Diagnosed bipolar but having hallucinations outside of any mood episode

For the past month or two I've been on a lot fewer meds than I used to be on. I used to be on 3 antipsychotics, and 3 mood stabilizers and a bunch of other stuff, now I'm just on Geodon, Wellbutrin, and Klonopin, and I've been having pretty regular hallucinations. I can see why I had a few for the few days I was manic last month, but aside from that I've been between episodes as far as I know, and still having psychotic symptoms.

One theory is that because I'm on fewer antipsychotics now hallucinations that would have been happening if I weren't on so many antipsychotics are now breaking through revealing underlying schizoaffective disorder. (I've been on a lot of antipsychotics pretty much since the first appearance of hallucinations until the past couple of months)

Another theory is the hallucinations are CAUSED by going off the other meds and not some other disease process.

I know you have to meet at least two of the DSM criteria to have schizoaffective. I have hallucinations and disorganized thinking, so that's two, but I also have one of the symptoms that on its own qualifies you for schizoaffective, namely hearing two or more voices carry on a conversation on their own, which happens to me a lot when I'm at work at night and everyone else is asleep.

But maybe it's all better explained by the fact that I have bipolar, or the medication changes. I'm just trying to sort out whether I have the right diagnosis or not, I think my pdoc is trying to figure it out too although he hasn't explicitly mentioned schizoaffective he keeps asking me if any of my hallucinations have occurred outside of a mood episode. Before I didn't know what to say because I had been depressed for so long, but I'm not depressed anymore. I had been having hallucinations during even the milder part of my depression too, if that makes a difference, not just during the deepest depths.

Does anyone have any insight?

Until I did a mood/event/thought chart and outright being told I hear things. My T says there is a fine line between bp w/ psychosis and SzA. You do sound like you have SzA but I still have bp1 w/ psychosis but my t says SzA.

Can you ask your PDoc outright what he thinks? Explain your concerns about your symptoms, maybe?

My theory involves kratom.

I've never heard of Kratom making anyone hallucinate. I just looked it up actually, and some people seem to think it's a hallucinogen, but it really just isn't. Some strains have been reported to make colors seem more vivid, but that's the extent of it. I've been taking kratom for 7 years and have only been having hallucinations for the past couple of years, and more recently, more hallucinations than usual. I'm also down to a really small dose of it anyway. About a quarter of what I used to use. So if it's kratom causing it, why would a lower dose be increasing my symptoms? Yeah, I just don't buy that theory, sorry.

I'll try to get up the courage to ask my pdoc what he thinks about me and SzA next time I see him.

I've also had hallucinations during long (like 10 month) breaks from kratom. So, another reason why I don't think that's it.

kratom caused me to hallucinate

Do you hallucinate anyway? In other words, do you have hallucinations when not on kratom? If so, the kratom may have just exacerbated a condition you already have.

Did it cause voices talking to each other, or calling out to you, music (like old timey radio music, or bad 90s rock, or marimba music), or tactile hallucinations like feeling like you've been bitten in the neck, or jumped on by a shadow creature? Or sometimes visual hallucinations like giant spiders and rats and shadow people, or seeing someone you know talking to you when they're actually snoring in their bed? Because those are the sorts of hallucinations I've been having.

I suppose it's possible that the kratom is exacerbating my hallucinations, but I only take it 4 days a week (my work days) and less than a gram at a time (which is basically nothing). All it does is help me be more social because I'm introverted and socially anxious and at my job you can't have that kind of personality.

In any case, I still don't think it's the Kratom. From what I've read, Kratom only causes hallucinations at high doses and only in people that are prone to hallucinations anyway (i.e. people who have psychotic disorders).

I know it probably sounds like I'm an addict and I'm in denial about it. But I've already recognized that and that's why I'm working on lowering my intake and ultimately quitting. I honestly don't even feel an effect from it anymore, so I think I'm just psychologically dependent on it. The court is out on whether or not Kratom is physically addictive. Since I don't take it on my weekends (3 days in a row) and have no withdrawals I don't really think it's physically addictive.

But anyway, I guess what I'm trying to emphasize is that I've been having hallucinations without Kratom being involved in any way. For instance, when I was in college I hallucinated an evil shadow twin of my cat that was plotting to kill me and kept telling me to jump off the roof. This was well before I discovered kratom. And I've taken many 6+ month breaks from Kratom and still had hallucinations. There has to be something else wrong. Whether it's just the bipolar or something else remains to be seen, but there has to be something going on here.

When do you see your pdoc again? You should explain this too him and see what his take on it is

kratom exacerbated my psychosis. it didnt cause it.

Not until the 12th. If this keeps up i might call him before then though. I see my therapist in the same building tomorrow maybe he can just pass a message to my pdoc.