[franz kafka]

I'm hypomanic right now but also having psychotic symptoms. According to the DSM psych bible does that automatically mean I'm manic? I have schizoaffective so I get psychosis outside of mood episodes even so maybe that's why this is happening. Just curious what you all thought.

[Moose72]

I was onve dx sza but my new pdoc removed that for some reason even though I clearly have psychosis outside of mood episodes.

You should consult with your psychiatrist on this, but to my knowledge, unless you're severely manic or severely depressed, people with just bipolar disorder don't have psychosis, and even many manic or severely depressed people don't always (if ever) become psychotic. If one has psychosis during milder episodes (or stability), then it is usually from something else, like schizoaffective bipolar type or something else. Only your psychiatrist can determine what is the case.

I guess there can be exceptions, but when I'm full blown manic (with or without psychosis) I'm not usually scratching my head wondering if I'm full blown manic. Such insight is usually not possible at that time for me. If I'm in a severe manic episode with mixed features I might be suffering enough to scream for help. Or if fully manic with euphoria (with or without psychosis) I'm usually riding the high and my thoughts are racing so much that I'm not really that pensive.

[franz kafka]

That's kind of what I was thinking, BirdDancer. I don't feel full blown manic (I have had that happen before). I was just wondering if psychosis blurred that distinction.

[Victoria'smom]

For me I don't have to be in any mood state to be psychotic.

[AspiringAuthor]

I was misdx'd SZA and in reality have BP I w/psychotic features that only come during a mood episode. Outside of mood episodes I am quite level-headed. Like BirdDancer, I do not know when I am psychotic - the insight comes later. Your post appears so level-headed that either you are not psychotic, or, you really have SZA and psychosis comes without a mood state. A manic person in psychosis would not write such a level-headed post, imho.

[-=O=-]

I don't think so.

[franz kafka]

I am definitely having psychotic symptoms but I'm not full blown psychotic yet. I also don't think I'm manic but I thought according to the DSM having psychotic symptoms means mania. Thanks all for your insight!

[*Laurie*]

Mania can definitely include psychosis and delusions (according to the DSM).

[amicus_curiae]

I ride a wave of manic/psychosis. Bipolar and schizoaffectic.

You may be doing the same.

[HALLIEBETH87]

My pdoc always seems to say I'm manic when psychosis hits but my psyd has seen psychotic symptoms even when my moods are fine

[LadyShadow]

Just a bit of advice, picking up the DSM and trying to figure out stuff yourself is not a bad thing, Franz, but its not a good thing either. It's sort of the psychology behind how all the people who go on WebMD and end up freaking themselves out, you follow me?

But you seem very level-headed about this situation right now. Like most people said, in a state of full blown mania, (coupled with psychosis), you wouldn't even notice it, and honestly when I experienced it, I didn't notice it either because it felt like it was the most natural thing in the world.

I had a breakthrough that I am going to discuss with my pdoc when I see him on Wednesday. I had been totally spinning out of control and going on 36 hours with no sleep recently. The breakthrough was that for the first time EVER, in all my bipolar history, I KNEW and FELT the psychosis coming. There was a voice in my head talking to me, (my own voice, but totally out of her damn mind). I recognized this voice immediately because she began to sing the same tune that used to send me straight into full blown mania, which eventually always lands me in the psych ward.

Franz when I tell you I shut her up, I totally shut her up. I took a shower and calmed my nerves and did EVERYTHING in my power to calm down and PUSH that voice out of my head. I shut off all the damn technology, (I have a real internet addiction that has contributed to most of my problems over the years), and took my meds, (and added on a pill of Melatonin because it was a total emergency). I KNEW I had to knock myself out. I NEEDED rest, I needed to shut my manic, spinning brain off, and I took the steps to do it.

I can honestly say, I have had a MAJOR life change since that event. I know I am a bit hypomanic, but I am extremely focused, and I am FORCING myself to keep to a rigid and strict routine of good sleep hygiene, regular meal times, and limited time on the internet.

I guess the point of this whole post is, that if you CAN identify it coming, you FEEL it in your head, (or hear it like my case), do everything you can to slow things down and REST. Rest that mind of yours.

Be sure to follow up with your pdoc too, I mean it can't hurt to see what he thinks.

Good luck, and also congratulations on all your recent progress too.

[BipolaRNurse]

Mania usually involves some mild psychosis for me (hearing classical music that's never been composed, becoming paranoid and having religious delusions etc.), but I discovered a few years ago that depression can bring it on too. I "saw" black and grey cats running under the linen carts in the ER where I'd gone for suicidal ideation/intent. It never happens between episodes or during HYPOmania though.

[franz kafka]

Thanks all for your responses!

I've been making sure to get enough sleep lately, which I think is helping. My pdoc doubled my zyprexa so that could be helping too. I'm doing whatever it takes to get rid of this before it turns into something worse.

[AspiringAuthor]

Originally Posted by franz kafka

Thanks all for your responses!

I've been making sure to get enough sleep lately, which I think is helping. My pdoc doubled my zyprexa so that could be helping too. I'm doing whatever it takes to get rid of this before it turns into something worse.

Are you taking Metformin (Glucophage) alongside Zyprexa? It may help prevent metabolic side effects and is a very safe old well-studied medication.

[franz kafka]

Originally Posted by AspiringAuthor

Are you taking Metformin (Glucophage) alongside Zyprexa? It may help prevent metabolic side effects and is a very safe old well-studied medication.

No, I don't have weight gain as a side effect from Zyprexa. In fact I've lost weight since starting it, paradoxically.

[amicus_curiae]

Originally Posted by franz kafka

That's kind of what I was thinking, BirdDancer. I don't feel full blown manic (I have had that happen before). I was just wondering if psychosis blurred that distinction.

Schizoaffective disorder presents as different types of psychosis.

[amicus_curiae]

Originally Posted by AspiringAuthor

I was misdx'd SZA and in reality have BP I w/psychotic features that only come during a mood episode. Outside of mood episodes I am quite level-headed. Like BirdDancer, I do not know when I am psychotic - the insight comes later. Your post appears so level-headed that either you are not psychotic, or, you really have SZA and psychosis comes without a mood state. A manic person in psychosis would not write such a level-headed post, imho.

I’m actually at my best when my mania and psychosis are on and aligned.

A bit depressed at the moment, I am. Just depressed. It will pass and I’ll return to my happier state.

***Meet me at the book burning***

[amicus_curiae]

Originally Posted by franz kafka

I am definitely having psychotic symptoms but I'm not full blown psychotic yet. I also don't think I'm manic but I thought according to the DSM having psychotic symptoms means mania. Thanks all for your insight!

No, psychosis isn’t a diagnostic criteria for bipolar manic episodes.

However both mania and psychosis lead the pack for Schizoaffective disorder.

I have both disorders. I don’t live in reality most of my waking hours. I’m ready to go back, now.

[amicus_curiae]

Originally Posted by *Laurie*

Mania can definitely include psychosis and delusions (according to the DSM).

I’m looking at Bipolar-> manic episode in DSM-5 and I don’t see any referenced psychosis/delusional states?

If you’ve a Bipolar Disorder with psychotic features, that’s a step beyond bipolar mania, isn’t it?

They’re listed with Schizoaffective bipolar type?

Doesn’t the OP have a Schizoaffective Bipolar type DX?

[amicus_curiae]

Originally Posted by LadyShadow

Just a bit of advice, picking up the DSM and trying to figure out stuff yourself is not a bad thing, Franz, but its not a good thing either. It's sort of the psychology behind how all the people who go on WebMD and end up freaking themselves out, you follow me?

Hmm. I don’t think that comparing a website designed for self-diagnosis by an average user, WebMD, can be compared to a text written for psychiatric diagnosis by professionals, the DSM.

I understand your reasoning - no one should rely on self-diagnosis - but the DSM really helps me to understand why I do that which I do and, in that sense, it’s my go-to psychiatric-diagnostic text.

Just my opinion

***Ashes, ashes, we all fall down***