[stahrgeyzer]

This article says "Hallucinations are more likely to be auditory than visual in people with bipolar disorder."

Does anyone know why someone with bipolar is more likely to have auditory hallucinations rather than visual? I'm just curious about the science of it. Or is it presently unknown why? It only says more likely. So it does not mean you will hear anything. For me that's true. I hear a lot of voices, but only on rare occasion will see something.

Do People with Bipolar Disorder Have Hallucinations?

I'm not aware of the science behind this, but I believe I once read that delusions are often more common in bipolar psychosis than even hallucinations. That has been the case for me, though I have had both visual and auditory hallucinations in bipolar manic and even depressive psychosis. I'm not sure which type of hallucinations were more numerous for me. I think about the same.

I believe that many people with schizophrenia more often have auditory hallucinations than visual. I think I heard that in a video I watched for my Abnormal Psychology class. I remember watching a video interview regarding John Nash. They said that most of his hallucinations were auditory, despite the movie Beautiful Mind depicting a lot of visual hallucinations. They said they showed visual mostly for movie effect. I'm not sure how experiences vary by person.

I've thought I had other types of hallucinations than just visual or auditory, but I'm not sure if they were psychotic types.

[Gabyunbound]

I had visual hallucinations (as well as delusions) during a full-blown manic episode a long time ago. More recently, I've had 2 episodes of visual hallucinations, one which included auditory, both in the context of going into manic episodes which were curtailed by increases in medication.

If BirdDancer is right, and schizophrenics do not experience much in the way of visual hallucinations, then who does?

[still_crazy]

it isn't that schizophrenic people don't see things sometimes...its that its far more common for them (and bipolar people) to hear things.

some of it may also be in how people are diagnosed. i read that, for a while at least, people with significant psychotic components to their problmes were called "Schizoaffective," not "Bipolar I." Now, from what I"ve seen...the Schizoaffective diagnosis is once again waning in popularity. anyway...maybe there are more visual hallucinations in the "Schizoaffective" category? I don't know.

[mogwai]

I've read that the development of psychosis symptoms in general tends to begin with auditory hallucinations (and thought disorder, scattered thinking etc). I think auditory is overall the more common hallucination, probably considered less complex and a lesser severity of break with reality.

So I would guess that because hallucinations are not very common (?) for bipolar and that it tends to happen at the extremes, and it's not necessary for diagnosis, that they're implying that bipolar experiences milder forms of psychosis than the schizophrenic spectrum. So you could start with auditory but it's less likely to increase further into more complex visual hallucinations.

Although, I've had mild visual hallucinations without having anything auditory. So who knows. Maybe the moral of the story is they don't know much about how this all works.

I felt like I should really attempt to back up some of what I wrote earlier with more than just "I believe I remember". In my post above, I mentioned that I learned (and personally experienced) that though hallucinations of various types are common in extreme episodes of bipolar disorder, that delusions are particularly common. In Prevalence and description of psychotic features in bipolar mania. - PubMed - NCBI it says "Grandiose delusions are the most common type of psychotic symptom [in bipolar disorder], but any kind of psychotic symptom, including thought disorder, hallucinations, mood-incongruent psychotic symptoms, and catatonia can present as part of a manic episode."

"Thought Disorder" as mentioned above as a possible bipolar psychosis symptom, is common in schizophrenia, too. I don't often read about this psychotic symptom for bipolar disorder, but in extreme psychosis I think it happens a lot. I have definitely experienced this. There is a helpful description at Thought Disorder | Johns Hopkins Psychiatry Guide A couple of the characteristics (an interesting list) are seen in various levels of mania, but my assumption is that when they get particularly severe it is on the level of psychotic.

In an article by John M. Grohol, Psy.D. published right here at Psych Central, he writes "Most people with schizophrenia experience auditory hallucinations, particularly hearing voices, and about one-fourth of those with the disorder experience visual hallucinations." That article can be found at Ever Wonder What a Visual or Auditory Hallucination Was Like?

[HALLIEBETH87]

I either have bp1 with psychotic features or schizoaffective bp type. depends on who you ask.

for me the first time I had psychosis I had both visual hallucinations and lots of delusions. I was a complete mess and don't remember very much of it. now when I get psychosis I get tactile hallucinations and still get lots of weird delusions but I very much believe its real.

[BipolaRNurse]

In mania, I don't hear voices, but I do hear classical music that's never been composed (don't ask me how I know that, I just do). I also tend to hear static, like when you're between radio stations and can hear both of them at the same time. Then there was the time I was suicidally depressed and "saw" black and grey cats running under the linen cart in the ER. That was weird. What little was left of my logical mind tried to explain to me that that was impossible, there were no cats in the ER, but the rest of my brain wasn't buying it. Those cats were as real to me as the bare "suicide room" I was sitting in.

That little wingding got me diagnosed as bipolar 1, even though it happened during a depressive phase and not a manic one. Four years later, I haven't had any more psychotic occurrences since then, but then I am very well medicated and not much gets through the protective layer of drugs.

Originally Posted by BipolaRNurse

In mania, I don't hear voices, but I do hear classical music that's never been composed (don't ask me how I know that, I just do). I also tend to hear static, like when you're between radio stations and can hear both of them at the same time.

I had a period of musical hallucinations that was exactly as you describe, though I don't think I was manic at the time, or at least not most of the time. It became very disturbing for me as the musical hallucinations started to ocurr more and more throughout the days. The whole experience lasted months. What was original music of various types became that DJ static you mentioned, then the worst happened. I started hearing an intro to a song I did know, but it repeated and repeated again and again for weeks. My psychiatrist sent me to a neurologist and I had several EEGs. Both had considered Tegretol XR (both a bipolar moodstabilizer and antiepileptic). It took a while, but when I reached 1400 mg (a large dose) the music stopped. It was a relief, but the experience has affected my enjoyed of music. The enjoyment has started to increase over the years, but has never fully returned. I almost never dance. When I try, it fizzles out. I only watch TV and movies with my husband, despite being at home all day, and generally only talk programs. Music and dance had been my passions.

I wrote a whole blog post about this topic once. To this day, I'm unsure if the musical hallucinations were psychiatric-based or seizure-related. Oddly, my psychiatrist was sure they were seizure-related. The neurologist thought they were psychiatric based. She did eventually diagnose me with possible Simple Partial Seizures, but from other symptoms and one of my four EEGs, the sleep deprivation EEG.

I eventually went to an epileptologist for a second opinion. He said my sleep deprivation EEG results didn't definitively show seizure activity. He wanted me to have a 3 to 6 day in-hospital EEG, but my husband discouraged it. The epileptologist wanted to halve my Tegretol XR, and that scared the hell out of my husband and me.

I haven't had musical hallucinations for about 7 years, since reaching that Tegretol XR dose. I haven't had anything else that would possibly be seizure activity. I have been manic several times since, but didn't have anything musical going on.

I have read other people with bipolar disorder mention musical hallucinations. Apparently a small number of people with seizures occasionally do, too.

Note: I did eventually realize that the music I heard during my musical hallucinations was not real, even while having them. In contrast, I truly thought my bipolar psychosis delusions and hallucinations were real, while having them.

[still_crazy]

auditory hallucinations with severe depression. --not fun--

i saw visions while severely manic. I don't know that I'd call them "visual hallucinations," per se; its more like...

once I totally lost it, it was all on my mind's eye, fast moving imagery, like a movie or something. the closest i came to bona fide visual hallucinations was floaters, and that may have been hypertension and sleep deprivation. :-(

but yeah...not fun, not fun. I'm fortunate that the "atypical" tranquilizer works so well for me. The anti-seizure drugs...ugh...hit or miss, honestly. I think trileptal caused some low mood, even straight up depression.

hopefully, i wont get tardive dyskinesia. (fingers crossed...)

[Moose72]

Oh boy....

Ive had visual and auditory. The visial ranged from seeing spider crawling over my DVDs to having a conversation with one of my delusions/hallucinations. That scared me when they told me it wasnt real because it damned well felt real. Mostly I have musical hallucinations or voices. Sometimes internal sometimes external. Earlier in my illness the cable reciever began whispering commands in a not-nice tone. It kept doing this until I left the room and walked back in.Then there are the hypnogogic and hypnopompic (if i got the names right) that seem as real as day but that has to do with falling asleep and waking up and anybody can have them. Last time, I heard someone banging really hard on the front door. Nobody there.