Understanding psychotic and bipolar disorders


Psychotic and manic depressive disorders can not only disrupt the life of the person suffering with one of these illnesses, but the lives of family and friends as well.

You should seek professional advice if you suspect that you, a friend or a relative or even a spouse may be experiencing a psychotic or bipolar disorder. It’s important not to attempt a diagnosis yourself. There are many external factors that can cause people to temporarily behave in unexpected or uncharacteristic ways. They can even exhibit symptoms of mental disorder for a short period and not actually be mentally ill.

Diagnosis requires detailed assessment by a trained mental health professional. It’s important to have an assessment (a social-emotional assessment or a full psychological assessment) done by a licensed psychologist or psychiatrist. Only a trained mental health professional would have the knowledge and skill to make an accurate diagnosis.

Mental health conditions are not like physical ailments that follow a set pattern. Two different people can have the same mental health problem and yet behave quite differently on the surface. Underlying patterns will be similar, but could exhibit in different ways. It takes a considerable amount of skill and experience to spot these similarities when they occur and to recognize them for what they are.

The symptoms expressed by psychosis or bipolar disorder can shift and change as the circumstances in a person’s life shift and change. They can be mild or severe. A person may even experience a period of stability where the symptoms almost completely disappear, only to have the symptoms return or become more severe with changes in environmental stimuli. And acute symptoms of psychosis can be dangerous and damaging to others, as well as the person suffering from them, because the individual loses control over thoughts, feelings and behaviors.

The term psychotic comes from the word “psychosis,” which simply means an abnormal mental condition. It is not in itself a diagnosis, but merely a description of a mental state related to loss of reality. Acute symptoms of psychosis are delusional beliefs, hallucinations, personality changes and disordered thoughts. These disordered thoughts are often expressed in acute cases as completely irrational sentence structure or talking gibberish. This may or may not be accompanied by bizarre or unusual behavior, but usually entails a lowering of ability to recognize reality. This is often manifested in an inability to carry out daily activities and in poor social interaction.

The recent changes in the scientific view of the nature of reality has also changed, to some extent, the definition of psychosis. It is no longer assumed that people are psychotic because they are experiencing unique or unshared experiences. Those who have had or presently experience unique paranormal or religious experiences are no longer considered psychotic. Certain researchers have argued that some psychosis may simply be a unique state of consciousness or a different way of processing reality.

This new view has encouraged a more holistic approach where the entire individual is taken into account and the unique beliefs and personality changes that person exhibits are evaluated as to their effect on that person and those around him. While certain aspects of reality are important and used in diagnosis, such as the ability to recognize friends and family members and the individual possessing a moral sense, people are no longer held up to an arbitrary definition of reality.

The key to psychosis is not a different view of the world, but a loss of control that may entail a loss of emotion or the impairment of the ability to function or think normally and relate to the environment. Such a disorder requires psychological help if the individual is to recover and lead a relatively normal life.

Bipolar disorder, also called manic-depression disorder has very different symptoms from psychosis.

Some of these symptoms are:

1. Obsessive indulgence in pleasure producing activities despite the consequences. Examples include rampant sexual indulgence, buying sprees that run up debts which the individual cannot pay, and wrecking one’s own possessions or the possessions of others in the pursuit of pleasure.

2. An inflated sense of self to the point of grandiosity

3. Less and less need for sleep

4. Poor attention, being easily distractible or having racing ideas and thoughts.

The above is the manic side of manic-depression. The depression side is characterized by feelings of guilt or worthlessness. Obsessive thoughts of death which may include suicidal tendencies are also common elements.

Both psychotic and bipolar disorders can be quite serious and even dangerous. The earlier that the diagnosis is made, the greater the chances that the person will make a complete recovery. It’s important to seek help from a trained professional as soon as possible. You may or may not be able to talk someone you love into seeking immediate professional help, but you can at least get professional advice on how to best help them.

So don’t be afraid or ashamed to ask.

Tali Shenfield is a clinical psychologist and director, Richmond Hill Psychology Center.


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