Bipolar Disorder Symptoms Delusions Occurring in Bipolar Disorder 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 July 13, 2020 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 Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Sanna Lindberg / Getty Images Table of Contents View All Table of Contents Psychosis in Bipolar Disorder Warning Signs of Psychosis Types of Delusions Treatment A delusion is a false belief that a person firmly holds to be true, regardless of whether it actually is true or even possible. Someone who's delusional will hang on tight to such a belief even if other people are able to logically explain why it's false. There is a recognized mental illness called delusional disorder in which delusions are the dominant symptom. In a type of bipolar disorder that includes psychosis, however, delusions are a psychotic symptom of the mood disorder. They often appear along with hallucinations—sensory perceptions aren't actually there. In order to understand delusions as a symptom of bipolar disorder, it is helpful to also become familiar with psychosis. Delusions vs. Hallucinations: What Are the Differences? Psychosis in Bipolar Disorder In the simplest terms, psychosis is the loss of touch with reality. When someone is having a psychotic event, their thoughts and beliefs become distorted. Sometimes the delusions and hallucinations that accompany bipolar symptoms are in keeping with a person's current mood state, in which case they're called mood-congruent symptoms, and sometimes the opposite is the case—a person's delusion doesn't match up with their mood, which is known as mood-incongruent symptoms. Psychosis is not an illness in and of itself, but a symptom of an underlying disorder. Roughly 3% of the U.S. population will experience psychosis during their lifetime, according to the National Institute of Mental Health, whether they have a mental disorder or not. In fact, there's an array of non-psychiatric conditions that cause psychoses, including: Certain drugs and medicationsHead injuriesHuntington's diseaseSleep deprivationTemporal lobe epilepsyThyroid disordersVitamin B12 deficiency In bipolar disorder, psychotic events usually occur during manic episodes, but they can develop during a depressive state as well. Either way, if psychotic episodes are part of your bipolar disorder, your official diagnosis will likely be a bipolar disorder with psychotic features (sometimes referred to as bipolar psychosis). If you are diagnosed with bipolar psychosis it doesn't mean that your illness is more severe than that of someone who has bipolar without psychosis. One study found that people with bipolar psychosis tend to be more likely to experience more rapid cycling, as well as more chronic mood disturbances, than those who have bipolar without psychosis. Symptoms of Bipolar Psychosis Warning Signs of Psychosis Psychosis doesn't normally happen suddenly. There are often warning signs that can let you know that it's coming, including: A decrease in performance at work or at schoolA sudden decline in self-care or personal hygieneBeing unable to do things you normally canConfused speech or trouble communicating, such as changing topics rapidly or speaking incoherentlyDifficulty telling reality from fantasyExtreme changes in sleeping or eating patternsHaving trouble focusing and concentratingSaying or doing bizarre things that don't reflect reality Spending a lot more time alone than usualStrong, inappropriate emotions or having no feelings at allSuddenly losing interest in the things you used to enjoySuspiciousness or uneasiness with others Types of Delusions There are many different types of delusions. These are the ones most commonly associated with mental disorders. Delusions of grandeur: Believing that you're famous or publicly important or that you're a god. Delusional jealousy: Believing that your spouse or partner is being unfaithful when they are not. Persecutory or paranoid delusions: Suspecting that you are being followed, spied on, secretly listened to, or the like. Somatic delusions: Believing that you have a certain medical condition or physical defect. Delusions of reference: Thinking that random events contain a special meaning for you alone. Bizarre delusions: Believing in things that are impossible, such as thinking you're a werewolf, or your sister is an octopus, or that giant worms make subway tunnels. What Is the Fregoli Delusion? Treatment Psychosis—and therefore the delusions and/or hallucinations that comprise it—is treatable, especially if treatment is focused and prompt. Early intervention makes a big difference in recovery. Treatment may include antipsychotic medications and psychotherapy, such as cognitive-behavioral therapy (CBT) and supportive psychotherapy. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 5 Sources 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. Cleveland Clinic. Delusional disorder. Early Assessment & Support Alliance. What is psychosis?. National Institute of Mental Health. RAISE questions and answers. Burton CZ, Ryan KA, Kamali M, et al. Psychosis in bipolar disorder: Does it represent a more "severe" illness? Bipolar Disord. 2018;20(1):18-26. doi:10.1111/bdi.12527 Skelton M, Khokhar WA, Thacker SP. Treatments for delusional disorder. Cochrane Database Syst Rev. 2015;(5):CD009785. doi:10.1002/14651858.CD009785.pub2 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.