I've had a few psychotic breaks, but was not hospitalized. When I was diagnosed with bp my mother said "Oh, there were more than a few times when I thought you should have been hospitalized". Thanks mom! I was, however, divorced from reality for long periods of time due to euphoric mania. More subtle than a full-on psychotic break. It is difficult to explain. I lived in this world, but thought and acted in a made up world and could do this for long periods of time until people began to understand that something was wrong. I could lead people on, unconsciously, to think that I knew exactly how to do what needed to be done, or feel what they wanted or needed me to feel. I would follow my own oblivious internal agenda until the schism between my reality and theirs became so great that I would lose jobs and relationships. I was like this from late college through my late 30's, punctuated by severe bouts of depression and a few psychotic breaks. Glad that's over!