Patients with bipolar disorder have abnormal highs and lows in their mood. For example, a patient can have periods of mania, the high mood, followed by a normal mood. The patient can also have depression, the low mood. Nevertheless, some bipolar disorder patients can have a break with reality, resulting in psychotic symptoms. The National Institute of Mental Health notes that doctors may misdiagnose bipolar disorder patients with psychotic symptoms as having schizophrenia.
Hallucinations
When a person has a hallucination, she hears or sees things that do not exist. Hallucinations can affect other senses as well, such as touch, taste and smell. For example, a patient with an olfactory hallucination smells things that do not exist. The National Institute of Mental Health notes that hallucinations occur during severe mania or depression, though the type of hallucinations change in each mood stage. For example, during a depressive episode, a patient may hear voices telling him to kill himself. During a manic episode, however, the voices may tell the patient he can do anything, encouraging him to participate in risky behaviors.
Delusions
Another psychotic symptom than can occur with bipolar disorder, delusions are false beliefs that patients hold as true. Just like the hallucinations, the delusions change depending on the mood the patient has. For example, the National Institute of Mental Health notes that common depression delusions include patients believing they committed a crime or are financially ruined; common mania delusions include patients thinking they are famous or have special powers. Bipolar disorder patients with psychotic symptoms strongly believe in these delusions, and may act out on them. For example, if a depressed patient thinks that he has no money left and has nowhere to turn, he may try to commit suicide.
Psychotic Break
Some bipolar disorder patients have a sudden onset of psychotic symptoms, also called a psychotic break. The Mayo Clinic's website notes that the psychotic break may be the first sign of bipolar disorder. During a psychotic break, patients have the hallucinations and delusions. Patients may also have changes in personality, such as becoming paranoid. Their mental functioning may become impaired, resulting in problems with memory and attention.
