Bipolar 1 disorder is a mood disorder characterized by episodes of mania and episodes of depression. People experiencing a manic episode have excess energy. They may appear restless, euphoric or irritable. People with mania often speak very quickly and jump from one thought to another. They are also tend to show poor judgment by going on spending sprees or taking risks with their safety. People with depression, on the other hand, may appear sad or withdrawn. They may lose interest in activities to the point where they don't even want to get out of bed. Feelings of worthlessness or guilt are also earmarks of depression. About six million people in the United States have bipolar disorder. Half of all people with bipolar 1 disorder experience psychotic symptoms at one time or another.
A person is said to be psychotic when he or she loses touch with reality. Psychosis involves hallucinations and/or delusions. Hallucinations are incorrect sensory perceptions. Most often, the person hallucinating sees or hears something that isn't really there. Hallucinations are more common in people with schizophrenia, but people with bipolar 1 disorder may experience them as well. Delusions are fixed, untrue beliefs. A person who believes he or she is immortal, for instance, is suffering from a delusion.
Among people with bipolar 1 disorder, psychosis more commonly appears during manic episodes. People experiencing mania frequently have grandiose delusions. They may believe they possess some secret knowledge like the meaning of life, or they may believe that they have a close relationship with a celebrity whom, in real life, they have never even met. When people with depression have delusions, they usually believe that some horrible fate is in store for them. A depressed person, for instance, may be convinced that he or she is dying of cancer despite medical evidence to the contrary. People who are suicidal sometimes report hallucinations such as a voice urging them to kill themselves immediately.
Bipolar 1 disorder with psychotic features is best treated with a combination of medication and talk therapy. Treating people with bipolar disorder can prove a challenge. One problem is that people experiencing a manic episode may not want treatment. They may see their mania as a positive, especially when compared to the pain of depression. They often do not realize that the mania is leading to unsafe and irresponsible behavior. Family and friends may have to step in to encourage their loved one with bipolar disorder to stick with his or her treatment regimen. It is also helpful if the person with bipolar disorder has built a trusting relationship with a therapist or a psychiatrist before the onset of mania. In the United States, a person can only be hospitalized against his or her will if he or she poses an immediate danger to self or others.