Recognizing psychotic hallucinations is the first step towards a psychosis free life.
(Hello! Please know that this blog talks about a very vivid topic: psychotic hallucinations. I describe what I experience in detail and don’t want anyone to be upset by reading my blog. I would like to encourage you to keep reading as the hallucinations I describe didn’t harm me at all and the story has a good ending. I talk about these experiences openly in order to help others who might be struggling with undiagnosed bipolar psychosis.)
Sneaky, sneaky hallucinations! I had my first depression hallucination at age 19. It was so vivid it felt real. My gorgeous Canadian boyfriend broke up with me and I had to move back in with my parents as I had nowhere to live. I flunked out of school the year before (I now know it was because of bipolar disorder, but was truly confused at the time. My parents had NO idea what was going on!) I was despondent over the breakup to the point that I had trouble functioning. When I took walks near traffic, I had images of myself being hit when I stepped off the curb as though a very vibrant movie where I was the star was played out in front of me. These images were often accompanied by suicidal thoughts. I got over the breakup by going into yet another euphoric manic episode, but that’s another story!
Over the years, the movies continued. I called them ‘death images’ and assumed all people dealt with them. My death images showed up in busy places where there were a lot of people and vehicles. Standing and waiting for the light to change at an intersection seemed to be the main location. I always saw my body get hit by a bus or car, flip up into the air and land at my feet. I was not disfigured and it wasn’t gory at all. I can distinctly remember being on street corners around the world waiting for lights to change and seeing myself be hit by a mighty large array of international vehicles! I talked to my friends about the images, but no one understood. I’m sure they thought I was describing a thought or a worry. Truthfully, these had nothing to do with thoughts or specific worries. They simply happened in vivid and colorful detail. I wasn’t scared per se, but the experiences did seem to coincide with changes in life, such as breaking up with a boyfriend, a move or any other event that caused stress.
It’s hard to believe that I once thought these vivid death images were normal experiences!
As my bipolar disorder became more severe over the years, the death images changed. I saw myself chased and bitten on the calves by pit bulls, saw things on the ground such as a leaf that looked like a severed hand and …. I will not go into details of what it was like when the psychosis was really raging, but for the most part, I had to live with these hallucinations.
I went to more doctors, therapists, body workers and healers than you can image in order to get help for my moods and these visions, but no one ever caught on to what was happening. I look back at the kind, but often incompetent health care I received for so long and it makes me sad! A few intelligent questions would have spotted my bipolar disorder and this depression psychosis easily.
When I finally saw a competent psychiatrist at age 31 in 1995, I was diagnosed with bipolar disorder in 20 minutes. Unfortunately, I wasn’t taught much about psychosis in my first few years of treatment and certainly wasn’t taught how to manage the psychotic symptoms. My treatment was medication based and rarely focused on how I could manage the illness myself. I knew this had to change, so I took over my own treatment three years after my diagnosis and my life changed for the better.
What is psychosis?
On a basic level, there are two types of psychosis: hallucinations and delusions. Hallucinations always involve the senses (visual, audio, olfactory, etc) while delusions are false beliefs. Seeing something that isn’t there, such as seeing myself get killed by a bus is a hallucination. Believing that someone has planted a recording device in your living room to frame you is a delusion. I should point out that psychosis in bipolar disorder is ALWAYS connected to either a depression or mania mood swing.
What? Death images are hallucinations?
It’s said that my type of bipolar disorder (bipolar two) rarely has psychosis. I now know this is baldersdash. These psychotic visual hallucinations do happen in bipolar disorder two, but people don’t know what they are so they don’t mention them during doctor visits. I wanted to get better. I went into detective mode and figured out that my death image hallucinations were always part of my anxious and overwhelmed depression and not a part of my euphoric hypomania. ( I probably had them with dysphoric mania, but that type of mania was rare for me when I was younger.) I set out to categorize the specific images and figure out if there was a trigger I could stop. I realized that just as I was teaching myself to manage depression, mania and anxiety, I could do the same with psychotic hallucinations.
Listing out my hallucinations gave me the information needed to do something about them. I realized that literally standing on an overwhelmingly busy street could conjure up the hallucinations, but it took me time to figure this out!
I concluded the hallucinations happened when I was in a new and stimulating place, especially a new country and when my life was going through a change, such as a relationship problem, success or stress at work, meeting new people and having new adventures. Isn’t it amazing that good stress could make me depressed and psychotic in the same way the bad stress did? (I also identified what caused my paranoid delusions and vowed to prevent them as well.)
Taming psychosis became a large part of my management plan. I learned to see the death image hallucinations as a sign that I needed to examine where I was in life. It was as though my brain was giving me a wake up call to be more present in my life in order to take care of my mental health. This made the hallucinations less worrisome and helped me make the changes needed to get them to go away. This isn’t a post on management, I talk about how I manage my bipolar disorder in my books, but I do want to encourage anyone with bipolar disorder or anyone who cares about someone with bipolar disorder to learn about psychotic hallucinations and how they can manifest when someone with bipolar disorder is simply under stress.
Psychosis is a disruptive and often destructive symptom that has to be managed along with the mania and depression.
Interestingly, the depression that went with my psychosis was often mild and I do wonder if I actually was having psychosis outside of a mood swing which would mean I have a touch of schizo-affective disorder.
I will never know this as something amazing happened in 2010.
I still experience some psychosis. It’s so rare for me now that I know that when it shows up it means I’ve had a reaction to a drug or I have to change something in my life immediately. My last death image was quite a gift as it made me realize a project I thought I loved was slowly making me ill, so I quit!
I hope this description of psychotic hallucinations in bipolar disorder helps others see if they have a touch of unexpected psychosis in their symptoms. Recognizing psychotic hallucinations is the first step towards a psychosis free life! I’m much, much happier now that my psychosis is rare. I hope the same for all of us with bipolar disorder!