Bipolar Disorder and Psychosis: Yes, we can have paranoid delusions!

Here is an example the BipolarHappens.com Newsletter   

Today’s Topic:  Bipolar Disorder and Paranoid Delusions

 

by Julie A. Fast

Paranoia is a type of psychosis called a delusion. A delusion is a false belief.

For example, paranoia can be the belief that you have done something wrong and that a person or an organization is upset with you. This is a scary experience as it feels so real.

Paranoia used to really cause me a lot of trouble. I’ve worked hard so that I can at least recognize paranoia before it makes me do something stupid.

I often get the feeling that my friends are ignoring me and that they have met friends they like a lot better than myself. It’s a terrible experience. Luckily, I know the signs of paranoia and don’t act on them, instead I call my friends and ask them to hang out.  When they say yes, I know that all is fine. My friends are the type who will tell me if something is wrong- so my paranoia is always rooted in bipolar disorder and not reality.

Paranoid delusions are FALSE, but you have to be careful because they are VERY sneaky. 

– Paranoid worry is often based on at least some factual evidence which makes it hard to figure out what is really happening. 

– Paranoia does not stand up to factual questioning- but for the person in the paranoid episode, it feels more real than anything they have ever experienced. If you try to talk a paranoid person out of their beliefs, it won’t work.  It’s like trying to convince someone that the sky isn’t blue.

Here are some examples of paranoia. Have you seen these in yourself or your loved ones?

1. Believing that someone is standing across the street staring at you through your apartment window, but when you look outside, there is no one there.

2. Feeling with great certainty that your coworkers have a plan to get you fired. You know this because when they are in a group and you walk up to them, they all scatter in different directions without saying hi.

3. Once, when my former partner Ivan was in the hospital, he was very, very paranoid. I went in one day to say hello and he looked at me and said, “Why is your face so red? Have you been doing something wrong that you aren’t telling me?” True paranoia. He told me later that he really believed  I was seeing someone while he was in the hospital. 

When you are well, these thoughts never even come up. You know there is no one outside and you know that your colleagues wouldn’t have time to plot against you even if they wanted to! They simply go back to their desks when they finish a conversation. You are not the focus of their day.

Paranoia is dangerous when the person takes action such as calling the cops on a neighbor or trying to break into their own office building to find cameras directed at their desk. 

What is the best treatment for paranoia? The first step is a symptom management plan like I teach in the Health Cards and Take Charge of Bipolar Disorder. Once you have identified the symptoms, you can get help.  I use a combination of my trigger management plan, lifestyle changes and medications to manage my psychosis. Anti psychotics work well- the lower the dose the better due to the side effects. Paranoid symptoms must be caught early so they don’t move into destructive behavior.

Education and prevention are key!

This is what I have done, so it’s possible to stay stable and steady when you live with psychosis. 

Julie

PS: There is a nice man I sit next to in Starbucks who has a lot of paranoia. It mostly comes out when he is reading the paper. He says all of this very quietly. 

They are rearranging everything to see you.  It’s the big pharmaceutical companies. What are they not telling you? Look at that picture all of those men. Too much stuff. It’s garbage. It’s all it can be. There is no reason to be there anyway. There is no reason to be there. It’s a prison.  All that stuff- 10s of billions. (Laughs.)  I’m not gonna hang around for Obama Clinton.  They do not acknowledge a single one- not one. Like the Tea Party. My mind is made up.

When he talks with friends- he still has the paranoid thinking, but it sounds more like an average conversation. His paranoia is around big pharma and I can understand that! 

 

Julie 

               

 

 

Ask Julie Fast: How do you remain organized and focused in your thinking?

A new way to focus my attention!  I am trying to focus on just one sporting event when faced with a gazillion TVs in a sports bar. HEHE. 

 

ANSWER:   I don’t remain organized and focused in my thinking. It’s a daily and sometimes hourly struggle for me to focus. I have to get help in order to get my work done.

I’m extremely unfocused- it’s pathological and is a struggle very single day. My manager Vy is a life savor. She makes charts that I work hard to follow. I cannot write books without help.

I’m getting worse as I get older and there is no question that my head injury from 2012 doesn’t help. This is not meant to be depressing. It is simply my reality. When I’m stable, I just deal with it. When I’m depressed, it’s my #1 worry. How are we supposed to work and support ourselves when our bipolar brains give us so much trouble? ARG!!!!

I CAN say that I truly use the tips in Get it Done When You’re Depressed. I use them every single day and they help me focus as best I can. So, I do have moments of focus and organization, but it’s hard work and I use everything I write about in my books. Get it Done saves me. It was written for depression, but it works for ADD/ADHD symptoms just as well. Anxiety is also a big reason for focus problems. Sometimes it hurts to work. I was much more able to work in the past. My goal these days is getting as much work done as possible when I’m stable so that I have a buffer on the tough days. I wish I could tell you that I focus just fine and that I have a secret so that you can end your focus problems. I have not found this yet. For now, it’s management. I am still here, still writing and still getting things done, so something is working.  You can do it as well!

 

I have a theory. I believe that many of us with bipolar disorder are innately restless. It is an issue that affects our work and relationships. Here is my blog for Bp Magazine:  Life with Bipolar: Why Am I So Restless? on the topic.

Tips to Get Out of a Severe Bipolar Depression

Remind yourself that depression is an illness. The symptoms will always be the same. It is not a personal problem. It is not a weakness. It is an illness.  Here are the signs of bipolar depression that remind you that bipolar depression needs to be treated in the same way you would treat pneumonia.

Bipolar Depression Symptoms:

Lack of joy in what used to bring joy. This does NOT mean you need to change your life. It means you need to end the depression so that you can again experience joy. Many people make the mistake of leaving relationships, quitting jobs and thinking a big change is the answer to ending depression. I suggest that managing depression is a better choice.

A sense that you will never get better. This is a symptom of depression. Depression is a succubus. It lies. I call depression the most successful illness in the world. It does the job well. I fight this by accepting that I am going to lose work time and energy while I am depressed. It feels like I am drowning even though I am sitting in a life raft. I have to open my eyes and see that I am in a life raft and I am going to get through the depression. I always do.

I could go on here- our list of symptoms is very long. I wrote my book Get it Done When You’re Depressed when I was depressed. I remember thinking I would NEVER finish the book. How could I possibly write a book when I was so sick from the stress of being in a downswing? I did it through reminding myself that even though I had little joy when writing the book , I would be better in the future. I was right.

There is a chance you are reading this while depressed. It’s ok to be depressed when you have bipolar disorder. What do you need to do next to get out of the depression? My book is available on Amazon and in libraries. There are other great books out there to help you. Programs are available from other writers. Support lines are ready for your call. All that matters is seeing bipolar depression for what it is- an illness.

Depression has nothing to do with YOU. I has nothing to do with me. It is not different than diabetes. It’s chemicals.

I fight my depression and I will win.

You can do the same.

Julie

What is Your SELF Inside the Bipolar Disorder?

 

I believe there is a SELF inside of ME that is separate from bipolar disorder. When something stressful happens in my life- a trigger- my bipolar disorder is the first thing to react.

I rarely get to respond to life from my SELF.

Life goes through my bipolar disorder filter first. If I’m unaware of my own bipolar disorder symptoms, such as my tendency to paranoia, self flagellation and the doomsday feeling that life is never going to work out, I will react to something without thinking.

This is damaging. I fight this desire to act from my first thought. I step back and see if it is bipolar talking or if my SELF is in control.

So far, my SELF always comes in second. My goal is to put the SELF first and respond from that position.

It is so hard. It takes so much time. It is stressful and frustrating to have to second guess myself, but it saves my work and it saves my relationships.

I encourage all of us to know our symptoms, write them down and live from the SELF and not our bipolar disorder reactions.

It’s a life long process that I never fully master. I will never stop trying!

Julie

Relationship Disappointment and How it Affects Bipolar Disorder

On the list of the worst triggers for bipolar disorder mood swings,  relationship troubles are right at the top for me. I used to walk into new relationships blindly. I would think, oh well, if it doesn’t work out I will just deal with the depression.

What a dumb plan! I can’t do this as a person with bipolar disorder. The bipolar will always win. I played with this illness for a long time around romantic relationships. I’ll go out with this guy, just for fun. I will be fine.

No, I wasn’t fine. When it self destructed, I did as well.

I have a different policy now.

Nothing is worth a terrible depression.

Nothing. We all have to protect ourselves from bipolar disorder by watching who we let into our lives. It makes me so mad that I have to be so careful. There are a lot of fun people out there who add excitement to life, but if they add mood swings as well, it’s just not worth it!

What about you? Is there someone in you life today who needs to go in order for you to be stable?

Julie 

Ask Julie Fast: Come on! Can you really tell you are manic by looking in your eyes?

A friend recently wrote me and asked if my mania in the eyes hypothesis was about the size of the pupil. Here is my reply.

Some background: If you are not familiar with my work, I wrote an article based off of personal and professional experience that hypothesizes we can see signs of mania in the eyes.In my opinion, this could revolutionize how we think about bipolar disorder. If mania is clearly seen in the eyes, it means this is a physical illness. If we can recognize mania in the eyes, it means we can override a manic brain that is telling us we are just fine. I’m currently part of a Southern Methodist University study to test my ideas. Here is link to the webpage if you would like to read more. My  Psychology Today blog: Three Clues to Recognize Bipolar Mania in the Eyes explains my ideas in full.

Julie, are you saying that we need to look for changes in the pupil to see if we are manic? 

MY ANSWER: I am not only talking about pupils here. Instead, I look at the entire eye including the skin around the eye in my hypothesis. The pupil is only one aspect.

 

Here are examples of what I am talking about.

Depressed

I always notice a dullness- whether there is flash or not. Also, my lid cover the top of my iris.

Stable

Lots of wrings around the eye and pretty closed lids when I smile.

 

Dysphoric manic

 

I have a super piercing gaze. No wrinkles under eye. This is where people report the most change in the pupil.

Euphoric manic

When I have euphoric mania- my eyes leap off the photo. No matter if there is flash or not. The whites of my eyes are very white and the color of my eyes is more complicated. I have no wrinkles around the eye and my lid is higher on the iris.

Another common feature is a liquid that covers the eyes when I am manic. It shimmers. I think that one reason we meet sexual partners SO easily when manic is that our eyes light up a room!

Julie

The study is ongoing. Please post your pictures. You can help change our bipolar disorder world!

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