someone about it, keep in touch with your psychiatrist. That's what has worked for me.