I just received the following comment from Laura regarding my article on psychosis for healthyplace.com.  She raises an imporant point- how do you know the difference between the diagnosis of bipolar disorder and schizo-affective disorder?

Hi Julie,

Your article was very helpful for me. It not only educated me but gave me hope which I desperately need right now. My 19 year old son is currently hospitalized after a suicide attempt. They have diagnosed with as BP type 1 but possibly schizoidaffective.
After reading about the psychosis differences between the two, I am hopeful – he seems to display the BP type of psychosis instead of schizphrenic type.

Hi Laura,

I am so glad the blog helped.  Schizoaffective disorder is actually easy to understand in terms of a diagnosis-  If the psychosis comes with an obvious mood swing- such a psychotic mania- ie, a person could be euphoric with high energy, zero desire to sleep with no tiredness the next day and the belief they are the reincarnation of a famous figure, that is bipolar disorder.  If the person has mood swings without psychosis such as a suicidal depression, that is bipolar disorder as well. If a person has psychosis with NO mood swing at the time- in other words they hear voices and feel the police have bugged the house- that would be a diagnosis of schizoaffective disorder.

Bipolar disorder psychosis can mimic schizophrenia psychosis, as it did with my partner Ivan who was in a three month manic/psychotic episode, but for others, it does fit the pattern I talk about in my psychosis article.

I hope your son is doing better. Please remind him that suicide and suicidal attempts are a normal part of bipolar disorder. He can learn to manage the illness so this doesn’t happen again.  He went into the hospital- so he is a strong guy who can get better. It just takes a plan. Julie

It’s often hard for people with bipolar disorder to know what is reasonable and what is unacceptable. If you’re born with a certain kind of brain- it makes you say and do things that are normal to you. For example, people with bipolar disorder get stressed a lot more easily than the general population. They get more angry- cry more- try to kill themselves more- and definitely get higher than anyone without the illness when it comes to mania.

But that is natural behavior for us! It’s not ok and it’s certainly not a very productive way to live- but it’s what our brains do. So it makes sense that we will all have to learn what is reasonable and acceptable.
How can you stop behavior that is unacceptable and non productive?  I have found an answer that took me a long time to master, but I’ve kept at it for 10 years and it’s working.

Here is the answer: I regularly examine how my behavior is affecting all of the people in my life. Do they want to be around me? Do I have friends who actually think I’m a cool person? Do people avoid me? Am I able to listen to someone without talking about my troubles all of the time? And most importantly, so people keep telling me that what I do is not ok and that they want me to stop?

Bipolar disorder is sneaky- you would think that the above would be rather easy- you simply have to look and listen to the people in your life and change your behavior, right?  Wrong- our brains are fighting reasonable self reflection.  Bipolar depression and bipolar mania lie to us and make it difficult to answer the above questions.  But it can be done! How would you answer the questions today? And if you love someone with bipolar disorder, how would they answer the questions?

Julie

I guess it’s ok to say the fo  llowing is an amazing article- even though I wrote it! I am so proud and pleased with how this turned out. It’s the first explanation that I know of regarding the differences between the psychosis found in psychotic disorders such as schizophrenia and the psychosis found in mood disorders that have mania and depression mood swings.  You will learn that the differences are quite large- but often confused. Please let me know what you think.  Here is a link to the article on the website www.healthyplace.com

 Click here to read the article:                 Julie Fast psychosis article on HealthyPlace.com

I feel this is especially helpful for family members, partners and friends of those with bipolar disorder.  Bipolar disorder psychosis is  SO confusing as it’s always present with either depression or mania.

Please let me know what you think of the article.  I have a new one coming soon from www.healthyplace.com and will keep you posted.

Please note that healthyplace.com shows the article section by section and you will need to click over to the next section!

Julie

PS: I wrote this when I was quite depressed- so it’s a testament that we can work to the best of our ability when we are ill. I missed a deadline for the first time in my career- but that is how it goes- what matters is that I finished. The depression went away eventually as it always does.

I have always liked the words greatness, champion and hard worker.  I apply those to bipolar disorder management.  I like to see myself as a champion. I certainly hope for greatness. To me these words mean that I simply keep going no matter what bipolar disorder throws at me. Sometimes I limp- fall down, hurt myself and dont’ want to go forward.  I know that is what bipolar disorder wants. I remember coming out of some manic episodes in the past and feeling that I would never recover from what I did while I was manic. But I recovered. I remember being so suicidal that I could hardly move because of fear I would do something I regretted. When I realized that I could make it through anything, that’s when I started to write my books. You may not know this, but I wrote all of my books while depressed. I am sure you can understand that I wasn’t exactly sitting down to write when the hypomania decided to show up.

How are things for you today? Maybe you just got out of the hospital, did something stupid while you were manic, said something awful to someone you love, thought of killing yourself or spent money you didn’t have.

I’ve been there! I’ve done that!  My idea of a champion is someone who makes it through bipolar situations and then finds a way to keep going so that they can create a plan for the future- a much better future.

Julie

As may of you know if you’re a regular to this blog- I had a very bad reaction when I changed from brand name Lamictal to to generic Lamictal (lamtrigine.) Others made the switch just fine. If you have switched over from your brand Lamictal to generic Lamtrigine and have noticed a difference in the efficacy of the drug, there are many blog entries under the Lamictal tab to the right that explain generic bipolar drugs in great detail. You can also ready my story- it was quite a saga! But it has all worked out.  My mother who takes Lamictal had no problems and has stayed on the lamotrigine. I went back to brand Lamictal and am very happy with the results. No matter what you take, knowledge of generic bipolar disorder drugs is essential!

Julie

 This is not generic Lamictal…. yes, I am trying to make you laugh!

Oh boy can this illness make a person sick.  That is just a fact. I guess you can change that sentence around-  We all get sick and tired of having this illness. One thing I want to do on this blog is to encourage people to keep going and going even when the days are really tough. One good thing about bipolar disorder is that it’s episodic- that means mood swings end. You can get better. Sometimes it takes way longer than expected- but life can be stable.

I tend to talk a lot about depression as that is what I experience the most- some of my friends talk more about the agitated mania or the psychosis they live with, sometimes for a long stretch of time. Sometimes you can have all three at once- dysphoric mania.

Today is a good day because I can get work done- today is a good day becuase I have a NAMI (National Alliance on Mental Illness) event tonight.

It’s important to focus on the good stuff during the day when you’re having a hard time- even if it’s only a small thing.

Julie

Bipolar disorder doesn’t like change. It likes structure and set schedules.

I’m not trying to anthropomorphize bipolar disorder. When I say ‘it’ I do know it’s an illness, but it can sure seem like a human adversary. It’s tricky, sneaky and nasty. Those are not exactly good qualities! But just like with any human adversary, it is possible to minimize the damage.

When an event sends you spiraling down into depression,  it’s easy to think that everything in your life is spiraling down. That is what bipolar disorder does. It distorts your thinking so that one event becomes about your whole life. So when you have a problem – with a relationship for example, bipolar disorder symptoms will whisper that this means you have trouble with all of your relationships and that you will never have good relationships again.

It doesn’t matter that this is impossible. It feels very real and the spiraling downward continues. Here is what you can do:

1. Say to yourself over and over again- ‘My life is made up of many, many experiences. This one experience is important, but it doesn’t mean my entire life is about this experience.’

2. Remind yourself that even the worst pain in the world can eventually end. Bipolar disorder will lie and tell you it won’t, but it does.

3. And finally, there is a person in you that has zero to do with this illness. The illness is like a blanket- it affects the real you, but it’s not you. Remember that when it feels that the blanket has covered up all of your life.

The way to end a downward spiral is to do anything and every thing to go into an upward spiral. The three suggestions above are a good start.

Julie

PS: Can you tell that I need my own advice today!  It’s always important that I only listen to the real person- myself!