Understanding Psychosis and Psychological Breaks: Bipolar Disorder, Schizophrenia, and Early Warning Signs
Psychosis is a condition that affects the mind, altering a person’s ability to distinguish between what is real and what is not. It can be a symptom of various mental health disorders, including schizophrenia and bipolar disorder. Experiencing a psychotic episode can be frightening, both for the person going through it and for their loved ones. Early recognition and intervention are critical in managing symptoms and improving outcomes.
In this blog, we’ll explore the nature of psychosis, how it relates to bipolar disorder and schizophrenia, early warning signs, and how to support someone experiencing a psychological break.
What is Psychosis?
Psychosis refers to a mental state where a person loses touch with reality. This can involve:
Hallucinations – Seeing, hearing, or feeling things that aren’t there (e.g., hearing voices or seeing shadows).
Delusions – Strong, false beliefs that don’t align with reality (e.g., believing one has supernatural powers or is being watched by the government).
Disorganized Thinking – Thoughts that seem fragmented or illogical, making speech difficult to follow.
Disordered Behavior – Unusual, erratic, or inappropriate actions, including agitation or withdrawal from social interactions.
Psychosis can be triggered by mental illnesses like schizophrenia or bipolar disorder, but it can also result from substance use, extreme stress, trauma, or medical conditions.
Psychosis and Bipolar Disorder
Bipolar disorder is a mood disorder characterized by extreme mood swings, including manic and depressive episodes. Psychotic symptoms can occur during:
Manic Episodes – The person may experience grandiose delusions (e.g., believing they are famous or invincible) and hallucinations. They may also engage in impulsive or risky behaviors.
Depressive Episodes – Delusions may take a more paranoid or nihilistic turn (e.g., believing they are worthless, doomed, or responsible for world catastrophes).
Not all individuals with bipolar disorder experience psychosis, but when they do, it is typically mood-congruent—meaning the delusions or hallucinations align with their emotional state.
Warning Signs of a Manic or Depressive Psychotic Episode
Sudden increase in energy, restlessness, or decreased need for sleep
Grandiose beliefs (thinking they are a celebrity, prophet, or have special abilities)
Rapid, pressured speech that is hard to interrupt
Impulsivity, excessive spending, reckless behavior
Severe paranoia or distrust in others
Expressing thoughts of hopelessness, guilt, or suicidal ideation
Bipolar disorder is usually diagnosed in late adolescence or early adulthood, though symptoms may appear earlier.
Schizophrenia and Its Onset
Schizophrenia is a chronic mental disorder characterized by persistent psychosis. Unlike bipolar disorder, where psychosis is episodic, schizophrenia involves ongoing symptoms that affect perception, thought, and emotional regulation.
When Does Schizophrenia First Appear?
Schizophrenia often emerges in late adolescence to early adulthood, typically between ages 16 and 30. The onset tends to be earlier in men (late teens to early 20s) and slightly later in women (early to mid-20s). It is rare for schizophrenia to develop after the age of 30, though late-onset cases exist.
Early Warning Signs of Schizophrenia
The early phase of schizophrenia, called the prodromal stage, may last weeks, months, or even years before full psychosis occurs. Signs to watch for include:
Withdrawal from family and friends
Decline in academic or work performance
Unusual or nonsensical speech patterns
Suspiciousness, paranoia, or excessive anxiety
Flat affect (reduced facial expressions or emotions)
Difficulty concentrating or following conversations
Strange beliefs or magical thinking
Decline in self-care and personal hygiene
As the illness progresses, hallucinations, delusions, and disorganized thinking become more apparent.
How to Help Someone Experiencing Psychosis
If you suspect someone is going through a psychotic episode, handling the situation with calmness and empathy is crucial. Here are key steps to take:
Stay Calm and Avoid Arguing
Avoid contradicting their delusions or hallucinations, as this may cause distress. Instead, acknowledge their emotions:
“I can see that this is really scary for you. I’m here to help.”
Prioritize Safety
Remove anything dangerous from the environment if the person is agitated.
If they are suicidal or a threat to themselves or others, call emergency services or a crisis line for immediate assistance.
Encourage Professional Help
Offer to help them contact a mental health professional or accompany them to an appointment.
If they refuse help, suggest talking to someone they trust, like a family member, religious leader, or close friend.
Avoid Judgment and Offer Support
People experiencing psychosis may feel ashamed or isolated. Reassure them that they are not alone:
“You’re not broken. You’re going through something difficult, and we can get through it together.”
Seek Emergency Help When Necessary
If the person is a danger to themselves or others, call 911 or a crisis hotline.
In the U.S., the 988 Suicide & Crisis Lifeline provides support for mental health emergencies.
Treatment for Psychotic Disorders
Psychosis is treatable with a combination of:
Medication – Antipsychotics, mood stabilizers, or antidepressants may be prescribed.
Therapy – Cognitive Behavioral Therapy (CBT) can help manage distressing thoughts.
Hospitalization (if necessary) – If the person is at risk, temporary inpatient care may be required.
Early intervention can greatly improve outcomes, reducing the severity and frequency of future episodes.
Final Thoughts
Recognizing the early signs of psychosis in bipolar disorder or schizophrenia is essential in helping individuals receive the care they need. If you or a loved one are experiencing symptoms, seek support from mental health professionals. Remember, psychosis is treatable, and with the right help, individuals can manage their symptoms and lead fulfilling lives.
Resources for Support
988 Suicide & Crisis Lifeline (U.S.): Dial 988
National Alliance on Mental Illness (NAMI): www.nami.org
Schizophrenia & Psychosis Action Alliance: www.sczaction.org
Sources
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
National Institute of Mental Health. (2023). Schizophrenia. Retrieved from www.nimh.nih.gov
Mayo Clinic. (2024). Bipolar Disorder and Psychosis. Retrieved from www.mayoclinic.org
Schizophrenia & Psychosis Action Alliance. (2023). Understanding Psychosis. Retrieved from www.sczaction.org