Psychosis/Delusions #compassionorbust By Joanne Phipps

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Psychosis: According to the book Loving Someone With Bipolar Disorder by Julie A. Fast and John D. Preston, which I will mention in the podcast covering bipolar disorder and psychosis/delusions, psychosis is: a severe break with reality that can occur with mania or depression (although not with cyclothymia or phyomania). Because there is so much confusion and stigma surrounding psychosis, it helps to know that although psychotic behavior seems totally bizarre, random, and frightening, it’s a normal symptom for many people with bipolar disorder.

It’s important, when we talk about psychosis to remember that it can truly impair the way that someone looks at the world, but if a loved one says or does something that seems completely unrealistic or frightening, it’s still important that you talk with their doctor about psychosis. Psychotic symptoms are also one of many major bipolar disorder symptoms (also including mania, depression, hypomania, anxiety, paranoia, self-harm, and suicidal thoughts and impulses).

Delusions: Again, according to the above mentioned book, delusions are far-fetched, highly unrealistic, even bizarre beliefs. Delusions are often times confused with hallucinations, but they are in fact different. Delusions are again BELIEFS: a person may believe that they have been chosen as a special messenger of God to save humanity, or that they have been cursed by Satan. Hallucinations are perceptions that occur when an actual stimulus is absent: hearing voices when you are alone, seeing visions that have no basis in reality.


In layman’s terms, psychosis = disruptions to a person’s thoughts or perceptions that make it difficult for them to recognize what is real and what is not. It’s very common for people with bipolar disorder who experience psychotic symptoms or delusions to keep them to themselves and not share this information with even their closest friends or family because it’s hard for even them to know what is happening and if it is or is not normal or a part of their illness.

Several things can contribute to the development of Psychosis:

  1. Genetics
  2. Trauma
  3. Substance Use
  4. Physical illness or injury (traumatic brain injuries, etc)
  5. Mental illnesses, particularly schizophrenia, bipolar disorder, schizoaffective disorder, and depression

Much like with most everything in life, the earlier the diagnosis of delusions and/or psychosis, the better the treatment outcome. Because psychosis/psychotic episodes rarely have a sudden and abrupt onset, it’s important to be aware of the early psychosis symptoms and help your loved one(s) understand the importance of early treatment.

Early psychosis symptoms include:

  1. Drastic change in school or work performance
  2. A decline in self-care and/or personal hygiene
  3. Spending more time alone than usual
  4. Strong, inappropriate emotions or feeling no emotions at all
  5. Trouble concentrating/thinking


Traditional treatment options for psychosis include psychotherapy and medication. More recent research has also shown a significant benefit from a treatment approach called: Coordinated Specialty Care, which includes:

  1. Family support and education
  2. Supported education and employment
  3. Peer support
  4. Medication management
  5. Psychotherapy






Book: Loving Someone With Bipolar Disorder

Psych Today: Delusional Disorder


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