Some of you guys may know that I have a diagnosis of bipolar 1 with mood-incongruent psychotic features. I've started to accept that Dx again. I have no idea why I'm not diagnosed with schizoaffective since my psychosis is persistent and since I share many symptoms with schizoaffective, but it is what it is. Maybe it's because I'm highly functional and the psychosis is usually mild in nature. My point is, though, that the psychosis exists NEARLY ALL THE TIME.

Anyway, although I'm fine now, I do get bad paranoia at times. For example, I might barricade my door because I'm afraid that someone is going to break in and murder me or that the government is chasing after me, trying to arrest and interrogate me about something I don't remember doing. Or, someone broke into my car in the middle of the night and hid in the trunk, and will pop out while I'm driving to put a gun to my head to have me rob a bank. I've also had feelings that being I'm watched on camera everywhere -- including in my car -- and that I even have cameras pointed at my desk at work. And I oftentimes have to keep my apartment blinds closed so that no one sees me and tries to break in to hurt me.

I don't know how to deal with delusional paranoia like that. Antipsyychotics don't touch it for some reason. I think the only options I have left are: (1.) work on it in therapy, and (2.) take some kind of anxiety med to at least calm me down.

The problem with (1.) is that therapy doesn't help when I get psychotic like that. No one can reason with me since I'm 100% convinced it's true. I've been trying really hard to do fact checking, but it never seems to work. Thus, (2.) seems to be the most viable option even if it doesn't eliminate the paranoia. I just don't know if (2.) will help at all. That's why I'm asking you guys what you think. Thanks in advance!

[tecomsin]

I also have had bouts of delusional paranoia like you describe and both me and my pdoc are not sure if I have bipolar with psychotic mania or schizoaffective.

When you say that antipsychotics don't touch it, which antipsychotics have you tried, and at what dosages? Those kinds of thoughts is why I take 1 mg of rexulti everyday.

I assume you've talked about your issue extensively with your psychiatrist. What does he/she say? I can't imagine them not trying anything else.

I have had a category of hallucinations ended by my anticonvulsant Tegretol XR, but not delusions. I have only ever had severe delusions and paranoia during full blown manias, which are helped by antipsychotics. The particular hallucinations I first referenced were outside of mood episodes. I have also had some dissociative hallucinations outside episodes in the past, but they were not delusions, just hallucinations, and only lasted for minutes at a time when triggered. Grounding techniques were the main treatments for those, in my case.

I'd think long and hard before using a benzo as a regular treatment of anything. "As needed" maybe, but I regret being on benzos long-term on a daily basis.

Earlier this year I was put on Risperdal PRN for exactly what you're describing. If an antipsychotic doesn't touch it, I don't really believe an anxiety med would (just my guess). It sounds like something you'd need to talk to your pdoc about, maybe you need a different or higher dose of an antipsychotic.
hope you find something that works.

[Stellata]

I don't have Bipolar, but do have recurrent paranoia. Aripirazole seems to be working well for me.

[yellow_fleurs]

This sounds really tough, bb. I don't have the expertise, but I doubt the anxiety med would help with delusions if the antipsychotic does not. That being said, I wonder if it could help keep you calm and have less anxiety related to it? I also find it odd that you are not diagnosed with schizoaffective, since it seems like having psychotic symptoms outside of mood episodes is what differentiates it from bipolar with psychosis, but maybe there are some things I don't understand as I am not a doctor. I think it is worth asking that question directly, though, and bringing up the concern about continued delusions with your doctor and therapist. I don't think therapy will necessarily get rid of them, but can help in the process of dealing with the delusions that are there.

[Moose72]

This is what ive been going through too. For weeks. Ativan does nothing. Pdoc just increased my Haldol. We'll see. I think people are going to break into my apartment, and car. There are beings in the walls coming to get me. I think these things and more every single day. Its hard. And I too am not sza but bipolar.

[tecomsin]

It makes a huge difference to have insight that these are delusional thoughts and ideas. My biggest disasters in life that were self-inflicted were when I lost insight these were in fact delusions and started believing in grandiose conspiracy theories that the great spy powers in the world had bugged my house and were secretly monitoring all of my communications and that I was part of a vast conspiracy to take over the world, or at least Canada... I would go back on zyprexa if I were to start having thought like that and especially act out on them, in addition to my ongoing 1mg of rexulti. Hoping to lower to 0.5 mg in a few months if the thoughts stay at bay. Meds don't help with my depression but i really do get relief for delusions on the right meds. 10 mg of olanzapine will knock me off my feet and I will sleep the day away instead of falling further into a delusional nightmare.

[Wild Coyote]

If anxiety is a component, anti-anxiety meds may help some?
I truly do not know.

(((((( BlueBicycle ))))))

Wanted to at least leave you a hug.

WC

[Fuzzybear]

(((((((( blue ))))))))

I also think they could help

Is it possible that the paranoia is a feature of your personality, and that it flares up when under extreme stress?

[Moose72]

Originally Posted by IRememberMyFirstBee

Is it possible that the paranoia is a feature of your personality, and that it flares up when under extreme stress?

No this is new since my diagnosis.

Originally Posted by Moose72

No this is new since my diagnosis.

I was asking the OP, Bluebicycle.

[Moose72]

Originally Posted by IRememberMyFirstBee

I was asking the OP, Bluebicycle.

Aha. . Thanks for clarifying.

Originally Posted by IRememberMyFirstBee

Is it possible that the paranoia is a feature of your personality, and that it flares up when under extreme stress?

I hope this wasn’t taken offensively. It’s actually how I explain my own paranoia. Please know this comment was not meant in any derogatory way.

I personally think you should probably increase your ap. Anti anxiety meds can help too tho. My son believes his delusions and is conStanley texting himself. I've never seen what he writes he won't let me. I can't see him holding a job right now.

I'm so baffled you can hold a job with all that paranoia. You function very well in spite of it.

[Pookyl]

I’m wondering if a different AP would be helpful?

Originally Posted by Moose72

This is what ive been going through too. For weeks. Ativan does nothing. Pdoc just increased my Haldol. We'll see. I think people are going to break into my apartment, and car. There are beings in the walls coming to get me. I think these things and more every single day. Its hard. And I too am not sza but bipolar.

Yikes. You're definitely like me. The only AP I'm on now is Rexulti, at the max dose.

Latuda, Abilify, Seroquel XR, and some other one I tried (can't remember what it was) didn't help. Though the psychosis was never this bad anyway, so who knows. But my pdoc's office refuses to prescribe first generation antipsychotics like Haldol. Don't know why.

[tecomsin]

Originally Posted by bluebicycle

Yikes. You're definitely like me. The only AP I'm on now is Rexulti, at the max dose.

Latuda, Abilify, Seroquel XR, and some other one I tried (can't remember what it was) didn't help. Though the psychosis was never this bad anyway, so who knows. But my pdoc's office refuses to prescribe first generation antipsychotics like Haldol. Don't know why.

I hope you find a solution. It's possible a combination might be more effective than one medication taken at a time. I would try to get a second opinion from another psychiatrist about your meds.

You might be more concerned about these delusions than your pdoc. I would ask the pdoc how concerned they are about your overall mental state, including the delusions.

Originally Posted by IRememberMyFirstBee

Is it possible that the paranoia is a feature of your personality, and that it flares up when under extreme stress?

I'm not sure, and that's a very good question. I guess I should talk to my therapist about this possibility, so that's a great idea. Thanks!

Originally Posted by rose1985

I personally think you should probably increase your ap. Anti anxiety meds can help too tho. My son believes his delusions and is conStanley texting himself. I've never seen what he writes he won't let me. I can't see him holding a job right now.

I'm so baffled you can hold a job with all that paranoia. You function very well in spite of it.

In all fairness, the paranoia was never really a problem until very recently. It really took off during this summer and has gotten worse. So my level of functioning has gone down.

I don't know what anxiety med is best, but I do remember gabapentin making me pissed off when I first took it. I don't know why it agitated me, but it did. Then again, I wasn't on an AP or AD, or anything, so who knows. I could try it again, or propranolol. I don't like my Klonopin because it cancels out my Ritalin's effects.

Originally Posted by tecomsin

I hope you find a solution. It's possible a combination might be more effective than one medication taken at a time. I would try to get a second opinion from another psychiatrist about your meds.

You might be more concerned about these delusions than your pdoc. I would ask the pdoc how concerned they are about your overall mental state, including the delusions.

I could get a second opinion, although... my old pdoc recently left and I got a new one. My new one seems to agree on the meds that I'm taking, the ones that my old pdoc prescribed. I suppose I could get a 3rd opinion, but I think you see where I'm coming from about pdocs.

[tecomsin]

If your delusions are worse than they have been before then that might warrant a change in their opinion on your meds... Have you talked to your pdoc about your delusions?