Is Delusional Bipolar Depression More Common Than We Think?
Delusions are false beliefs that are held in spite of a lack of evidence or even evidence to the contrary. For example, a delusion might be believing that the FBI is surveilling you every day or that you can predict the future. Delusions are a part of psychosis which can be present in bipolar depression or bipolar mania.
Delusions are easiest to spot when they’re exaggerated, like in the above examples, but I would suggest that delusions are much more common when we give them credit for. I would suggest that delusions are present in most cases of severe bipolar depression.
I’m the Worst Person in the World
People with bipolar depression often believe things that are decidedly untrue. Examples of this are:
- I’m the worst person in the world.
- The world would be better off without me.
- I’m the ugliest person on the planet.
- Everyone hates me.
These things are clearly untrue but can be staunchly held beliefs anyway. I don’t think these statements would get you diagnosed with psychotic delusions, but I would argue they certainly are. Even when a person can state they know they aren’t true, they will frequently also admit to believing in them anyway. That’s a delusion plain and simple. It doesn’t involve the FBI, but it’s a false belief nonetheless.
Dealing with Psychotic Delusions
In bipolar disorder we fight our brains on what we know to be real in many ways. We fight the hypomania when we know it’s not a good idea to paint our living room purple at 2 o’clock in the morning and we fight the depression when we don’t kill ourselves. Fighting delusions is, in some respects, the same. We have to fight the poor signals coming from our brain with what we know is real. And once we can grasp that our beliefs truly are delusional, this can be easier to do.
Treating Bipolar Depression Delusions
As the name implies, antipsychotics were developed to treat psychosis, traditionally in schizophrenia, but many antipsychotics are now prescribed for bipolar disorder whether recognized psychosis exists or not and they work quite well. And maybe the reason they work in the cases of severe bipolar depression is because what we’re really experiencing is delusions, is psychosis, but is not recognized as such. Maybe the reason why they work is because that end of bipolar disorder is closer to schizophrenia than we think.
(And, by the way, research on the brain supports the link between bipolar disorder and schizophrenia. It’s pretty common to see similar brain deficits between the two disorders only, in the case of schizophrenia, it tends to be more pronounced.)
I could be wrong about this, but I don’t think I am. I think what we’ll find as brain research matures is that the underlying problems in severe depression where these kinds of false beliefs are held are similar to the problems in the brains of people with schizophrenia.
So maybe it’s time for some of us to recognize that what we’re experiencing is delusions and not just garden variety depression. It might help to put things in a new perspective and make those beliefs easier to handle.
Tracy, N. (2013, July 16). Is Delusional Bipolar Depression More Common Than We Think?, HealthyPlace. Retrieved on 2019, July 19 from https://www.healthyplace.com/blogs/breakingbipolar/2013/07/delusional-bipolar-depression-more-common
Author: Natasha Tracy
I'm sorry to hear you and your husband are going through that. Many service people have mental health challenges when they return to civilian life.
I _highly_ recommend you get this book: http://mybacktothewall.com/
It _really_ speaks to warriors about the things they are going through - exactly like you are describing and it deals with the challenges in getting help.
(In case you're wondering, I had a hand in editing the book, but I make no money from it, I just think it's a great resource.)
I hope that helps.
This makes a lot of sense to me because my delusions, as you suggest them, stopped as soon as I started taking an anti-psychotic (in addition to my other medications). It was like one minute they were there, and the next minute there was silence inside my head.
I recognize that I got really lucky with my medications. I'm so very thankful!
No, it's not as obvious as imagining the FBI is surveilling but it is definitely delusional thinking.
Another delusion: the belief that strangers are thinking or saying bad things about them when they're depressed -- so they stay away from others and public places, isolating themselves at home.
People often hide these thoughts or beliefs from doctors and other people because they kind of know they're delusional even though they believe them -- so they're too embarrassed to mention them.