[IDoNotExist]

This dx was always puzzling. In fact, after my psychotic episode (which involved extreme paranoid delusions and powers/forces unseen and unknowable), the 2nd doctor at my partial hospitilization claimed what I thought was true, "Once you have a psychotic episode, you are bipolar I."

But my psych that I saw for the longest has Bipolar NOS. Should I entertain the notion of schizoaffective dx? I suppose it wouldn't matter as the treatment for both is identical, but a part of me just wants to know what this is.

I find scant and poorly documented cases of SA where it could easily be BP w/ psychotic features

[Curiosity77]

The difference between Schizoaffective and Bipolar with psychotic features, is that in Bipolar the psychosis happens only during extreme mood states (mania or depression), while in Schizoaffective the psychosis is present even when the mood is stable. It's a subtle distinction, and the same person might get either diagnosis depending on how they look to the doctor at that time. If there is psychosis Bipolar II is ruled out.

[BipolaRNurse]

I read somewhere recently that it depends on whether the psychosis appears in the manic or depressed phase. Evidently you can still be bipolar 2 if your psychosis happens during depression, while in bipolar 1 it happens with mania. My experience has been that the psychosis only accompanies manic episodes; I don't have it with depression at all.

[Trippin2.0]

I have the same dx.

My severe depressions manifest with psychosis, but I've never been manic so BP1 has been ruled out.

As mentioned above, Schizzoaffective is put on the table when psychosis is experienced independent of a bp mood episode.

[Victoria'smom]

I have psychosis as soon as I hit hypo manic or depression. My husband only get severe psychosis when depressed and he was bp2 until mania hit.

[wing]

The sorry state of affairs with BP is that so many symptoms get labelled that the lines are fuzzy. IMO

[Nightside of Eden]

I have psychotic features with severe depressive episodes and am diagnosed Bipolar II. I have never had a full manic episode or any psychotic features during hypomania (those moods are fun and productive for me and not actually a problem).