Bipolar disorder and psychosis are two serious conditions that can impact kids and teens. Both of these conditions involve abnormal and disruptive thoughts, beliefs, and perceptions — but they are very different. Psychosis, or psychotic symptoms such as hallucinations and delusions, can sometimes occur in people with depression or other mental illnesses, as a result of a medication or substance use, or as an isolated event in response to stressors such as trauma. Bipolar disorder is a type of mood disorder. People who have bipolar have episodes of mania (a lot of energy) and depression (little energy). These two conditions do not necessarily go together; someone can have one without the other. When parents hear about any scary-sounding “disorders” their first reaction is: What does this mean for my kid? Does it mean they are crazy? Will they need medication for the rest of their life? Will they be able to grow up, get married, and have children?
The answers are all yes! Kids with these conditions can live happy normal lives if they receive treatment at the right time.
Psychosis is a break from reality: either you cannot tell what is real and what is not, or you know something is not real but cannot stop yourself from acting as if it were. Psychosis can occur in a wide range of disorders, including bipolar disorder, schizophrenia, and major depression. In the context of bipolar, a person is usually experiencing a manic episode, or a state of extreme euphoria in which they cannot sleep or think straight and feel they are on top of the world. In the context of depression, a person is feeling so bad that they cannot get out of bed and think they do not deserve to live. In each case, the person experiencing psychosis, while very ill and in need of help, can be frightening to see. If you see signs of psychosis, take your child to the hospital right away.
People with bipolar disorder experience extreme shifts in their mood and energy levels, and may also have changes in their ability to function. Bipolar I Disorder (BD I) is marked by severe shifts from depression to mania. Bipolar II Disorder (BD II) is marked by less severe shifts from depression to hypomania. Hypomania is an elevated mood that is less intense than mania, but often interferes with a person’s functioning. The term “bipolar disorder” refers to a group of mood disorders that are characterized by cycling moods: depressive episodes alternating with manic episodes (or hypomanic episodes in the case of bipolar II). Bipolar disorder is also known as manic depression because it can cause both periods of depression and periods of extreme elation or manic behavior. Bipolar disorder affects more than 2.8 million American adults, and is 3 times more common in women than men. B Bipolar disorder can begin as early as childhood and can last a lifetime. Bipolar disorder may also occur along with other mental illnesses, such as anxiety disorders, eating disorders, and substance abuse. Bipolar disorder is a serious mental illness. It is not a condition that people can easily “snap out of” or that they can control by themselves.
When someone is in the midst of a psychotic episode, the mental illness that is often diagnosed is schizophrenia, not bipolar disorder. There is an overlap with bipolar disorder, though, and some people with bipolar may experience psychotic episodes. Bipolar disorder and schizophrenia are both serious mental illnesses. They are each diagnosed in about 1% of the population. The symptoms of these disorders vary greatly, and a diagnosis relies on the presence of certain symptoms that are not due to another mental illness. People with bipolar disorder experience episodes of mania, hypomania, or depression. People with schizophrenia often have symptoms of hallucinations, voices that are not there, episodes of disorganized speech, and other bizarre experiences that are not typical of other mental illnesses. People with schizophrenia may also experience delusions. In bipolar disorder, delusions are typically related to a person’s extreme mood (e.g., I am the king of the world). In schizophrenia, delusions are not related to a person’s mood. It is common for people with bipolar disorder to experience an episode of psychosis. This is not the case with schizophrenia.
First, don’t panic – psychotic symptoms occur in many people, and they don’t always lead to a diagnosis of schizophrenia. Some kids who have mood swings or depression also have psychotic symptoms, but they don’t have schizophrenia. If your child is having psychotic symptoms, it is important to bring them to the hospital right away. If they are released, they should be monitored closely and have a follow-up appointment with a mental health professional. If your child has been diagnosed with bipolar disorder, they may have psychotic symptoms or delusions during a manic episode. If they have been diagnosed with schizophrenia, they may have psychotic symptoms or delusions at any time throughout the course of their illness. Some kids who have a diagnosis of depression or anxiety disorder may also have psychotic symptoms. Whatever the diagnosis, if your child is having psychotic symptoms, you will want to bring them to the hospital to receive a thorough evaluation and treatment.
If your child has any psychotic symptoms, get them to the hospital. There are effective treatments for psychotic symptoms, but they can’t be treated without diagnosis. Psychosis is common in people with mood disorders and often responds well to treatment. Psychosis is scary, and it’s important to get help for your child before it gets worse. If you have questions about symptom severity or what treatment options are available, talk to your doctor. Knowing the signs of these conditions in kids is key to getting them the help they need to lead healthy and happy lives.