Mania vs Psychosis

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Originally uploaded by versionz.

psychosis (sike-oh-sis) - a severe mental disorder in which the sufferer's contact with reality becomes highly distorted.
- Collin's English Dictionary

As promised, here is my response to JungleTart's (a fellow BiPolar Type 1) observation the other day.

"...you are the first and only to discuss psychosis as compared to other bipolars only talking about mania. There's a huge difference..."

Yip, BiPolar communities often talk about mania and psychosis like they're interchangable. They're not.

(please note that what follows is based on my personal opinion and experience, and no greater authority)

To some degree they lie on the same spectrum, starting with hypomania on the mild end, with mania in the middle, and psychosis at the extreme end of mania. But even though it is a spectrum there is a definite "cross over point" between mania and full-blown psychosis, which this post will attempt to define.

BiPolar Type 2's will unlikely have experienced psychosis - if they had, they would've been diagnosed as BiPolar Type 1 s. In fact, I reckon that the percentage of all BiPolars that have been psychotic is probably in single figures.

It's not that easy pinpointing where the difference between severe mania and psychosis lies. Both conditions could, I suppose, be described as irrational. Where I think they differ is in the nature of the irrationality. Mania, to my mind, is more of a rash, impulsive, over-confident irrationality. Psychosis on the other hand, involves the whole belief system. Which would explain why so many psychotic episodes are experienced (erroneously?) as spiritual or religious. (Me - I thought I was God the first psychotic episode, A mantic the second, and a Seer the third)

If you know anything about drugz, I suppose that Mania is to Psychosis, as a Cocaine buzz is to an LSD trip (but how would I know these things?)

The best way I could describe my own psychotic experience is for you to put yourself into Truman's (of the "Truman Show" movie - one of BPG's all time favs) shoes. At the point that you (Truman) start realising that all is not as it seems, that strange occurances and coincidences keep happening, and that somehow you, yourself, are at the centre of it all - THAT's how psychosis feels.

Here are some other manai/psychosis differences (according to Garp BPG):

• Psychosis often involves Paranoias. Like convincing beliefs that evil agents are plotting against you, and you're been spied upon. I've gone through this, and it's terrifying. A gazillion times worse than any horror movie. I know for a fact that I will NEVER, EVER shit myself as much as I did my first episode (something I tell myself when real-world scary situations arise)
• Before being diagnosed as BiPolar, your first psychotic episode often earns you the label of "Schizophrenia" - Paranoid Schizo in my case. Only a year or so later, when you are living a "normal" life again (something which Schizos can apparently never get fully back to) can the dear doctors deduce that, no, you're actually BiPolar Type 1, not Schizo.
• It's harder to get a psychotic "back to earth" than a manic. One of the scarier things about psychosis is that there is no guarantee that it will end - sometimes when you slip gravity you never get completely back to earth. (in which case the dear docs will deduce that, no, they were wrong, you were actually Schizophrenic all along). Seriously though, mania has relative comfort in that you know it will blow over (probably into full-blown depression, but that's another topic). With psychosis there's no knowing, which is pretty terrifying, especially to your loved ones. The only way i came back was through ECT.
  
• The primary way of diagnosing psychosis (in my experience anyways) is by a method called "reality testing". This is a particularly interesting topic for the philosophically minded, but i won't even go there. Basically it's a conversation with a PDoc and if they ask you (as in my case), whether you really are the third Messiah, and you answer yes without a shadow of doubt on your excited face, well then you're psychotic.
  

There are probably loadsa other differences I haven't touched on. But I'll finish up with Hunter S. Thompson's wonderful quote (which seems pretty relevant right about now):

“The Edge... there is no honest way to explain it because the only people who really know where it is are the ones who have gone over.”