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Soooo,

Bipolar II, but experience voices in the distance, music playing, etc...other audio hallucinations.  Occasionally see things that aren't there out of the corner of my eye....ghosts moving across the room, etc.

REALLY paranoid thinking as in people are out to get me, in parking lots especially.....

can I just be bipolar with a bit of psychosis?....or does this make me schizo???

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Soooo,

Bipolar II, but experience voices in the distance, music playing, etc...other audio hallucinations. Occasionally see things that aren't there out of the corner of my eye....ghosts moving across the room, etc.

REALLY paranoid thinking as in people are out to get me, in parking lots especially.....

can I just be bipolar with a bit of psychosis?....or does this make me schizo???

You can be bipolar and experience psychosis. Really. Really really.

According to the current DSM IV criteria, this automatically makes you BPI instead of BPII, but I think this is a ridiculous and artificial distinction. If the I and II designations are supposed to divide severity, psychosis should be included under both, as you can have comparatively mild mood swings and have psychotic symptoms while in a mood state, and you can have extreme mood swings and never hallucinate (though you do go off your rocker, as delusional thinking is part of true extremes). As a result, some doctors are pitching the precise criteria out the window and giving patients labels like "you're BP II with psychotic symptoms." That just can't be true if you follow the current rulebook, but human experience never did follow the rules. The text must be made to reflect reality.

I'm bipolar. I've been way up and way down beyond the "normal" range. Medication has helped in a big way.

The major distinction between bipolar psychosis and schizoaffective disorder (which is the "bastard hybrid" of bipolar and schizophrenia) is when you experience your hallucinations and delusions. Is it when you are manic, depressed, or in some form of mixed state? If yes, you are bipolar. If no, if you have psychotic experiences even when in a "normal" mood state, then you probably belong on the schizophrenia/schizoaffective/whatever psychoses board.

I think certain personality disorders are characterized by varying degrees of paranoia, anxiety, etc, as well. If you have a PD (like BPD) in addition to bipolar, that might account for some of your symptoms. Hallucinations are probably BP, or maybe you have an eventual schizo-family diagnosis in your future.

Even normal people hallucinate every so often, though. Mildly. Intermittently. And they don't get called crazy for it. "I was SURE I heard you call my name...."

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You can be psychotic without being schizophrenic like me. I dont have any negative symptoms - anhedonia, flat affect, avoiding socialising, neglecting personal hygiene - or thought disorder but I have hallucinations and delusions. You may be relieved to hear that psychosis does not automatically equal schizophrenia  ;)

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Agree. I had a crazy psychotic experience the other day, thinking I was being followed, someone gave me a leaflet and i thought it was a tracker, had to keep running across the street from people the voice in my head told me was unsafe...I'm hoping it was part of a quick-onset, short (ie a couple of hours) mixed state, as I already get mild hallucinations/voices and moderate delusions in mania.

My mother helpfully said the other day that she thought maybe I had a crazy kind of cross between schizophrenia and bipolar, not knowing of there being schizo affective disorder, so I am a little scared from that point of view, but I think I'm probably bipolar with psychotic features.

Ultimately, it's just a label. If on the off chance I am schizo-whatever, it doesn;t change me- I'm already what I am, if that makes sense.

Don't worry too much.

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You can be psychotic without being schizophrenic like me. I dont have any negative symptoms - anhedonia, flat affect, avoiding socialising, neglecting personal hygiene - or thought disorder but I have hallucinations and delusions. You may be relieved to hear that psychosis does not automatically equal schizophrenia
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You can be psychotic without being schizophrenic like me. I dont have any negative symptoms - anhedonia, flat affect, avoiding socialising, neglecting personal hygiene - or thought disorder but I have hallucinations and delusions. You may be relieved to hear that psychosis does not automatically equal schizophrenia
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psychosis is also found in severe depression, borderline personality disorder, paranoid personality disorder, and, the European ICD10 has something called 'Acute psychotic disorder'...I don't have the links to hand right now, but google is friendly if you wanted to know. ;)

and, what all the others said :)

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Like some of the others have posted, psychosis does not automatically mean schizophrenia.  If you have the psychotic symptoms when you're not manic or depressed it could be schizo-affective or just the psychotic symptoms that occur with biplar disorder. Talk to your pdoc about it and see what he/she thinks. 

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I have psychotic episodes and none of the negative symptoms of schizophrenia. I have had DX's around psychosis, e.g. schizophrenia, schizoaffective, also bipolar but have settled on borderline personality disorder with psychotic tendencies. I think you need to see if the BP being stabilised leads to less psychosis, if the highs and lows are managed for me, I am less psychotic.

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I have psychotic episodes and none of the negative symptoms of schizophrenia. I have had DX's around psychosis, e.g. schizophrenia, schizoaffective, also bipolar but have settled on borderline personality disorder with psychotic tendencies. I think you need to see if the BP being stabilised leads to less psychosis, if the highs and lows are managed for me, I am less psychotic.

<{POST_SNAPBACK}>

Hmmm, I think you may be right.  I need to get myself stable before I can tell if my psychosis stuff happens when I'm in a high or low, or if they just happen all the time.  Right now I couldn't say.  I often have auditory stuff, but I'm not sure about that either because I notice much more when I'm in a "low"....sometimes I don't realize I'm manic until AFTER it's over...or at least after a few days of destructive behavior or out of control spending that is... ;)

Thanks for the replies people!!  I notice a bunch of people have asked the difference btw bipolar with psychotic features and schizoaffective...gah, does anyone have a link to a REALLY good explanation??

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  • 2 months later...
You can be psychotic without being schizophrenic like me. I dont have any negative symptoms - anhedonia, flat affect, avoiding socialising, neglecting personal hygiene - or thought disorder but I have hallucinations and delusions. You may be relieved to hear that psychosis does not automatically equal schizophrenia
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blackbunny19 Posted Today, 05:22 AM

but not all schizophrenics have disorganized speech or negative symptoms (neglect of hygene, flat afect, avoiding socializing). I mean, you can still fit into the catergory of schizophrenia even if your only symptoms are hearing voices/and or delusions. The difference between schizophrenia  and the hallucinations and delusions a bipolar person might experience is that the schizophrenic hallucinates/has delusions even in a normal state of mood.

hope im making sense

Yeah, I have toyed with the idea that I am proper schizophrenic (fitting all the diagnostic criteria except negative symptoms and disorganised thought) but they just don't tell me for fear of ruining my life  ;) Nice guys that they are!

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The main difference between Mood Dx with Psychotic Symptoms and Schizoaffective Disorder is when a person experiences psychotic thinking/behaviors. For Schizoaffective there must be a period of time when a mood episode and active symptoms of Schizophrenia are both preset and also a period of time when delusions, hallucinations, etc. occur in absence of mood symptoms for at least 2 weeks.

For Schizophrenia Dx duration of symptoms is at least 6 months with at least 1 month when two or more active phase symptoms - delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms, flat affect, etc.- are present (or only one criteria if delusions or bizarre hallucinations).

Distinguishing Schizophrenia from Mood Dx w/ psychotic festures/symptoms and Schizoaffective Dx is complicated because mood disturbances (manic and depressive) in Schizophrenia do occur but are usually brief and do not meet full criteria for a mood episode. If mood symptoms do last long enough or are clinically significant a person can have Scizophrenia Dx and Bipolar NOS Dx. 

With Mood Dxs (major depressive episode, manic episode, Depressive Dx, BP1(manic, mixed, depressive episode), BP2 (depressed episode) all can be classified/Dx Severe with Psychotic Features.

Wow, did I just make things more confusing?!?

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Cool, I'm schizophrenic. I went way longer than 6 months with delusions + "disorganised speech" (well it made sense to me anyway..) and "disorganised behavior" (again, I was acting within my own fantasy world..) with a side order of neglected personal hygiene. I've always enjoyed informing people I am schizo and watching their reactions.

Just sometimes people get let down when you tell them you don't hallucinate. Seems schizo=hallucinations in joe public's mind. And the people that get really interested in my "schizophrenia" get dissapointed when I say I don't hallucinate. But fuck it, I am crazy, whatever they think. What the fuck am I on about. Saturday night. I do apologise. I have a new job so this sort of thing should happen less in the future anyway. And the future is a whole new crazy thing. Bet none of us has the future sorted out in our heads. crazy. See you next time I am drunk. Sorry...

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  • 2 weeks later...

There are many types of psychosis.

Firstly, it is common for bipolar disorder to include some elements of psychosis - after all, the manic state is prone to delusions and disordered thought.

Depressive psychosis is also common.

Then there are other psychotic states like drug psychosis, which is usually temporary.

Typically your primary diagnosis will represent the best fit for your symptoms.

So in other words, psychosis doesnt necessarily mean schizophrenia.  Of course it can do, but usually only when the psychotic features are the primary cause of problems or primary symptoms of illness.

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