[Movingon69]

There have been times when I'm completely out of touch with reality and believe the grandiose thoughts in my head as well as hallucinations. If I understand correctly this would be considered psychosis.

What if you are having some of those symptoms but there's a small part of you that understands it isn't reality. For instance sometimes I think I'm getting messages from God. If I really believe that that's psychosis, right? What if there is this small voice in my head that understands that is not real even if there is a strong feeling that it is. Is this manic?

I'm still so new to this that I'm trying to understand the nuances.

[tecomsin]

Hi Movingon69

I've asked all those questions too. My psychotic manias start out with questioning delusional beliefs and hallucinations but then I start to believe them more and more. That's when it's time to up the antipsychotics. In my last psychosis I thought I was rewriting the Qu'ran. I'm not religious and was raised in a Christian society. It was part of a global conspiracy to take over the world. At first I knew it was fanciful and not real but eventually I started to believe the conspiracy more and more as I found 'signs' it was true.

If that were to happen again i would start to take prn Zyprexa (an antipsychotic) to add to the daily AP, Rexulti until I felt better.

I tend to think of psychotic mania as being it's own thing. Anyway I would take these symptoms seriously although not over stress about it. Are you on an antipsychotic?

There are some devout people who experience talking with God but are not having symptoms of psychosis.

[Movingon69]

Originally Posted by tecomsin

Hi Movingon69

I've asked all those questions too. My psychotic manias start out with questioning delusional beliefs and hallucinations but then I start to believe them more and more. That's when it's time to up the antipsychotics. In my last psychosis I thought I was rewriting the Qu'ran. I'm not religious and was raised in a Christian society. It was part of a global conspiracy to take over the world. At first I knew it was fanciful and not real but eventually I started to believe the conspiracy more and more as I found 'signs' it was true.

If that were to happen again i would start to take prn Zyprexa (an antipsychotic) to add to the daily AP, Rexulti until I felt better.

I tend to think of psychotic mania as being it's own thing. Anyway I would take these symptoms seriously although not over stress about it. Are you on an antipsychotic?

There are some devout people who experience talking with God but are not having symptoms of psychosis.

Thanks. This really helps. I'm not on antipsychotic yet. My pdoc wants to get me on the "right" dosage of Lamictal before adding either that or an antidepressant.

I'm religious as well. However, these messages are ones God would never give. Like the latest one that told me to kill myself.

You have provided some clarity and progression makes a lot of sense. Thanks!

[AspiringAuthor]

I personally had Lamictal cause elevated mood and lead to mania, which is not that unusual. I would think that Lamictal AND an antidepressant, without an antipsychotic, is really the very worst thing that one can do to your medication regimen given your past episodes. I hope you receive a prescription for an antipsychotic PRN as soon as possible, so that you are prepared. In that light, I second tecomsin's mention of Zyprexa. You do not need to be on it for maintenance - the drug gives awful metabolic side effects - but it is a lifesaver as a PRN medication. I would not leave the pdoc's office without a PRN prescription for it next time you go. This, especially given that you are blessed with the benefit of insight at the beginning of such states, so you really will be equipped with the tool to quash incipient mania while you still possess insight and a critical eye.

[tecomsin]

Hey Movingon69,

It's also reassuring to me to know that other people have similar experiences.

Have you told your pdoc about these symptoms? I'd want to know what they would have to say.

I have a tendency to not report those kinds of symptoms but in retrospect my life would have gone better if I had given all the harm that can come out of a psychotic mania that isn't interrupted before it spins out of control.

Sometimes the 'thought disordered' part of the mania can be controlled by just controlling the mood. I would be very careful about taking an antidepressant and watch the amount of sleep.

[Movingon69]

Originally Posted by AspiringAuthor

I personally had Lamictal cause elevated mood and lead to mania, which is not that unusual. I would think that Lamictal AND an antidepressant, without an antipsychotic, is really the very worst thing that one can do to your medication regimen given your past episodes. I hope you receive a prescription for an antipsychotic PRN as soon as possible, so that you are prepared. In that light, I second tecomsin's mention of Zyprexa. You do not need to be on it for maintenance - the drug gives awful metabolic side effects - but it is a lifesaver as a PRN medication. I would not leave the pdoc's office without a PRN prescription for it next time you go. This, especially given that you are blessed with the benefit of insight at the beginning of such states, so you really will be equipped with the tool to quash incipient mania while you still possess insight and a critical eye.

I will talk to her about that at the next appointment. Thanks!

[Movingon69]

Originally Posted by tecomsin

Hey Movingon69,

It's also reassuring to me to know that other people have similar experiences.

Have you told your pdoc about these symptoms? I'd want to know what they would have to say.

I have a tendency to not report those kinds of symptoms but in retrospect my life would have gone better if I had given all the harm that can come out of a psychotic mania that isn't interrupted before it spins out of control.

Sometimes the 'thought disordered' part of the mania can be controlled by just controlling the mood. I would be very careful about taking an antidepressant and watch the amount of sleep.

I've only been diagnosed for about a month. I see my T once a week and have seen the pdoc twice so far. I told both of them about the thought that God was sending me the message to kill myself. She said when I feel like that I need to go straight to the hospital. I'm going to have to figure out at what point in the progression I need to make that step because by the time I thought God was talking to me I didn't want anyone to stop me.

[tecomsin]

Originally Posted by Movingon69

I've only been diagnosed for about a month. I see my T once a week and have seen the pdoc twice so far. I told both of them about the thought that God was sending me the message to kill myself. She said when I feel like that I need to go straight to the hospital. I'm going to have to figure out at what point in the progression I need to make that step because by the time I thought God was talking to me I didn't want anyone to stop me.

I know what you mean about not wanting anyone to stop you after it has gotten to a certain point. Do you have other disordered thoughts?

[AspiringAuthor]

Originally Posted by Movingon69

I've only been diagnosed for about a month. I see my T once a week and have seen the pdoc twice so far. I told both of them about the thought that God was sending me the message to kill myself. She said when I feel like that I need to go straight to the hospital. I'm going to have to figure out at what point in the progression I need to make that step because by the time I thought God was talking to me I didn't want anyone to stop me.

This might have been a mixed state. Mixed states make the management of bipolar I a challenge (not that it is not a challenge anyway!). You have grandiosity (God talking to you), which is manic, and you have suicidality, which is depressive. I personally have tried suicide in such states - it is not that God was telling me to kill myself, but the speed of my thoughts was manic (very rapid) while the content was depressed. I did not gain insight until much later in retrospect. For me personally such states are the most dangerous ones.

[BipolaRNurse]

You mean God isn't talking to me?? j/k

Seriously, I've had episodes that I didn't know were episodes before I was diagnosed. I experience delusions that make me believe that I'm God's messenger, sent here to help a specific person in a specific situation. It took me years to accept the fact that it IS a delusion and not reality. I'm religious and want to believe I can influence events for the good by merely being present and praying, but in saner moments I know it's not so.

[Unrigged64072835]

You can be manic without psychosis, and you can have psychosis without mania. I've had psychosis with depression and I've been manic without psychosis.

From what it sounds like though--no, God wouldn't want you to do that. Hope you go IP before it gets too bad.

[Movingon69]

Originally Posted by Fharraige

You can be manic without psychosis, and you can have psychosis without mania. I've had psychosis with depression and I've been manic without psychosis.

From what it sounds like though--no, God wouldn't want you to do that. Hope you go IP before it gets too bad.

I'm not dealing with this right now. This incident happened on May 20th and, yes, I should have gone to the hospital. I'm trying to get an understanding for the future.

[tecomsin]

Originally Posted by AspiringAuthor

This might have been a mixed state. Mixed states make the management of bipolar I a challenge (not that it is not a challenge anyway!). You have grandiosity (God talking to you), which is manic, and you have suicidality, which is depressive. I personally have tried suicide in such states - it is not that God was telling me to kill myself, but the speed of my thoughts was manic (very rapid) while the content was depressed. I did not gain insight until much later in retrospect. For me personally such states are the most dangerous ones.

I agree it could be a mixed state. Also has the disordered thought been a recurrent one or a one off?

Zyprexa is my go to PRN when I start to notice psychotic thoughts or signs of mania. In my case, mania and psychosis tend to feed off each other until it spirals out of control. I haven't needed to take it though since starting Rexulti.