How Quickly Can Bipolar Moods Change
What is rapid cycling? Some people with bipolar disorder develop rapid cycling where they experience four or more episodes of mania or depression within a 12-month period. Mood swings can occur very quickly, like a rollercoaster randomly moving from high to low and back again over a period of days or even hours.
What Bipolar Disorder Looks Like
If you have bipolar disorder, your mood can have big shifts. You may have periods called mania, when you feel extremely happy and full of energy. But you may also go into a depression phase and start to feel sad and hopeless.
There are two main types of bipolar disorder, which vary in how serious your episodes get and how long they last.
Bipolar I disorder involves periods of full-blown mania. You may have high energy, behave recklessly, and act in an extremely impulsive way.
If you have bipolar II disorder, you’ll get “low-grade” periods of mania. When that happens, you might have “up” moods and high energy, but your symptoms don’t get in the way of your daily life.
With severe bipolar disorder, you may have hallucinations, where you see or hear things that aren’t there. You may also have delusions, where you firmly believe in something that just isn’t true. This is when it’s easy to confuse bipolar disorder for schizophrenia.
Some signs that you’ve got bipolar disorder are:
Mania symptoms. When you’re in an “up” period, you may feel:
- Easily triggered or set off
- Full of energy and great ideas
- Happy and bursting with joy
- Jumpy or wired
- Keep jumping from one activity to the next
- Stop eating or sleeping
- Talk fast and have thoughts that are all over the place
- Think you can do anything, so you do something risky like spend money you don’t have
Depression symptoms. When your mood swings to a depressed phase, you may feel:
What Treatment Should The Nhs Offer Me
The National Institute for Health and Care Excellence recommend that you should be offered antipsychotic medication and talking therapy if you hear voices. If you decide not to take medication you should still be offered talking therapy.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at www.nice.org.uk.
Your GP may refer you to a specialist mental health team such as the early intervention team , community mental health team , or crisis team.
Medication
Antipsychotic medication can help with hearing voices. Medication may not make symptoms go away but it can make voices seem distant or less noticeable. Try not to be too upset if the first antipsychotic that you try doesnt help. There are lots of different antipsychotics to try because people respond to different medications. You might need to try more than one before you find one that helps. The main negative with medication is that it can have bad side effects. A common side effect is weight gain.
Talking therapies
There are different types of talking therapies recommended for people who hear voices.
Cognitive behavioural therapy
CBT can help you to manage your voices and to notice any patterns. This can help you learn what is your trigger for the voices. And how to cope with them. For example, for some people stress can trigger voices. CBT can help you find ways to deal with your stress.
What is CBT?
CBT is a talking treatment.
CBT aims to:
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When You Have Other Symptoms Of Psychosis
Your symptoms could meet criteria for bipolar disorder with psychotic features, but they could better fit a diagnosis of schizoaffective disorder.
This mental health condition involves mixed symptoms of bipolar disorder and schizophrenia. But with schizoaffective disorder, youll also experience psychosis when you arent having a mood episode.
To diagnose this condition, a mental health professional will help you track when psychosis appears and note whether its present during just your mood episodes, or at other times, too.
Typically, bipolar disorder requires professional treatment, though treatment may require different approaches:
- during mood episodes
- during a manic episode versus a depressive episode
- once mood symptoms start to improve
- when you arent experiencing any symptoms
During a mood episode, treatment generally focuses on improving severe symptoms with medications, including:
After a mood episode, treatment generally aims to reduce future mood episodes and help you maintain a euthymic mood state.
To achieve this goal, you might work with your treatment team to:
- find medication dosages that work well, with few side effects
- learn helpful ways to manage stress
- address hallucinations, and any other concerning symptoms, in therapy
- explore lifestyle changes and self-care habits to improve sleep, physical health, and emotional well-being
- discuss complementary treatments, like light therapy, acupuncture, or mindfulness practices like meditation and yoga
What If I Am Not Happy With My Care Or Treatment
If you are not happy with your treatment you can:
- talk to your doctor about your treatment options,
- ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service and see whether they can help, or
- make a complaint.
There is more information about these options below.
Treatment options
You should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.
Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.
Second opinion
A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.
You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.
Advocacy
An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.
The Patient Advice and Liaison Service
You can find your local PALS details through this website link:
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Heres The Good Newsyes There Is Good News
Bipolar disorder is an episodic illness. We have all of our symptoms while in a mood swing. This means we are STABLE when we are not in a mood swing. The symptoms I list above usually go away when the illness is successfully managed. It can take regular monitoring for those of us who have daily symptoms. Others who have long breaks between mood swings may even forget the symptoms even existed. This is why we must have a management plan that can recognize the dangerous, aggressive, and violent behavior psychosis and cognitive impairment as soon as they begin.
I know we want to protect our reputation around this illness. We dont want to be seen as different or freaks. But I ask that within our community, we get brutally honest about what really happens to those of us with the illness. Its the ONLY way to stop the symptoms and make them stay away forever!
Originally posted January 29, 2015.
Bipolar People Can Experience Auditory Hallucinations Too
Most people associate hearing voices or auditory hallucinations with schizophrenia. But almost no one speaks of this issue when it comes to bipolar disorder, despite the fact that 20-50 percent of us who live with bipolar experience them, according to Psychiatric Times.
Hearing things that arent there is scary. Like very scary.
While I dont hear voices per se, I do hear noise. Sometimes if I am at a party in an enclosed space with lots of loud talking, when I leave the space, I hear a jumble of sounds that echoes throughout my brain and wont stop. Its as if I am hearing a murmur of dialogue lingering all at once after the party. Many voices in dissonance.
When this happens, I immediately need to jump in a taxi or rideshare and head home. I remember one instance in which my auditory hallucinations caused a panic attack. In the cab, I would lay down, then get up, lay down and get up. I couldnt stop moving.
Im a recovering alcoholic and If I have a craving in a public place where alcohol is present, I also leave instantly.
These situations are worse than my most terrible anxiety symptom: perpetual sweaty palms.
I started noticing this happening several years ago at a party my ex-partner and I threw at our spacious apartment in DUMBO, Brooklyn during my first and major manic episode. I was stuck. Nowhere to hide. Everyones coats were on the bed, so I couldnt even retreat to my bedroom. There was nowhere to go.
Getty image by LUMEZIA
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How Does Bipolar Disorder Cause Psychosis
Bipolar psychosis happens when a person experiences an episode of severe mania or depression, along with psychotic symptoms and hallucinations. The symptoms tend to match a persons mood. During a manic phase, they may believe they have special powers. This type of psychosis can lead to reckless or dangerous behavior.
Information For Family Carers Friends
If you are a carer, friend or relative of someone who hears voices, you can get support.
How can I get support?
You can do the following.
- Speak to your GP about medication and talking therapies for yourself.
- Speak to your relatives care team about family intervention. For more information about family intervention look at the previous section ‘What treatment should the NHS offer me?’.
- Speak to your relatives care team about a carers assessment.
- Ask for a carers assessment.
- Join a carers service. They are free and available in most areas.
- Join a carers support group for emotional and practical support. Or set up your own.
What is a carers assessment?
NICE guidelines state that you should be given your own assessment through the community mental health team to work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.
The CMHT should tell you about your right to have a carers assessment through your local authority. To get a carers assessment you need to contact your local authority.
How do I get support from my peers?
You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. Or you can contact the Rethink Mental Illness Advice Service and we will search for you.
How can I support the person I care for?
You can do the following.
What is a care plan?
Can I be involved in care planning?
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How Your Memory Deals With Hearing Sounds And Voices
Your memory is like an amazing supercomputer. Only a part of a word, a single sound or a quick glance at an object is enough to tell us what something is. We can hear the difference between a car engine and a motorcycle. When seeing a single flower petal, we understand it belongs to a flower and are able to visualise the complete image. We can even come up with an image that belongs to a sound or a smell. So you do not have to see something to imagine it. With a single piece of the puzzle, your memory uses your imagination to complete the whole image, so to speak.
Sometimes you are convinced you have seen or heard something. But what really happened, is that your imagination replaced your perception with the complete image from your memory. Your expectations play an important role in this: you are not going to expect a bike when you hear a big car.
This process of completing perceptions by memory plays an important role in hearing voices. Actually, your memory is complementing the perception to soon. This often puts you on high alert and makes you respond to sounds or events quickly. People who hear voices can misinterpret a stimulus and see or hear something other than what is really there. This is called hallucinating or auditory hallucinations.
What Causes Psychosis
Psychosis isn’t a condition in itself it’s triggered by other conditions.
It’s sometimes possible to identify the cause of psychosis as a specific mental health condition, such as:
- schizophrenia a condition that causes a range of psychological symptoms, including hallucinations and delusions
- bipolar disorder a mental health condition that affects mood a person with bipolar disorder can have episodes of depression and mania
- severe depression some people with depression also have symptoms of psychosis when they’re very depressed
Psychosis can also be triggered by traumatic experiences, stress, or physical conditions, such as Parkinson’s disease, a brain tumour, or as a result of drug misuse or alcohol misuse.
How often a psychotic episode occurs and how long it lasts can depend on the underlying cause.
For example, schizophrenia can be long term, but most people can make a good recovery and about a quarter only have a single psychotic episode. Episodes related to bipolar disorder usually resolve, but may recur.
Read more about the causes of psychosis.
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The Voices In My Head
When it comes to schizophrenia, one of the most common questions is where do these inner voices come from? It turns out that people with schizophrenia are actually hearing their own voices in their heads. This is due to a phenomenon called subvocal speech, which most of us experience in a slightly different way.
Have you ever thought so intently about something that you subconsciously said it out loud? Most likely the answer is yes, even if you dont realize it. For example, you might mutter take out the garbage after a partner reminds you for the 100th time. This phenomenon is subvocal speech and, for most of us, its a common part of everyday life.
Our brains process all language, even the private thoughts we have in our own heads. These thoughts then transform into subvocal speech when this cognitive function stimulates our speech muscles, even though that stimulation is usually not strong enough to generate a voice that anyone could actually hear. You might just mumble under your breath, or make no sound at all.
Psychosis Is Not The Same As Psychopath
The terms “psychosis” and “psychopath” should not be confused.
Someone with psychosis has a short-term condition that, if treated, can often lead to a full recovery.
A psychopath is someone with an antisocial personality disorder, which means they:
- lack empathy the capacity to understand how someone else feels
- are manipulative
- often have a total disregard for the consequences of their actions
People with an antisocial personality can sometimes pose a threat to others because they can be violent. Most people with psychosis are more likely to harm themselves than others.
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Medication To Quiet Down The Voices
In the past, it was believed that people hearing voices had a mental illness. So the traditional treatment was to give them medications. Currently, treatment has become more and more focused on the personal life history of the voice hearer. Hearing voices in your head is often an effect of emotional events and traumatic experiences that one has not dealt with. The voices may have the identity of someone connected to the traumatic memory.
Antipsychotics may help in getting the voices to calm down, but they do nothing about the cause of the voices. Why are the voices there? What is the problem that causes the voices? With antipsychotics, the person is not learning to deal with the problems. However, treatment with medication can still help to temporarily get to calmer waters, where you can start to learn to deal with the voices.
Understanding The Message Of The Voices
Therapy can learn you that what the voices are saying, should often not be taken literally. Like an interpreter, you learn to translate the messages to your personal situation. For the voice hearer this is often a difficult and emotional process, because they have to face what their problems are really about.
Watch the animation How to handle the voices
Hearing voices is different for everybody. Some people only hear voices at one time in their life and only for a while. While others hear several different voices that never quiet down. Some have voices that talk to one another, other voices can be helpful, or aggressive. Someone who is hearing voices is not necessarily psychotic and not everyone who is psychotic is hearing voices. But generally, people who are prone to psychosis do hear voices more often than people without psychotic vulnerability.
There is a worldwide network of voice hearers and care workers the hearing voices movement.
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I Hear Voices This Is What Id Like You To Know
Late last year, I was diagnosed with bipolar disorder type one with psychotic features. For multiple reasons, this diagnosis was life-changing. Before I received help from the home treatment team, and I saw a psychiatrist who diagnosed me with bipolar and recommended I take some type of antipsychotic and mood stabilizer, my life was a mess. to put it bluntly, Im very lucky to be alive.
Before my life-changing diagnosis, I was extremely paranoid to the point I wouldnt leave my flat or answer the door because I had delusional thoughts that people were out to cause me significant harm, including my friends and loved ones. I now know this isnt true, but delusions of persecution have a vice-like grip that seems so hard to escape. At the time, not only do they feel real but with psychosis, they are part of our altered sense of reality, which means to us they are real. An analogy I like to use for those with a psychotic disorder is how it feels like youre wearing a t-shirt that you know for a fact is blue, but everyone around you is telling you are wrong and that your t-shirt is, in fact, bright yellow. It is confusing and terrifying, to say the least, feeling like you are in a different reality to other people when, with all the evidence our brains perceive to be as true and factual, we arent the ones in the wrong.
1. What is psychosis?
3. What hearing voices is like.
4. Hearing voices is more common than you think.
5. Recovery is possible.