Bipolar Disorder Symptoms Symptoms of Bipolar Psychosis By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on February 19, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Rafael Elias / Getty Images Table of Contents View All Table of Contents Symptoms Delusions Hallucinations Safety Considerations More than half of people living with bipolar disorder will experience at least one symptom of psychosis over the course of their lives. Psychosis is defined as the loss of contact with reality in which the person cannot tell the difference between what is real and what is imagined. Symptoms include delusions (believing something that is not real) and/or hallucinations (seeing, hearing, touching, smelling, or tasting something that is not real). Psychosis usually accompanies episodes of extreme mania in people with bipolar I disorder (the more severe form of the disease). While less common, it can also happen to people with bipolar II disorder. Psychosis is also a feature seen with other types of mental illness, including schizophrenia and schizoaffective disorder. Certain physical illnesses such as Parkinson's disease, Alzheimer's disease, brain tumors, and stroke can also trigger a psychotic episode, and it can even be an extreme feature of postpartum depression. Symptoms Within the context of bipolar disorder, there is no clear understanding of what causes psychosis. While people will often refer to it as a "psychotic break," the reality is that a psychotic episode usually develops slowly over time. Early Warning Signs of Psychosis Some early warning signs of psychosis include:Consistently worrying about grades or job performanceExperiencing strong, inappropriate feelings or no feelings at allFailure to keep up with personal hygieneHaving unwarranted suspiciousness of othersStruggling to concentrate or think clearlyWithdrawing from friends and family Getting help for psychosis sooner rather than later can make the recovery process faster and easier, so early indicators should not be ignored. That said, people close to the person experiencing psychosis are usually the ones to detect these symptoms. Mood-Congruent vs. Mood-Incongruent People experiencing psychosis will typically appear incoherent and completely unaware of how extreme their behavior has become. In terms of symptoms, they are typically classified as being either mood-congruent or mood-incongruent. Mood-Congruent Symptoms The hallucinations and/or delusions match the person's mood. The hallucinations may be contextualized by a person's delusions. The underlying belief that you're being spied on can manifest with imagined sounds or voices from the next room. Mood-Incongruent Symptoms A person's mood does not match the hallucination and/or delusion. People will often believe that there are voices telling them what to do or that they are being influenced by some unseen force. The episodes are considered serious and will more often than not require hospitalization. Delusions Delusions are false beliefs that a person believes are true. Previously referred to as paranoid disorder, delusions are characterized by episodes that are either bizarre (something beyond the realm of possibility) or non-bizarre (things that are within the realm of possibility). Examples of bizarre illusions include being abducted by aliens or having a CIA tracking device in your head. Non-bizarre delusions, by contrast, often manifest with claims of being poisoned, followed, or loved from afar. Unlike hallucinations, delusions can often seem perfectly normal in casual situations. Psychotic delusions are typically clustered around one or several of the following themes: Erotomania, the belief that someone important loves you Grandiosity, characterized by an inflated sense of self-worth Jealousy, usually related to a loved one's infidelity Persecution, in which you believe others plan to do you harm Somatic delusions, by which you believe you are ill or have a physical defect Delusions Occurring in Bipolar Disorder Hallucinations Hallucinations are characterized by physical sensations that are not real. With regards to bipolar disorder, hallucinations may be caused by an extreme manic episode combined with extreme sleep deprivation (the latter of which can also cause hallucinations in people who don't have bipolar disorder). Hallucinations don't just involve perceptions, but actual sensations involving one or more of the five senses. They can be classified as: Auditory hallucinations, such as hearing voices that aren't thereOlfactory hallucinations, involving smellsTactile hallucinations, such as feeling bugs crawling all over youTaste hallucinationsVisual hallucinations What Is a Hallucination? Safety Considerations The word "psychosis" can be scary for some people, suggesting the affected person is likely to inflict self-harm or cause harm to others. While this is possible, particularly in cases of severe mood-incongruent psychosis, episodes are usually more troubling than dangerous, but they still require treatment. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. A Word From Verywell With a holistic approach to the treatment of bipolar psychosis—including psychotherapy, medication, and social support—most people can fully recover and return to their normal life without further incident. While bipolar disorder cannot be "cured" in the traditional sense, with proper diagnosis and treatment, symptoms of the disorder can be successfully controlled over the long term. Was this page helpful? Thanks for your feedback! Dealing with racing thoughts? Always feeling tired? Our guide offers strategies to help you or your loved one live better with bipolar disorder. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 1 Source Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Dunayevich E, Keck PE. Prevalence and description of psychotic features in bipolar mania. Curr Psychiatry Rep. 2000;2(4):286-290. doi:10.1007/s11920-000-0069-4 Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.