Maddy

Bipolar Psychosis In Mania/mixed Vs Hypomania

91 posts in this topic

There are two key differences between mania and hypomania:

One of the criteria for a hypomanic episode is:

The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
For a manic episode:

The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

http://www.behavenet.com/capsules/disorder...cation.htm#Mood

But there are similar features of both:

[these are noticeable changes]

  • feelings of optimism, confidence, creativity, sometimes feeling 'high'


  • Sometimes feeling easily agitated


  • inappropriate behavior or risk taking


  • heightened senses, noted clarity of thought


  • noting events, coincedences, or events as being more signifigant than they are

Psychotic symptoms are not seen in hypomania, the key defining mood state of Bipolar II Disorder.
-Black Dog Institute

http://www.blackdoginstitute.org.au/bipola...a.cfm#Psychotic

Examples of psychotic features are hallucinations are delusions and hallucinations.

A hallucination is an unreal experience.

A delusion is an untrue thought.

Hallucinations can manifest itself in all five senses: sound, taste, touch, smell, sight.

Delusions can be either grandiose or persecutory.

Someone can think they are capable of fantastic things, or are a fantastic being [a king, a millionare, a healer] or think that they are being followed, something bad might happen, someone might want to hurt them.

http://www.blackdoginstitute.org.au/bipola...a.cfm#Psychotic

Other psychotic symptoms can include disorganized speech and thought. An observer of this will likely not be able to understand or make any connection between one topic and the next.

Problems with movement, called "catatonic symptoms," which may include extreme physical agitation or slowness and odd movements or postures, [can] occur in... people experiencing episodes of depression or mania.

http://www.camh.net/about_addiction_mental...order_mhfs.html

These symptoms are not terribly common, but they do happen. They are the symptoms which can lead to mis-diagnosis.

Edited by AirMarshall
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*Reply posted by crazynotstupid on: Jan 30th, 2005, 4:18pm*

Eh.  Bleh.  As I sit here in mixed hell right now...good info!  I wish our damn DOCS would tell us this shit.  I mean, what is it we pay them for??

Looks like number 3 fits exactly my state of mind when I had my "episode" last October...which is interesting to me, considering had I not plead out, my trial would be in 3 weeks or so.

I would SO have gotten off.  But then, I might SO have gotten committed!  So, whatever...no looking back, just ahead.

Great info navy, thanks!

Edited by NavySurya

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*Reply posted by NavySurya on: Jan 30th, 2005, 4:35pm*

Something I wrote while, basically in a two and a half week mixed state with a few hours rest every day. This one was medication induced. BLEH!

I really, really, really try to give everything a shot and I don't want to cut of my options but I goddamn can't take this shit anymore. I Seriously feel like I haven't gotten a normal, refreshing, productive nights sleep in FOREVER. It is getting to me.. very bad.

The goddamn medication  doesn't help.

My pdoc THINKS it's helping.. I don't think it is.

BUt at night when I take it.. not only does it make me not go to sleep.. but it makes me feel like SHIT.  I feel irritable, and lonely, and really fucking depressed and I can't goddamn deal with it and I ahte it!!!! ... and i am flipping out all over the place and my body hurts and I am SO PISSED. and I don't want to go on lithium..

... Feeel like punching my fist threw a sheet of glass after I took it every night! GAH! I am so frustrated... don't noo what to do... so now I feel kinda scared..

Sometimes I feel like I am really trying SOOO hard...

GODDAMNIT.

Yeah.. crazyness.

Can't always predict what's going to do it though.

It was a kinda unusual thing

I think the med mixed states are the worst. For me anyway, I've never asked other people.

Does anyone find that Med-induced mixed states are worse? Or does it not matter?

~navy~

Edited by NavySurya
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*Reply posted by libertyjones on: Jan 30th, 2005, 4:38pm*

ok i have a first question.... if you "know" you're being delusional is it really delusional? gah. i'll expound when i have time to think more.

Edited by NavySurya

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*Reply posted by NavySurya on: Jan 30th, 2005, 4:42pm*

on Jan 30th, 2005, 4:38pm, libertyjones wrote:

ok i have a first question.... if you "know" you're being delusional is it really delusional? gah. i'll expound when i have time to think more.

Not sure...

When I was having paranoia, I could recognize it.

I still had it, DEFINATELY. I was completely freaked out.

I couldn't let go of the paranoid ideations, but at the same time, I couldn't entirely qualify them.

However, if i had tried to ignore them for another day or so, that realization would probably have not been there anymore.

I was also having some hallucinations. For me, those are much easier to recognize. It think that might be a generally true.

... on the other hand, that particular instance, the one that is first coming to mind, was med-induced.

But the one that I was writing about above,which was also med-induced, I was having some hallucinations that I couldn't quite tell were real. In all likelihood, I probably had some 'mild' delusions as well.  There were also some black out periods during that episode... err... I guess it could go either way.

And the non-med ones I have had hallucinations, but not many delusions... so...

~navy~

Edited by NavySurya

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*Reply posted by libertyjones on: Jan 30th, 2005, 4:46pm*

      Does anyone find that Med-induced mixed states are worse? Or does it not matter?

man i hope i don't have to find that one out. but my bet's on the drug induced hell. i can deduce this from my meth daze.  sorry we cross posted last time.

some fucker just drove into and over my fence and drove away! fuck. grrrrrrrrrrr!!!! fooie!

Edited by NavySurya

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*Reply posted by crazynotstupid on: Jan 30th, 2005, 9:32pm*

So, question...if you can't quite answer, that's OK.

Where do you draw the line with paranoia and paranoid delusions?  I've got this thing where...well, my bedroom window got knocked out by my dogs (long story) a couple months ago, so it's boarded up.

So now, I can't see out that direction, which is the road, and right where my driveway is.  Damn near everytime I'm in there and hear someone drive by (quite often, as I'm just near the main county road) I swear it's either the cops coming to arrest me again, animal control coming to get my dogs, my neighbor coming to yell at me about my dogs, or my dad coming because my phone is out again.

It's especially bad when they go SLOW, which they do because it's dirt, and it's getting all washboardy now, and I get freaked out, especially later at night, cuz I start getting sure the cops found out something I did that violates my probation and are coming to arrest me and it's gonna go down RIGHT NOW MAN...

I'm not sure if it's just anxiety or not, but I keep wanting to put my ninja combat sword by the front door just in case...so now I'm thinking it's more than anxiety...

Especially because I think my neighbors are looking at me all the time when they're outside now.  Well, for the last couple months, actually.

So where's the line between "normal" paranoia and delusional paranoia?  And how long before I learn how to build mail bombs?  Argh....

Edited by NavySurya

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*Reply posted by NavySurya  on: Jan 30th, 2005, 9:39pm*

I don't KNOW, and I will see if I can find  some sort of good answer.

But here is a question, that might be important.

Do you think, all the time, that the cops are going to come and get you and that they are driving by to make you nervous and one of these times, eventually, it WILL be them, and they will come 'get you'?

Or do you just get really nervous, and 'paranoid' when you hear a car coming, and can't see it, because you got in trouble with the law? As in... do you plan on the cops being out to get you?

hmm...

Edited by NavySurya

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*Reply posted by Tegorck  on: Jan 30th, 2005, 9:48pm*

good  reference, thanks Navy.

Edited by NavySurya

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*Reply posted by libertyjones  on: Jan 30th, 2005, 10:45pm*

Especially because I think my neighbors are looking at me all the time when they're outside now.

i feel that way like almost always. sux.

you know i had this long actually thoughtful post (this thread) going on much earlier but my frickin computer froze up on me. bah. not my day. i'll back be in the a.m. though. great thread.  see you all tomorrow!

Edited by NavySurya

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*Reply posted by Sduibek  on: Jan 30th, 2005, 11:56pm*

Okay Navy... I gots me a question.

I'm pretty sure i've never had a full manic episode, except induced by rec. drug use, but I don't think that really "counts" (do you?  hmm).  usually I just feel REALLY REALLY good, sociable, attractive, etc.  in fact i do much much better in school/job/whatever during those times, so i'm pretty sure it's just hypomania.

the thing is, i have delusions/hallucinations on any extreme mood swing or state of consciousness, be it positive or negative.

for example, let's say i feel like crap because i haven't eaten in 2 days.  my body has a lot of stress, hence anxiety, at a time like that.. probably irritability too, and 'racing thoughts'.  well, i'll start thinking i see people out of the corner of my eye... and in darkness random shapes will become evil faces and such.

plus, i hear footsteps and/or my name being called.

i'll also think really wierd things... during one of these 'downer manias' about a week ago, i was 100% CONVINCED that i was possessed by demons, and that dreams i've been having are these evil spirits communicating with me.  i even tried not to sleep for fear that they would take over my body...  I got these INTENSE urges to say "I sell my soul to satan" in all seriousness.  I might have even said it a few times, I don't remember.

Undecided

Only way I got through that was repeating "you can't take my positive energy" and (after a quick online search) "jesus christ of nazareth rebukes you" over and over for like 3 days.

ok... i realize that makes me sound totally fucking batshit crazy.  just wondering what, if any, dx would be tagged along to something like that.  would that be a dysphoric mania w/psychotic stuff.. or like... schizo or what. i know we aren't supposed to dx ourselves.. but like... i wanna come prepared cause my doc is starting me on depakote on tues.

thanks and sorry for rambling Grin  you rule! Kiss

Edited by NavySurya

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*Reply posted by NavySurya  on: Jan 31st, 2005, 12:02am*

  IF this is in the context of assuming you are bipolar,  and I would assume that you would be BPI, based on THAT-

THAT WOULD BE A MANIC EPISODE

....

but actually...

I WOULD need more info... I think anyone would.

You didn't really give a whole lot.

What's your DX?

How do those episodes compare to the descriptions?

Hard to say... 

I would say it's a manic thing.

I don't know anything else going on, though.

...OOOOhhhh

Wait....

did you mean a DEPRESSED STATE?

do you have delusional thinking during a depressed state?

Edited by NavySurya

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*Reply posted by Sduibek  on: Jan 31st, 2005, 12:16am*

  Really?  I thought people weren't depressed when they got manic episodes?  i'm all confused now.. Lips Sealed

i was pretty sure until today i was BPII... but... now i'm like "hhmmm" cause i do hear my name being called, have for years, and LOTS of times blurry shapes in the dark look lke really sinister shit.

i dunno, dx's are so confusing...  grarg.  i'm torn.  part of me wants to just let my doc handle everythnig, but the other part of me really worries that i'll forget to tell him something and i'll get a mis-dx.  for example he seemed to act like just hearing my name called like "wasn't good enough" or some crap.  same with my old doc. 

oh and for the record i think he's one of those docs that focuses on symptoms not dxs... which is cool.  but he's putting me on depakote soon, so obviously he thinks it's some kind of BP-something Wink

Edited by NavySurya

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*Reply posted by NavySurya  on:  Jan 31st, 2005, 12:21am*

  Mixed state?

Reread the mixed state stuff... and check out the link too? I'm having a hard time figuring it out...

hmm

Edited by NavySurya

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*Reply posted by Sduibek  on:  Jan 31st, 2005, 12:23am*

  on Jan 31st, 2005, 12:02am, NavySurya wrote:

did you mean a DEPRESSED STATE?

do you have delusional thinking during a depressed state?

heh, well mostly my thinknig is dellusional

but clinically speaking, yah my thinking gets way fucked when i'm depressed.  people start trying to say positive stuff to cheer me up, and it actually makes me feel WORSE and i start crying and stuff.  last time i felt like what i'm describing, i HAD to start clawing at my arm until i bled.  only way i could feel better...

oh i also have vivid hallucinations of like slicing people up... hmm

i'm thinking mixed state fits i suppose.  because i am very very very depressed at these times, nothing makes me feel better.  nothing.  BUT i also have some amount of high energy.. heart pounding, etc.  it's like i'm all revved up ... but i always just assumed that was just anxiety/stress sort of thing.. never realized that's actually a different type of BP state. hmm.. i'll read more

hmm..

Thoughts often race as in a manic episode, but the content is often dark and full of pessimism, worry, guilt, and self-hatred. Anxiety is also often a prominent feature of mixed mood states, evidenced by an increase in panic attacks and compulsions. Many persons with bipolar disorder describe mixed episodes as feeling much worse than either mania or depression alone.

Okay... so racing thoughts is NOT a symptom usually associated with "normal" depression or "normal" (heh) depressive BP states?  Only in a BP mixed state would you have racing thoughts AND depressive thoughts?  because whenever i have self-described episodes of really really bad depression, my thoughts race bigtime, at least in recent months.  it seems sometimes the worse i feel the more my thoughts race.  like i said i assumed it was just like anxiety or something.  and like that paragraph, every thought is 100% negative... i just keep going around in circles in my head talking to myself about how shitty everything is.  naturally it sucks

*still reading* this is fun lol

Edited by NavySurya

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*Reply posted by crazynotstupid  on:  Jan 31st, 2005, 12:44am*

  on Jan 30th, 2005, 9:39pm, NavySurya wrote:

I don't KNOW, and I will see if I can find  some sort of good answer.

But here is a question, that might be important.

Do you think, all the time, that the cops are going to come and get you and that they are driving by to make you nervous and one of these times, eventually, it WILL be them, and they will come 'get you'?

Or do you just get really nervous, and 'paranoid' when you hear a car coming, and can't see it, because you got in trouble with the law? As in... do you plan on the cops being out to get you?

hmm...

It's partly because I get in trouble with the law...and I can't see the cars...

But dammit, looking at it now, it's more like MY FUCKING NEIGHBORS ARE RATTING ON ME.  I moved out here cuz my uber-bitch neighbor was always calling animal control on me...and always giving me "the look" (I'm serious, I really don't even think this is the paranoid part) and dammit, animal control has been out here 3 times now and I don't know if I'm paranoid or nervous or what.

All I know is I want to murder all my neighbors with my axe.  Or sledge hammer.  My old one had her bedroom 5 feet away from my kitchen.  These guys, the closest I couldn't even shout to, but they're still too close.  I can't move again, and they've got me freaking out so bad I don't know if I'm paranoid-delusional or just freaking super anxious!

I DO know I want a 6 foot privacy fence so they can't see me when I let the dogs out.  I've been WAY jumpy when I'm outside anymore.  I'm convinced someone's watching me, which one of these bastards, I don't know, and not a damn one of them is sociable enough to say hi or wave when they drive by.  I think they all think I'm just the crazy dog/cat guy.

Oh yeah, I'm sure the whole getting arrested thing didn't help.  Y'know, getting cuffed and stuffed, 2 cop cars and an ambulance in the driveway.  On a Thursday morning.  Right about the time everybody's going to work and taking their kids to the bus stop.  Yeah, I'm sure I'm Mr. fucking Popular around here.

Gah.  Don't know if I'm going psychotic, but I sure am pissed at my neighbors!  And navy, don't sweat finding answers too much.  I'll have a pdoc one of these days.  At least, that's the rumor... But thanks for the help, and the thread!

Edited by NavySurya

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*Reply posted by Sduibek  on:  Jan 31st, 2005, 12:50am*

  obviously i'm not expert.... but i'd say you're just getting that look from them because people fear/hate/can't stop staring at folks who have trouble with the law.  sad but true i know this sounds insane... but have you tried doing something nice for them?  bring them some bread or something, nothing fancy.  and just be honest... say "hey, i've been in a rough period lately.. i'm sure you can relate, we all go through bad times.  anyways, just wanted to apologize for the ruckus i caused and let you know i'm really not a bad guy, okay?"  and if you're able to do that, maybe go the next step sometime in the future, like plan a barbeque or something.

something like that.  maybe that's not really within your ability right now, but hey i'm just tossing out ideas i know you're saying you wanna kill em and stuff, but to me (i know, uneducated non-pdoc observer...) it seems like their mistrust/anxiety/whatever towards you is actually causing those negative feelings towards them.  (unless there's more you aren't telling or more i somehow missed when reading.)  so, hopefully if you can break yourself out of that thinking style for a bit and give yourself the challenge of making your neighbors at ease.... they will make your life easier to live as well by being more peacable, or maybe even understanding your plight somewhat.  hmm maybe i give them too much credit, heh. either way, i believe in you!  first step, the neighborhood.. next step, THE WORLD.  all hail crazynotstupid.  lol

oh sorry about ranting @ you about the whole Iraq thing in that other thread... god i swear i'm cycling like every 2 hours this week 

Edited by NavySurya

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*Reply posted by crazynotstupid  on:  Jan 31st, 2005, 2:02pm*

Hey sduibek--

First off, while your suggestions are generally good, I'm just not a reach-out kind of guy.  I moved out here (few miles out of town, more rural area) to get some space!  Hoped for better neighbors, but mostly they've been rude assholes from the get-go, with a couple exceptions.  The couple that lives directly behind me, for example, are horrid.  Passive-aggressive and push all my rage triggers.

Second, don't worry about the Iraq thing--keeping myself away from that forum; politics is one of my major rage triggers, and it's not like I need more of that these days, now is it? 

Bleh. 

Edited by NavySurya

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*Reply posted by BPII  on:  Feb 1st, 2005, 9:26pm *

Crazynotstupid: how are you feeling? I'm a little worried about you having to deal with your shitty neighbors and cops and whatnot. I think those external stressors would bug me out big time. We don't need people helping make us nutty. Bastards.

Navy: many, many thanks for the information. You rock hard, Grrl!

Edited by NavySurya

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*Reply posted by ibchupacabra  on: Feb 2nd, 2005, 10:36am *

Hey Sbu... I think you sound a lot like me, Mrs. Batshit fucking crazy.....

My doc diagnosed me as rapid cycling BPII w/mixed states.  Obviously a few psychotic episodes are thrown in there just to mix things up. 

Mixed states cause a tremendous amount of anxiety - think of depression and mania as waves in the ocean hitting each other  - just a lotta churn and drama So when you experience both states at the same time - your body and mind process it as Anxiety - and when it's REALLY bad, the delusions (demons & footsteps) start to show up. 

Does that make any sense?

Edited by NavySurya

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*Reply posted by Sduibek  on: Feb 2nd, 2005, 12:03pm  *

@chupa:  Yes.  I might be BPI vs BPII tho.  i'm not really concerned wth the dx... as long as i get meds and the meds work....

well see how depakote works.  hmm wonder if ill need an AP too...

Edited by NavySurya

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*Reply posted by blackmilk  on: Feb 3rd, 2005, 6:17pm  *

  hey Sduibek can I threadjack  for a minute based on something you said?

I'm just curious about the sort of quasi-Satanic delusions and urges you've been having. Here's a question - are you religious? do you think people get possessed by demons all the time?

I ask because I'm not religious - at all - but I've had similar experiences. So either a) it's because my dad was a minister, and no I've never seen a possessed person or an exorcism or anything like that in my life - in which case I need more therapy. Or B) it's a bipolar thang, and I should talk to my pdoc.

Or c) I should stop smoking the green stuff.

A little more would be appreciated. Thanks so much. Hope you got a helluva deal for that soul

K

Edited by NavySurya

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*Reply posted by superblondgirl  on: Feb 3rd, 2005, 7:49pm  *

  It makes me feel so much better that it's "normal" to see things out of the corner of your eye when you know they're not there.... because, man, I thought I was going even crazier!  But I think it's definitely med-related, I didn't see things before the Lamictal.  And now I know that I've got the textbook "mixed state" thing.  I wish I could feel like jesus or something, instead.  My husband is BP, too, and he's always saying how he misses that awesome high manic feeling.

Edited by NavySurya

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*Reply posted by Sduibek  on: Feb 3rd, 2005, 8:52pm  *

  on Feb 3rd, 2005, 6:17pm, blackmilk wrote:

hey Sduibek can I threadjack  for a minute based on something you said?
TERRORIST!!!!  ;)

I'm just curious about the sort of quasi-Satanic delusions and urges you've been having. Here's a question - are you religious? do you think people get possessed by demons all the time?

My parents grew up Mormon, but left the church when I was very young.  So basically I grew up being Atheist/Agnostic (kinda depended on my mood... lol that really sounds bipolar huh?  )  I don't necessarily believe in possession... it's hard to say.  Given that I now realize i've got some deep-seated mental issues, i'm wondering if what I thought was "proof" of paranormal stuff was simply me hallucinating/having dellusional thoughts.  Because until recently I did believe in demons and ghosts and whatnot, just not in the typical sense.

I AM very "spiritual" in general though.  Just not religious (Took me a long time to realize those two are different, heh)

Or c) I should stop smoking the green stuff.
Good idea....

Hope you got a helluva deal for that soul

Hmmm... so far i'm having more rage problems, more problems with oppositional thinking, and had less self-esteem.  Also my art has definitely taken on a more grotesque and sexual nature to it.  No superpowers or anything like that.  Damn!

No more nighttime visits by ghosts/demons anymore though.  So either my meds are working or the little imps got bored of messing with me

Edited by NavySurya

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*Reply posted by PickledPixie  on: Feb 21st, 2005, 11:27pm  *

  k, i know this is an old post, and I tried (and HAVE tired) to swim thru all the different "explanations" of the different BP disorders. But I sitll don't get it. My pdoc jsut diagnosed me as BP.. nothing special afterwards, not really explaining my diagnosis. I know that When I'm pissed for no reason and want to kill people, that's my mania.. and them when i feel like shit and want to kill myself, that's my depression. But I can't see a cycle.. maybe cuz they threw me on meds so fast. See, a quick explanation... my insurance sucks. So they sent me to the cheapest Pdoc in town, the STATE MENTAL HEALTH CENTER. She's a really good doc, and I feel like I'M making progress, but it's not as if she is at my disposal for long lenghty answers of my illness. Are there any places i can check out in plain english jsut what the hell is wrong with me? I've got an appoinment on thursday too, i guess i could ask her. ( fancy that!) =) I gotta post more on my Jerry Springer post, beore i turn this into that. Hah.

Edited by NavySurya

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