Can psychosis exist in bipolar disorder?

[GlassJar]

Here is what is going on, let me say right now I have not drunk alcohol for 5 months straight and I have not taken any illegal drugs for 3 months. Just to sum up that, as you'll probably ask that later.

I am asking if psychosis exists in bipolar disorder because I have been experiencing episodes that make it difficult to concentrate on anything. I frequently have blackouts, where I honestly cannot remember how I got from point A to point B.

I will frequently lose concentration and "zone off into space". When this happens everything starts to blur and I can literally take myself out of the situation and just feel really surreal. To top it off, after I am able to focus again I see things that aren't there, or read things wrong or see things out of the corner of my eye. Is this because I might not be getting enough sleep?

I get vertigo from standing still not from heights, just standing. It makes me sick.

I am tired of this disorder ruining my life. I just want it to be controlled, but the last anti-psychotic I was on (Zyprexa) made me gain 20lbs and I haven't been able to lose it yet. I am currently on 900mg of Lithium.

Are these episodes a result of lack of sleep? (I didn't think I was getting abnormal hours)
Are they because my lithium isn't high enough?
Is there such a thing as psychosis in bipolar?
Is there something else wrong with me?


Please, I am really confused and I don't like medication very much. I would really like your honest opinion and not a simple "go to your doctor".

[ILADVOCATE]

Some of what you are describing could be neurological so have some tests done to rule that out first. As for psychosis existing in bipolar it can especially in bipolar with psychotic features and schizoaffective as I have made a full recovery from (read through my posts). Zyprexa causes sedation and a fair amount of weight gain from what I've found and is somewhat hard to tolerate. You could ask your psychiatrist about other options as regards antipsychotics. But make sure they rule out some common neurological criteria such as epilepsy first or whatever else they might think of. Have an informed conversation with your psychiatrist.

[billgonz1]

Hi ! The reason I was dignosed is I had a psycotic break . First I could not sleep . Then started having audio hallucinations . Went straight to Doc .How put me in hospital. That is the last thing i remember . I was psycotic 10 day do not remember anything . I hear it was something ealse .Any way I was under more stress than the avarage Joe could handle . That is when I found out I'm Bipolar . I'm 43. I would get straight to PsyDoc .You do not want it any worse .Congrads on sobrity . You may have been self medicating . It took me 25 years to figure that out. Every brain is diff. go to a pro . Bill

[jtssteph]

You can definitly have a psychotic episode while you are bipolar. And you keep mentioning a possible lack of sleep. That is a major trigger for mania, and mania can lead to hallucinations, etc. You may be right on the verge of a manic episode and need to calm it down before it spirals upwards. I hate to say go to your doctor, but unless you have something that has worked in calming you down and letting you get some more rest, I would make a phone call to the doctor.

I've seen some pretty scary things since I've been diagnosed bipolar. Nearly ALL of them have happened while I wasn't sleeping properly.

Hope that helps.

[bastet56]

I have not been in as serious psychotic episodes as you have been, but without the help of anti psychs I am waaaaaayyyy out there. I see things, get very paranoid and have truly bazaar thoughts. I also become self destructive. I have to stay on an anti psych. Unfortunately I have gain MUCH more than 20lbs but it is a small price to pay for staying "sane". Our society puts too much emphasis on body image when you should be thinking that yes, I've gained weight but at least I can function.  

[bernie40]

The simple answer to your question is yes.  However it is best to rule out other causes and not just assume it is the bipolar.  This is where I say you definitely need to speak to your Doctor :-)  

Tiredness is also a contributor.  Keep a sleep diary and a daily diary to see if there is any pattern to these hallucinations.

Make sure you get your lithium levels checked regularly.  If you are new to lithium it should be done monthly.

Congrats on achieving everything you have so far.  I don't know what substances you used but it would be worth checking that there are no long lasting hangover effects from those - this probably depends on how long and how much you were using as well.  A local drug awareness group should be able to help you with that sort of information.

[mejeba]

All good comments and advice.  And I agree.  Apparently psychosis is present in 90 ish % of full manic episodes, and if the illness is Schizoaffective Disorder, can be ongoing regardless of mood.  My son has constant psychosis but has it well under control with Clozopine.  None of the other AP's worked for him.  He's also on 1200 mg Lithium.

Sorry to say but yes, get thee to a doc- to check out other physical possibilities for these symptoms, and to your pdoc.  It sounds like you really do need pro help.

[paranoid_cataclysm]

From my experience, psychosis exists during depressed, manic and mixed states but then I'm also autistic.  It just happens randomly for me with no specific triggers that I know of.  I kind of understand how it is for those people who talk to people who aren't there because I get confused and don't know if I actually talked to someone or just thought about talking to them.  Psychosis definitely can exist with Bipolar disorder.

[jst4shanell]

Geodon is a great AP.  I have zero side effects and I have been taking it for a long time.  I have a tendency for psychosis so I just keep taking Geodon.  It's outrageously expensive though.  My pdoc just gives me massive amounts of samples so that's good for me.  Sounds like it's definately time to see the doc.  Good luck

[citroprishka]

interesting comments! I wanted to know if small amounts of alcohol, say 40- 60 ml which is approx  one unit a day .can cause harm to a lithium taker?

[Anonymouse88]

It's best to avoid alcohol, and please get your doctor's opinion before drinking any.  It seems that a small amount of alcohol may be ok with lithium, but that large amounts would be a really, really bad idea.  Alcohol makes you pee more, which can easily dehydrate you, which is a no-no for lithium.  Ask a pharmacist about the interaction as well as your doctor, since pharmacists are good with interactions.